Accuracy of cone beam computed tomography in following simulated autogenous graft resorption in maxillary sinus augmentation procedure: anex vivostudy

Abstract

Objectives: Maxillary sinus augmentation is a well-documented procedure with long-term success in implant dentistry. Assessing graft volume changes over time is crucial, since resorption remains a major concern. CBCT is commonly employed to assess the quantity and quality of the available bone at the implant receptor site. However, its applicability in following graft volume changes is yet to be determined. The study aimed to assess CBCT accuracy in following simulated graft resorption ex vivo. Methods: 4 differently sized autogenous bone blocks harvested from the zygomatic buttress were bilaterally placed in the maxillary sinus of 12 human cadavers. The Accuitomo (J Morita, Kyoto, Japan) CBCT system was employed to scan each one of the 4 grafts in each of the 12 cadavers using identical settings. Gold standard graft measurements were obtained using micro-CT. One independent observer assessed the volume of each graft on CBCT images twice. Intraobserver reliability was assessed using Cohen's kappa and one-sample t-test was used to compare CBCT with micro-CT volumetric measurements. Results: The mean micro-CT graft volumes were 97.12 ± 1.4, 197.32 ± 3.4, 361.41 ± 4.2 and 1040.11 ± 3.2 mm 3 for Grafts 1-4, respectively, and the mean CBCT volumes of the corresponding grafts were 115. 39 ± 7.01, 205.97 ± 9.91, 404.05 ± 16.81 and 1138.04 ± 20.98 mm 3 . CBCT measurements were statistically significantly different from micro-CT measurements (p 5 0.001). Intraobserver reliability was good (r 5 0.78). Conclusions: In every case, CBCT overestimated the maxillary graft volume in comparison with micro-CT. However, the measurement differences were limited and might not influence clinical performance.

Volumetric changes of grafted volumes and the Schneiderian membrane after transcrestal and lateral sinus floor elevation procedures: A clinical, pilot study

“…Various volumetric graft reduction rates have been reported in different studies, even when the same biomaterial was used (Cosso et al., ; Gultekin, Borahan, Sirali, Karabuda, & Mijiritsky, ; Kim, Moon, Kim, Park, & Oh, ; Kirmeier et al., ; Mazzocco et al., ; Sbordone et al., ; Umanjec‐Korac et al., ). The present study can agree on this, as the same composition of biomaterials was used for every treatment option.…”

“…Recently, three-dimensional (3D), cone-beam computed tomography (CBCT) analysis has been described as a fast, simple, relatively accurate and promising approach to quantify long-term changes in the grafted area (Ohe et al, 2016;Umanjec-Korac, Parsa, Darvishan Nikoozad, Wismeijer, & Hassan, 2016).…”

Long‐term outcomes of osteotome sinus floor elevation without grafting in severely atrophic maxilla: A 10‐year prospective study

“…This might help to preserve the "tent" shape of the elevated membrane, contributing to endo-sinus bone formation in their study. A previous study has evaluated the graft volume change following sinus augmentation with CBCT (Umanjec-Korac et al, 2016). It was reported that the measurement differences were limited and would not influence clinical performance.…”

Ten Years of Micro-CT in Dentistry and Maxillofacial Surgery: A Literature Overview

“…The cone beam volume CT or CBCT is another kind of tomography system, X-ray based, commonly employed to assess the quality and quantity of bone. Despite that, micro-CT is combined with it due to the higher accuracy for small dimensions, for example, to obtain gold standard measurements of graft volumes in maxillary sinus augmentation procedure [124] or to determine how microarchitecture influences the morphology [125]. In recent years, the power of the available commercial systems is continuously growing in terms of range of dimensions and resolutions.…”