Agreement between Histomorphometry and Microcomputed Tomography to Assess Bone Microarchitecture of Dental Implant Sites.
BACKGROUND
Histomorphometry and microcomputed tomography (microCT) have been used in implant studies but need better understanding before being used as equivalent methods.


OBJECTIVE
The purpose of this study was to investigate the agreement between 2D (histomorphometry) and 3D (microCT) reference methods for assessing jawbone microarchitecture in vivo.


METHODS
Forty-four bone specimens from 32 patients were obtained during implant placement and examined by microCT, followed by hematoxylin-eosin staining and histomorphometric analysis. The morphometric parameters included bone volume density (BV/TV), bone surface fraction (BS/TV), bone surface density, trabecular thickness, trabecular number, and trabecular separation (Tb.Sp). Bland-Altman plots were used for pairwise agreement analysis between the equivalent 3D and 2D parameters, and complemented with Mountain plots. The association between the two methods was tested using Pearson's correlation followed by Passing-Bablok regression.


RESULTS
Systematic bias was observed in all Bland-Altman and Mountain plots, including constant bias for BV/TV and Tb.Sp, and proportional bias for all other parameters. Significant correlation was found for BV/TV (r = 0.80; p < .001) and BS/TV (r = 0.44; p = .003), and the Passing-Bablok regression showed constant bias for BV/TV and proportional bias for BS/TV.


CONCLUSIONS
Because of the poor agreement between measures obtained by histomorphometry and microCT, these methods should not be used interchangeably for jawbones.
Department of Oral Medicine, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil.
Danilo Rocha
DR
Dias
Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil.
Cláudio Rodrigues
CR
Leles
Department of Oral Medicine, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil.
Aline Carvalho
AC
Batista
Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden.
Christina
C
Lindh
Department of Oral Medicine, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil.
Rejane Faria
RF
Ribeiro-Rotta
D000328:Adult; D015519:Bone Density / Q000502:physiology*; D001842:Bone and Bones / Q000648:ultrastructure*; D003430:Cross-Sectional Studies; D015921:Dental Implants; D005260:Female; D006801:Humans; D008297:Male; D055114:X-Ray Microtomography / Q000379:methods*
D015921:Dental Implants
bone; computerized tomography; histological analysis; implant