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Detection of peri-implant bone defects with different radiographic techniques - a human cadaver study
Sebastian Kühl1, Silvia Zürcher1, Nicola U Zitzmann2
1Department of Oral Surgery, Oral Radiology and Oral Medicine, School of Dental Medicine University of Basel, Basel, Switzerland.
Objectives:
Two- and three-dimensional radiographic techniques are available to determine peri-implantitis-related bone loss around dental implants.
Purpose:
To compare the performance of detecting different peri-implant bone defects in intraoral radiography (IR), panoramic radiography (PR), Cone Beam Computer Tomography (CBCT) and Computer Tomography (CT).
Material And Methods:
Six implants were inserted under ideal conditions into the lower jaw of an edentulous human cadaver. IR, PR, CBCT and CT were performed. Two-wall, three-wall and four-wall defects with 1 mm depth were artificially created around two of the implants (one anterior and one posterior), and radiographies were repeated. The identical set-up was used for 3-mm-deep bone defects. All images were presented to seven observers. Sensitivity (SN) and specificity (SP) were determined for each modality, defect type and depths, and likelihood ratios were calculated.
Results:
The highest sensitivity was found with IR and CBCT for 1 mm (0.67; 0.68) and 3-mm defects (0.81; 0.79). The highest specificity was found with IR for both defect depths (0.51). The best classification of defect type revealed PR for both 1-mm and 3-mm-deep defects. Both likelihood ratios (LR+ and LR-) were best for IR with 1-mm (1.37 and 0.65) and with 3-mm defects (1.65 and 0.37).
Conclusions:
IR should still be recommended as favourable method evaluating bone loss around dental implants, while CT demonstrated the lowest performance in detecting peri-implant bone defects.
