title: Imaging evaluating of the implant/bone interface-an in vitro radiographic study.
abstract: OBJECTIVE
  To analyze the diagnostic accuracy of conventional and digital radiographic images and the impact of digital filters in evaluating the bone-implant interface.
  
  
  METHODS
  Titanium implants were inserted into 74 fresh bovine ribs blocks, 37 fitting tight to the bone walls (simulating the existence of osseointegration) and 37 with a gap of 0.125 mm (simulating a failure in the osseointegration process). Periapical radiographs were taken with conventional film and two phosphor plate systems [VistaScan®(Dürr Dental, Bietigheim-Bissingen, Germany) and Express®(Instrumentarium, Tuusula, Finland)]. Digital radiographs were investigated with and without enhancement filters. Three blinded examiners assessed the images for the presence of juxtaposition in the bone-implant interface using a five-point Likert scale. Sensitivity, specificity and the area under the receiver-operating characteristic curve (AUC) and its 95% confidence interval (CI) were calculated for each variable. Intraexaminer and interexaminer agreements were analyzed using Kendall's concordance test.
  
  
  RESULTS
  Intraexaminer and interexaminer agreements were >0.80 for both digital and conventional images. Conventional radiographs (AUC = 0.963/CI = 0.891 to 0.993) and digital images with high enhancement filters such as Caries2 (AUC = 0.964/CI = 0.892 to 0.993), Endo (AUC = 0.952/CI = 0.875 to 0.988) and Sharpen3 (AUC = 0.894/CI = 0.801 to 0.954) showed the greatest accuracy for evaluating the bone-implant interface. Original images from both digital systems and the further enhancement filters tested showed low sensitivity for the diagnosis task tested.
  
  
  CONCLUSIONS
  Conventional radiographs or digital radiographs with high-pass filters could help enhance diagnosis on implant-bone interface.
authors.affiliation: 1 Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
authors.forename: Michele M
authors.initials: MM
authors.lastname: Vidor
authors.affiliation: 2 Department of Stomatology, School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
authors.forename: Gabriela S
authors.initials: GS
authors.lastname: Liedke
authors.affiliation: 1 Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
authors.forename: Mariana B
authors.initials: MB
authors.lastname: Vizzotto
authors.affiliation: 1 Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
authors.forename: Heraldo L D
authors.initials: HLD
authors.lastname: da Silveira
authors.affiliation: 1 Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
authors.forename: Priscila F
authors.initials: PF
authors.lastname: da Silveira
authors.affiliation: 3 Institute of Informatics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.|4 Viewbox Software, Porto Alegre, Brazil.
authors.forename: Cristiano W
authors.initials: CW
authors.lastname: Araujo
authors.affiliation: 1 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
mesh_terms: D000818:Animals; D002417:Cattle; D015921:Dental Implants; D020007:Implants, Experimental; D066298:In Vitro Techniques; D019252:Radiography, Dental, Digital / Q000295:instrumentation / Q000379:methods*; D012272:Ribs / Q000000981:diagnostic imaging* / Q000601:surgery; D012680:Sensitivity and Specificity; D014025:Titanium
chemical_list: D015921:Dental Implants; D014025:Titanium