title: Factors affecting the possibility to detect buccal bone condition around dental implants using cone beam computed tomography.
abstract: OBJECTIVE
  To evaluate factors with impact on the conspicuity (possibility to detect) of the buccal bone condition around dental implants in cone beam computed tomography (CBCT) imaging.
  
  
  METHODS
  Titanium (Ti) or zirconia (Zr) implants and abutments were inserted into 40 bone blocks in a way to obtain variable buccal bone thicknesses. Three combinations regarding the implant-abutment metal (TiTi, TiZr, or ZrZr) and the number of implants (one, two, or three) were assessed. Two CBCT units (Scanora 3D - Sc and Cranex 3D - Cr) and two voxel resolutions (0.2 and 0.13 mm) were used. Reconstructed sagittal images (2.0 and 5.0 mm thickness) were evaluated by three examiners, using a dichotomous scale when assessing the condition of the buccal bone around the implants. A multivariate logistic regression was performed using examiners' detection of the buccal bone condition as the dependent variable. Odds ratio (OR) were calculated separately for each CBCT unit.
  
  
  RESULTS
  Implant-abutment combination (ZrZr) (OR Sc = 19.18, OR Cr = 11.89) and number of implants (3) (OR Sc = 12.10, OR Cr = 4.25) had major impact on buccal bone conspicuity. The thinner the buccal bone, the higher the risk that the condition of the buccal bone could not be detected. The use of lower resolution protocols increased the risk that buccal bone was not properly detected (OR Sc = 1.46, OR Cr = 2.00). For both CBCT units, increasing the image reconstruction thickness increased the conspicuity of buccal bone (OR Sc = 0.33, OR Cr = 0.31).
  
  
  CONCLUSIONS
  Buccal bone conspicuity was impaired by a number of factors, the implant-abutment material being the most relevant. Acquisition and reconstruction factors had minor impact on the detection of the buccal bone condition.
authors.affiliation: Oral Radiology, Department of Stomatology, School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.|Section of Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark.
authors.forename: Gabriela S
authors.initials: GS
authors.lastname: Liedke
authors.affiliation: Section of Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark.
authors.forename: Rubens
authors.initials: R
authors.lastname: Spin-Neto
authors.affiliation: Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
authors.forename: Heloisa E D
authors.initials: HED
authors.lastname: da Silveira
authors.affiliation: Section of Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Schropp
authors.affiliation: Deptartment of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden.
authors.forename: Andreas
authors.identifier: http://orcid.org/0000-0001-8161-3754
authors.initials: A
authors.lastname: Stavropoulos
authors.affiliation: Section of Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark.|Institute of Odontology, Copenhagen University, Copenhagen, Denmark.
authors.forename: Ann
authors.initials: A
authors.lastname: Wenzel
mesh_terms: D000818:Animals; D054893:Cone-Beam Computed Tomography; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D007091:Image Processing, Computer-Assisted; D007568:Jaw / Q000000981:diagnostic imaging*; D056948:Orthognathic Surgical Procedures; D011861:Radiography, Dental; D013552:Swine
chemical_list: D015921:Dental Implants
keywords: 
  in vitro
  ; buccal bone; cone beam computed tomography; implants; titanium; zirconium