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Published on: January 28, 2020
Mandibular cone beam-CT radiomorphometric indices for enhancing precision in predicting implant outcomes
Manar K AbdAllah1, Fatma M El-Badawy2, Mary M Farid3
1Assistant Lecturer, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
Statement Of Problem:
Despite advancements in implant dentistry, implant failure remains a significant challenge. The current application of cone beam computed tomography (CBCT) is a descriptive, not a predictive, assessment of failure risk. This diagnostic limitation requires research to refine CBCT-derived metrics for risk prediction.
Purpose:
The purpose of this retrospective clinical study was to evaluate the predictive value of CBCT-derived mandibular radiomorphometric indices in distinguishing between successful and failed dental implants.
Material And Methods:
A retrospective analysis was performed on 301 CBCT scans of male patients with dental implants. The implants were categorized as successful or failed according to predetermined radiographic criteria. Two quantitative indices, computed tomographic mental index (CTMI) and computed tomographic index (CTI), and 1 qualitative index, computed tomographic cortical index (CTCI), were independently evaluated by 2 experienced radiologists. Intraobserver and interobserver reliability were assessed, and the relationships between these indices and dental implant outcomes were investigated. The Shapiro-Wilk test for normality guided the selection between parametric and nonparametric tests. The chi-squared test analyzed the categorical variable CTCI (α=.05).
Results:
CTMI and CTI demonstrated strong intraobserver and moderate interobserver concordance. However, the CTCI exhibited moderate intraobserver and interobserver agreement. Radiographic signs of implant failure were found in 156 implants (51.8%). The quantitative indices CTMI and CTI could not discriminate between situations of implant success and failure. However, a significant difference was found between the qualitative CTCI scores of failed and successful implants (P=.011).
Conclusions:
The qualitative index CTCI showed weak but significant predictive value for dental implant failure, while the quantitative indices CTMI and CTI could not predict implant outcomes. These findings indicate that compromised mandibular cortical integrity could be a contributing factor in determining implant outcomes.
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