Accuracy of cone beam computed tomography is limited at implant sites with a thin buccal bone: A laboratory study

Danijel Domic; Kristina Bertl; Salman Ahmad; Lars Schropp; Kristina Hellén-Halme; Andreas Stavropoulos

doi:10.1002/JPER.20-0222

Accuracy of cone beam computed tomography is limited at implant sites with a thin buccal bone: A laboratory study

Danijel Domic, Kristina Bertl, Salman Ahmad, Lars Schropp, Kristina Hellén-Halme, Andreas Stavropoulos^*

^*Corresponding author for this work

Department of Dentistry and Oral Health - Section for Oral Radiology and Endodontics

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Abstract

BACKGROUND: To evaluate whether buccal bone thickness (BBT), implant diameter, and abutment/crown material influence the accuracy of cone beam computed tomography (CBCT) to determine the buccal bone level at titanium implants.

METHODS: Two implant beds (i.e., narrow and standard diameter) were prepared in each of 36 porcine bone blocks. The implant beds were positioned at a variable distance from the buccal bone surface, thus resulting in 3 BBT groups (i.e., > 0.5-1.0; > 1.0-1.5; > 1.5-2.0 mm). In half of the blocks, a buccal bone dehiscence of random extent ("depth") was created and implants were mounted with different abutment/crown material (i.e., titanium abutments with a metal-ceramic crown and zirconia abutments with an all-ceramic zirconia crown). The distance from the implant shoulder to the buccal bone crest was measured on cross-sectional CBCT images and compared to the direct measurements at the bone blocks.

RESULTS: While abutment/crown material and implant diameter had no effect on the detection accuracy of the buccal bone level at dental implants in CBCT scans, BBT had a significant effect. Specifically, when BBT was ≤ 1.0 mm, a dehiscence was often diagnosed although not present, i.e., the sensitivity was high (95.8%), but the specificity (12.5%) and the detection accuracy (54.2%) were low. Further, the average measurement error of the distance from the implant shoulder to the buccal bone crest was 1.6 mm.

CONCLUSIONS: Based on the present laboratory study, BBT has a major impact on the correct diagnosis of the buccal bone level at dental titanium implants in CBCT images; in cases where the buccal bone is ≤ 1 mm thick, detection of the buccal bone level is largely inaccurate. This article is protected by copyright. All rights reserved.

Original language	English
Journal	Journal of Periodontology
Volume	92
Issue	4
Pages (from-to)	592-601
Number of pages	10
ISSN	0022-3492
DOIs	https://doi.org/10.1002/JPER.20-0222
Publication status	Published - Apr 2021

Keywords

alveolar process
cone-beam computed tomography
dental implants
titanium
zirconium

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Journal of Periodontology - 2020 - Domic - Accuracy of cone‐beam computed tomography is limited at implant sites with aFinal published version, 787 KBLicence: CC BY-NC-ND

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@article{911e0a0c6b5643b2aeb71a27e8c7f52f,

title = "Accuracy of cone beam computed tomography is limited at implant sites with a thin buccal bone: A laboratory study",

abstract = "BACKGROUND: To evaluate whether buccal bone thickness (BBT), implant diameter, and abutment/crown material influence the accuracy of cone beam computed tomography (CBCT) to determine the buccal bone level at titanium implants.METHODS: Two implant beds (i.e., narrow and standard diameter) were prepared in each of 36 porcine bone blocks. The implant beds were positioned at a variable distance from the buccal bone surface, thus resulting in 3 BBT groups (i.e., > 0.5-1.0; > 1.0-1.5; > 1.5-2.0 mm). In half of the blocks, a buccal bone dehiscence of random extent ({"}depth{"}) was created and implants were mounted with different abutment/crown material (i.e., titanium abutments with a metal-ceramic crown and zirconia abutments with an all-ceramic zirconia crown). The distance from the implant shoulder to the buccal bone crest was measured on cross-sectional CBCT images and compared to the direct measurements at the bone blocks.RESULTS: While abutment/crown material and implant diameter had no effect on the detection accuracy of the buccal bone level at dental implants in CBCT scans, BBT had a significant effect. Specifically, when BBT was ≤ 1.0 mm, a dehiscence was often diagnosed although not present, i.e., the sensitivity was high (95.8%), but the specificity (12.5%) and the detection accuracy (54.2%) were low. Further, the average measurement error of the distance from the implant shoulder to the buccal bone crest was 1.6 mm.CONCLUSIONS: Based on the present laboratory study, BBT has a major impact on the correct diagnosis of the buccal bone level at dental titanium implants in CBCT images; in cases where the buccal bone is ≤ 1 mm thick, detection of the buccal bone level is largely inaccurate. This article is protected by copyright. All rights reserved.",

keywords = "alveolar process, cone-beam computed tomography, dental implants, titanium, zirconium",

