title: Planning of dental implant size with digital panoramic radiographs, CBCT-generated panoramic images, and CBCT cross-sectional images.
abstract: OBJECTIVE
  To compare the implant size (width and length) planned with digital panoramic radiographs, cone beam computed tomography (CBCT)-generated panoramic views, or CBCT cross-sectional images, in four implant systems.
  
  
  METHODS
  Seventy-one patients with a total of 103 implant sites in the upper premolar and/or lower molar regions were examined with digital panoramic radiography (D-PAN) and (CBCT). A metal ball 5 mm in diameter was placed in the edentulous area for the D-PAN. CBCT data sets were reformatted to a 10-mm thick CBCT panoramic view (CBCT-pan) and 1-mm cross-sections (CBCT-cross). Measurements were performed in the images using dedicated software. All images were displayed on a monitor and assessed by three observers who outlined a dental implant by placing four reference points in the site of the implant-to-be. Differences in width and length of the implant-to-be from the three modalities were analyzed. The implant size selected in the CBCT-cross images was then compared to that selected in the other two modalities (D-PAN and CBCT-pan) for each of the implant systems separately.
  
  
  RESULTS
  The implant-to-be (average measurements among observers) was narrower when measured in CBCT-cross compared with both D-PAN and CBCT-Pan. For premolar sites, the width also differed significantly between D-PAN and CBCT-pan modalities. The implant-to-be was also significantly shorter when recorded in CBCT-cross than in D-PAN. In premolar sites, there were no significant differences in implant length among the three image modalities. It mattered very little for the change in implant step sizes whether CBCT-cross was compared to D-PAN or CBCT-pan images.
  
  
  CONCLUSIONS
  Our results show that the selected implant size differs when planned on panoramic or cross-section CBCT images. In most cases, implant size measured in cross-section images was narrower and shorter than implant size measured in a panoramic image or CBCT-based panoramic view.
authors: Department of Dentistry - Oral Radiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors: Leticia Ruhland
authors: LR
authors: Correa
authors: Rubens
authors: R
authors: Spin-Neto
authors: Andreas
authors: A
authors: Stavropoulos
authors: Lars
authors: L
authors: Schropp
authors: Heloísa Emília Dias
authors: HE
authors: da Silveira
authors: Ann
authors: A
authors: Wenzel
mesh_terms: D000328:Adult; D000368:Aged; D054893:Cone-Beam Computed Tomography; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D017267:Dental Prosthesis Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D011300:Preoperative Care; D011862:Radiography, Panoramic; D012984:Software
chemical_list: D015921:Dental Implants
keywords: cone beam computed tomography; digital panoramic radiography; implant planning; implant size