title: A comparison of cone beam computed tomography and conventional periapical radiography at detecting peri-implant bone defects.
abstract: OBJECTIVE
  To compare the diagnostic accuracy of conventional periapical radiography and cone beam computed tomography (CBCT) at detecting peri-implant bone defects.
  
  
  METHODS
  Implants were placed in fresh bovine ribs in osteotomy sites of varying diameter (five with no peri-implant space, five with a 0.35 mm space, five with a 0.675 mm space) and imaged using (i) digital long cone periapical radiographs (LCPAs), (ii) limited volume CBCT using 3D Accuitomo 80(®) and (iii) large volume CBCT using i-CAT Next Generation(®). Images from each were randomly presented to nine examiners on two occasions. Confidence in diagnosing the presence or absence of a peri-implant radiolucency was recorded on a five-point scale. Receiver Operating Characteristic (ROC) analysis and Kappa tests were performed.
  
  
  RESULTS
  Digital LCPAs were better at diagnosing a peri-implant bone defect when the peri-implant space was 0.35 mm (P < 0.02). As the peri-implant space increased to 0.675 mm, there was no significant difference in diagnostic accuracy between the three imaging methods. Sensitivity of LCPAs (100) and Accuitomo (97.8) was better than i-CAT (64.4) (P < 0.02). LCPAs and i-CAT had significantly better specificity and positive predictive value than Accuitomo. The negative predictive value of LCPA was significantly better than i-CAT. LCPAs showed better intra-examiner and inter-examiner agreement than CBCT.
  
  
  CONCLUSIONS
  Within the limitations of this study, LCPAs are a reliable and valid method of detecting circumferential peri-implant bone defects and performed significantly better than CBCT.
authors.affiliation: Department of Restorative Dentistry, King's College London Dental Institute, Tower Wing, Guy's Hospital Campus, London, SE1 9RT, UK.
authors.forename: Meetal
authors.initials: M
authors.lastname: Dave
authors.forename: Jonathan
authors.initials: J
authors.lastname: Davies
authors.forename: Ron
authors.initials: R
authors.lastname: Wilson
authors.forename: Richard
authors.initials: R
authors.lastname: Palmer
mesh_terms: D000818:Animals; D002417:Cattle; D054893:Cone-Beam Computed Tomography; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D066298:In Vitro Techniques; D010027:Osteotomy; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D019252:Radiography, Dental, Digital; D012272:Ribs / Q000000981:diagnostic imaging* / Q000601:surgery
chemical_list: D015921:Dental Implants