Detection of crestal radiolucencies around dental implants: an in vitro experimental study.
OBJECTIVE
The aim of this study was to compare the diagnostic potentials and practical advantages of different imaging modalities in detecting bone defects around dental implants.


METHODS
Crestal bone defects with sequentially larger diameters were randomly prepared around 100 implants that were inserted in bovine bone blocks. Conventional periapical radiography (PR), direct digital radiography (DDR), panoramic radiography (PANO), cone-beam computed tomography (CBCT), and multislice computed tomography (MSCT) were performed for all specimens. The diagnostic accuracies of the devices, confidence of the answers, subjective image quality, defect visibility in planar orientations, and duration of diagnosis were analyzed based on the interpretations of 7 calibrated observers.


RESULTS
The agreement levels of intra- and interobserver scores were rated good. PR, DDR, and CBCT were mostly more accurate than PANO and MSCT (P < .05). Confidence levels were positively correlated with the defect size (ρ = 0.20, P < .01), and that of DDR was the highest (P < .05). The subjective image quality of PR and DDR was higher than that of CBCT, PANO, and MSCT (P < .05 for all comparisons). Axial-coronal-sagittal visibilities of the defects were higher for CBCT compared with MSCT (P < .05). The diagnostic time was shorter for DDR (P < .05) and longer for the tomographic systems (P < .05) than for the other devices.


CONCLUSIONS
DDR may provide a faster and more confident diagnostic option that is as accurate as PR in detecting peri-implant radiolucencies. CBCT has a comparable potential to these intraoral systems but with slower decision making and lower image quality, whereas PANO and MSCT become more reliable when bone defects have a diameter that is at least 1.5 mm larger than that of the implant.
Faculty of Dentistry, Department of Oral Surgery, Istanbul University, Istanbul, Turkey. ysirin@istanbul.edu.tr
Yigit
Y
Sirin
Sinan
S
Horasan
Duygu
D
Yaman
Cansu
C
Basegmez
Cem
C
Tanyel
Ali
A
Aral
Koray
K
Guven
D000818:Animals; D001847:Bone Diseases / Q000000981:diagnostic imaging*; D002417:Cattle; D054893:Cone-Beam Computed Tomography / Q000592:standards; D003657:Decision Making; D015921:Dental Implants; D017267:Dental Prosthesis Design; D061330:Multidetector Computed Tomography / Q000592:standards; D015588:Observer Variation; D019047:Phantoms, Imaging; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000592:standards; D016300:Radiography, Bitewing / Q000592:standards; D019252:Radiography, Dental, Digital / Q000592:standards; D011862:Radiography, Panoramic / Q000592:standards; D011897:Random Allocation; D013997:Time Factors
D015921:Dental Implants