Peri-implant assessment via cone beam computed tomography and digital periapical radiography: an ex vivo study

Abstract

OBJECTIVES:This research evaluated detail registration in peri-implant bone using two different cone beam computer tomography systems and a digital periapical radiograph.METHODS:Three different image acquisition protocols were established for each cone beam computer tomography apparatus, and three clinical situations were simulated in an ex vivo fresh pig mandible: buccal bone defect, peri-implant bone defect, and bone contact. Data were subjected to two analyses: quantitative and qualitative. The quantitative analyses involved a comparison of real specimen measures using a digital caliper in three regions of the preserved buccal bone – A, B and E (control group) – to cone beam computer tomography images obtained with different protocols (kp1, kp2, kp3, ip1, ip2, and ip3). In the qualitative analyses, the ability to register peri-implant details via tomography and digital periapical radiography was verified, as indicated by twelve evaluators. Data were analyzed with ANOVA and Tukey’s test (α=0.05).RESULTS:The quantitative assessment showed means statistically equal to those of the control group under the following conditions: buccal bone defect B and E with kp1 and ip1, peri-implant bone defect E with kp2 and kp3, and bone contact A with kp1, kp2, kp3, and ip2. Qualitatively, only bone contacts were significantly different among the assessments, and the p3 results differed from the p1 and p2 results. The other results were statistically equivalent.CONCLUSIONS:The registration of peri-implant details was influenced by the image acquisition protocol, although metal artifacts were produced in all situations. The evaluators preferred the Kodak 9000 3D cone beam computer tomography in most cases. The evaluators identified buccal bone defects better with cone beam computer tomography and identified peri-implant bone defects better with digital periapical radiography.

Effect of Metal Artifacts Reduction Protocols and Electric Potential Difference (kVp) on Metal Artifacts in Cone Beam Computed Tomography ( A Diagnostic Accuracy study )

“…Although lower kVp values were used by Silveira-Neto et al (2017) (27) , but this was not very supported in the previously reported studies, as this might affect the overall image quality (19,20) On the other hand, using 70, 80 & 90 kVp values in our study was due to the following: firstly, the highest kVp found in the ProMax 3D machine was 90 kVp, secondly, increasing the kVp values was found to increase the radiation dose to the patient, without significantly reducing the artifact production, knowing that an overall reduction in radiation dose is nearly 62% when decreasing the peak kilovoltage from 120 kVp to 100 kVp (20) .…”

“…Cone beam computed tomography (CBCT) is considered to be the main diagnostic tool with high potential for diagnosis and treatment planning in the maxillofacial area (27) .…”

Detection of peri-implant bone defects using cone-beam computed tomography and digital periapical radiography with parallel and oblique projection

“…Improper biomechanical features and plaque-induced inflammation are the 2 main etiological factors in the formation of peri-implant bone defects, which can eventually lead to progressive peri-implant bone loss and loss of the implant itself if undetected. [14][15][16] Therefore, early diagnosis of bone defects is of great importance for preservation of the implants and their surrounding bone structure, rendering radiographic assessments necessary. The position, configuration, and size of a defect greatly influence its visibility on radiographs.…”

“…The position, configuration, and size of a defect greatly influence its visibility on radiographs. 17,18 Silveiro-Ne-to et al 16 reported that peri-implant defects on the buccal aspect of dental implants were not identifiable on PPA radiographs, while proximal defects were readily diagnosed. Dave et al 3 assessed the radiographic visibility of peri-im- Parallel periapical radiography 4 (40) 6 (60) 3 (30) 7 (70) P<0.05 Oblique periapical radiography 10 (10) 0 (0) 10 (10) 0 (0) Cone-beam computed tomography 10 (10) 0 (0) 10 (10) 0 (0)…”

Cone Beam Computed Tomography Imaging in Dental Implants: A Primer for Clinical Radiologists

“…7). 4,21,22 One important issue that limits CBCT imaging for the diagnosis of peri-implant bone defects is the problem of artifacts, such as blooming of the implant with enlargements easily reaching 12 to 15% of the implant diameter. 23 In areas where the thin vestibular bone plate needs to be observed, blooming artifacts may bias diagnosis.…”