title: Preoperative implant planning considering alveolar bone grafting needs and complication prediction using panoramic versus CBCT images.
abstract: OBJECTIVE
  This study was performed to determine the efficacy of observers' prediction for the need of bone grafting and presence of perioperative complications on the basis of cone-beam computed tomography (CBCT) and panoramic radiographic (PAN) planning as compared to the surgical outcome.
  
  
  METHODS
  One hundred and eight partially edentulous patients with a need for implant rehabilitation were referred for preoperative imaging. Imaging consisted of PAN and CBCT images. Four observers carried out implant planning using PAN image datasets, and at least one month later, using CBCT image datasets. Based on their own planning, the observers assessed the need for bone graft augmentation as well as complication prediction. The implant length and diameter, the need for bone graft augmentation, and the occurrence of anatomical complications during planning and implant placement were statistically compared.
  
  
  RESULTS
  In the 108 patients, 365 implants were installed. Receiver operating characteristic analyses of both PAN and CBCT preoperative planning showed that CBCT performed better than PAN-based planning with respect to the need for bone graft augmentation and perioperative complications. The sensitivity and the specificity of CBCT for implant complications were 96.5% and 90.5%, respectively, and for bone graft augmentation, they were 95.2% and 96.3%, respectively. Significant differences were found between PAN-based planning and the surgery of posterior implant lengths.
  
  
  CONCLUSIONS
  Our findings indicated that CBCT-based preoperative implant planning enabled treatment planning with a higher degree of prediction and agreement as compared to the surgical standard. In PAN-based surgery, the prediction of implant length was poor.
authors.affiliation: OIC, OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium. ; Master of Periodontology, Universidad San Martin de Porres, Lima, Peru.
authors.forename: Maria Eugenia
authors.initials: ME
authors.lastname: Guerrero
authors.affiliation: Master of Periodontology, Universidad San Martin de Porres, Lima, Peru.
authors.forename: Jorge
authors.initials: J
authors.lastname: Noriega
authors.affiliation: OIC, OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium. ; Department of Oral and Maxillofacial Surgery, University Hospitals, Leuven, Belgium.
authors.forename: Reinhilde
authors.initials: R
authors.lastname: Jacobs
keywords: Alveolar Bone Grafting; Cone-Beam Computed Tomography; Dental Implants; Radiography, Panoramic