author = "Danijel Domic and Kristina Bertl and Salman Ahmad and Lars Schropp and Kristina Hell{\'e}n-Halme and Andreas Stavropoulos",

year = "2021",

month = apr,

doi = "10.1002/JPER.20-0222",

language = "English",

volume = "92",

pages = "592--601",

journal = "Journal of Periodontology",

issn = "0022-3492",

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Accuracy of cone beam computed tomography is limited at implant sites with a thin buccal bone: A laboratory study. / Domic, Danijel; Bertl, Kristina; Ahmad, Salman et al.
In: Journal of Periodontology, Vol. 92, No. 4, 04.2021, p. 592-601.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Accuracy of cone beam computed tomography is limited at implant sites with a thin buccal bone

T2 - A laboratory study

AU - Domic, Danijel

AU - Bertl, Kristina

AU - Ahmad, Salman

AU - Schropp, Lars

AU - Hellén-Halme, Kristina

AU - Stavropoulos, Andreas

PY - 2021/4

Y1 - 2021/4

N2 - BACKGROUND: To evaluate whether buccal bone thickness (BBT), implant diameter, and abutment/crown material influence the accuracy of cone beam computed tomography (CBCT) to determine the buccal bone level at titanium implants.METHODS: Two implant beds (i.e., narrow and standard diameter) were prepared in each of 36 porcine bone blocks. The implant beds were positioned at a variable distance from the buccal bone surface, thus resulting in 3 BBT groups (i.e., > 0.5-1.0; > 1.0-1.5; > 1.5-2.0 mm). In half of the blocks, a buccal bone dehiscence of random extent ("depth") was created and implants were mounted with different abutment/crown material (i.e., titanium abutments with a metal-ceramic crown and zirconia abutments with an all-ceramic zirconia crown). The distance from the implant shoulder to the buccal bone crest was measured on cross-sectional CBCT images and compared to the direct measurements at the bone blocks.RESULTS: While abutment/crown material and implant diameter had no effect on the detection accuracy of the buccal bone level at dental implants in CBCT scans, BBT had a significant effect. Specifically, when BBT was ≤ 1.0 mm, a dehiscence was often diagnosed although not present, i.e., the sensitivity was high (95.8%), but the specificity (12.5%) and the detection accuracy (54.2%) were low. Further, the average measurement error of the distance from the implant shoulder to the buccal bone crest was 1.6 mm.CONCLUSIONS: Based on the present laboratory study, BBT has a major impact on the correct diagnosis of the buccal bone level at dental titanium implants in CBCT images; in cases where the buccal bone is ≤ 1 mm thick, detection of the buccal bone level is largely inaccurate. This article is protected by copyright. All rights reserved.

AB - BACKGROUND: To evaluate whether buccal bone thickness (BBT), implant diameter, and abutment/crown material influence the accuracy of cone beam computed tomography (CBCT) to determine the buccal bone level at titanium implants.METHODS: Two implant beds (i.e., narrow and standard diameter) were prepared in each of 36 porcine bone blocks. The implant beds were positioned at a variable distance from the buccal bone surface, thus resulting in 3 BBT groups (i.e., > 0.5-1.0; > 1.0-1.5; > 1.5-2.0 mm). In half of the blocks, a buccal bone dehiscence of random extent ("depth") was created and implants were mounted with different abutment/crown material (i.e., titanium abutments with a metal-ceramic crown and zirconia abutments with an all-ceramic zirconia crown). The distance from the implant shoulder to the buccal bone crest was measured on cross-sectional CBCT images and compared to the direct measurements at the bone blocks.RESULTS: While abutment/crown material and implant diameter had no effect on the detection accuracy of the buccal bone level at dental implants in CBCT scans, BBT had a significant effect. Specifically, when BBT was ≤ 1.0 mm, a dehiscence was often diagnosed although not present, i.e., the sensitivity was high (95.8%), but the specificity (12.5%) and the detection accuracy (54.2%) were low. Further, the average measurement error of the distance from the implant shoulder to the buccal bone crest was 1.6 mm.CONCLUSIONS: Based on the present laboratory study, BBT has a major impact on the correct diagnosis of the buccal bone level at dental titanium implants in CBCT images; in cases where the buccal bone is ≤ 1 mm thick, detection of the buccal bone level is largely inaccurate. This article is protected by copyright. All rights reserved.

KW - alveolar process

KW - cone-beam computed tomography

KW - dental implants

KW - titanium

KW - zirconium

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DO - 10.1002/JPER.20-0222

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SN - 0022-3492

VL - 92

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EP - 601

JO - Journal of Periodontology

JF - Journal of Periodontology

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ER -

Accuracy of cone beam computed tomography is limited at implant sites with a thin buccal bone: A laboratory study

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