Is cone beam computed tomography accurate for post-operative evaluation of implants? an in vitro study

Publication date: Available online 3 August 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Michele Machado Vidor, Gabriela Salatino Liedke, Mathias Pante Fontana, Heraldo Luis Dias da Silveira, Nadia Assein Arus, André Lemos, Mariana Boessio Vizzotto
ObjectiveTo evaluate the accuracy of CBCT images for bone/implant interface diagnosis in comparison to periapical radiographs.Study DesignTitanium implants were inserted in 74 bovine rib blocks in intimate contact to the bone walls, and with a gap of 0.125 mm (simulating a failure in the osseointegration process). Periapical radiographs were taken with conventional film, and CBCT scans were acquired with i-CAT (0.2mm and 0.125mm voxel) and Kodak (0.2mm and 0.076mm voxel) units. Three examiners evaluated the images using a 5-point scale. Diagnostic accuracy was analyzed through sensitivity, specificity, and the area under the ROC curve (AUC) with 95% confidence intervals (CI). Intra- and inter-examiner agreements were analyzed through Kendall's concordance test.ResultsIntra- and inter-examiner agreements showed satisfactory results. The greatest accuracy was observed with conventional radiographs (AUC = 0.963 / CI 95% = 0.891-0.993). I-CAT 0.125mm images showed good accuracy (AUC = 0.885 / CI 95% = 0.790-0.947), with no significant difference compared to conventional radiography. Kodak images had high specificity and low sensitivity, presenting more false-negative results.ConclusionConventional radiographs showed the highest accuracy for bone/implant interface diagnosis. However, CBCT scans (i-CAT 0.125 mm voxel), if available or if performed for pre-surgical assessment of another implant site, may provide similar accuracy.



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