Mathematical analysis of projection errors in "paralleling technique" with respect to implant geometry

"Standardized" radiographs acquired in paralleling technique serve for monitoring of marginal bone levels around endosseous implants. Under clinical conditions, parallel adjustment of the film to the implant is beset with great difficulties. A mathematical model matching clinical conditions was developed to evaluate projection geometry within an interval of clinically relevant angulations (+/- 10 degrees from parallel position). Radiographs of two implants (Frialit 2, Friadent AG, Mannheim, Germany; Implant No. 1: 3.8 mm, length 10 mm; Implant No. 2: 6.5 mm, length 13 mm) were separately produced per angulation (2 degrees increments) at one focus-object distance (FO=322.9 mm). Implant images were repeatedly measured along their midline/vertical edge, local magnification (MF) was calculated and the values were compared to the computed ones. Projected dimensions of the implants were calculated for a second distance (232.3 mm). The experimentally acquired data were in agreement with the mathematical calculation. MF calculated for assessment along the vertical edge varied less (+/-1.94% from mean value) than along the midline (+/-2.74%), with a range of 1.037-1.068 (FO=322.9 mm) and 1.061-1.099 (FO=232.3 mm) for implant No.1, and 1.060-1.101 (FO=232.3 mm) and 1.037-1.069 (FO=322.9 mm) for Implant No. 2. Magnification revealed a mean variation of 4%. Radiographic evaluation of periimplant bone level should not exceed a precision of 0.5 mm, when parallelism between film and implant is not guaranteed and FO is less than 380 mm.