Non‐invasive assessment of peri‐implant mucosal thickness: A cross‐sectional study

Abstract

BackgroundThis study aimed to evaluate the reliability and reproducibility of different non‐invasive methods for the assessment of peri‐implant mucosal thickness.MethodsSubjects with two adjacent dental implants in the central maxillary region were included in this study. Three different methods to assess facial mucosal thickness (FMT) were compared: digital file superimposition using Digital Imaging and Communication in Medicine (DICOM) and stereolithography (STL) files of the arch of interest (DICOM‐STL), DICOM files alone, and non‐ionizing ultrasound (US). Inter‐rater reliability agreements between different assessment methods were analyzed using inter‐class correlation coefficients (ICCs).ResultsA total of 50 subjects with 100 bone‐level implants constituted the study population. Assessment of FMT using STL and DICOM files demonstrated excellent inter‐rater reliability agreement. Mean ICC values of 0.97 and 0.95 were observed in the DICOM‐STL and DICOM groups, respectively. Comparison between the DICOM‐STL and US revealed good agreement, with an ICC of 0.82 (95% CI: 0.74 to 0.88) and a mean difference of –0.13 ± 0.50 mm (–1.13 to 0.86). Comparison between DICOM files alone versus US showed good agreement, with an ICC of 0.81 (95% CI: 0.73 to 0.89) and a mean difference of –0.23 ± 0.46 mm (–1.12 to 0.67). Comparison between DICOM‐STL and DICOM files revealed excellent agreement, with an ICC of 0.94 (95% CI: 0.91 to 0.96) and a mean difference of 0.1 ± 0.29 mm (LOA –0.47 to 0.46).ConclusionsQuantification of peri‐implant mucosal thickness via analysis of DICOM‐STL files, DICOM files, or US assessment are comparably reliable and reproducible methods.

The use of digital technologies in peri‐implant soft tissue augmentation – A narrative review on planning, measurements, monitoring and aesthetics

“…Recent evidence strongly supports the non-invasive, highly reliable and reproducible nature of using CBCT with STL files or CBCT alone for assessing periodontal and peri-implant phenotypes. A recent study evaluated the reliability and reproducibility of CBCT with or without STL for the assessment of peri-implant mucosal thickness in the anterior maxilla (Couso-Queiruga et al, 2023). The authors found that superimposed DICOM-STL files and DICOM files alone were reliable and reproducible methods for assessing peri-implant mucosal thickness in patients with adjacent implants in the anterior maxilla (Couso-Queiruga et al, 2023).…”

“…A recent study evaluated the reliability and reproducibility of CBCT with or without STL for the assessment of peri-implant mucosal thickness in the anterior maxilla (Couso-Queiruga et al, 2023). The authors found that superimposed DICOM-STL files and DICOM files alone were reliable and reproducible methods for assessing peri-implant mucosal thickness in patients with adjacent implants in the anterior maxilla (Couso-Queiruga et al, 2023). Moreover, the reliability tended to increase when DICOM-STL files were superimposed (compared to DICOM files alone).…”

“…Despite these promising findings, it is important to acknowledge that the presence of dental implants and restorative components made of metal and high-strength ceramics can introduce image artefacts. These artefacts may adversely affect the accuracy of mucosal thickness assessment when using Digital Imaging and Communication in Medicine (DICOM) files (Couso-Queiruga et al, 2023). Moreover, an inherent drawback of these methods is the exposure to ionizing radiation, which poses a limitation on their routine use in daily clinical practice (Couso-Queiruga et al, 2023).…”

“…These artefacts may adversely affect the accuracy of mucosal thickness assessment when using Digital Imaging and Communication in Medicine (DICOM) files (Couso-Queiruga et al, 2023). Moreover, an inherent drawback of these methods is the exposure to ionizing radiation, which poses a limitation on their routine use in daily clinical practice (Couso-Queiruga et al, 2023).…”