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. 2022 Apr;33(4):433-440.
doi: 10.1111/clr.13903. Epub 2022 Feb 16.

Accuracy of bone-level assessments following reconstructive surgical treatment of experimental peri-implantitis

Ahmed Almohandes  1 , Henrik Lund  2 , Olivier Carcuac  1 , Max Petzold  3 , Tord Berglundh  1 , Ingemar Abrahamsson  1
Affiliations

Accuracy of bone-level assessments following reconstructive surgical treatment of experimental peri-implantitis

Ahmed Almohandes et al. Clin Oral Implants Res. 2022 Apr.

Abstract

Aims: The purpose of this study was to evaluate the accuracy of bone-level assessments using either cone-beam computed tomography (CBCT), intra-oral peri-apical (PA) radiographs or histology following reconstructive treatment of experimental peri-implantitis.

Materials and methods: Six Labrador dogs were used. Experimental peri-implantitis was induced 3 months after implant placement. Surgical treatment of peri-implantitis was performed and peri-implant defects were allocated to one of four treatment categories; no augmentation, bone graft materials with or without a barrier membrane. Six months later, intra-oral PA radiographs and block biopsies from all implants sites were obtained. Marginal bone levels (MBLs) were measured using PA radiographs, CBCT and histology.

Results: Significant correlations of MBL assessments were observed between the three methods. The measurements in PA radiographs consistently resulted in an overestimation of the bone level of about 0.3-0.4 mm. The agreement between the methods was not influenced by the use of bone substitute materials in the management of the osseous defects.

Conclusions: Although MBL assessments obtained from PA radiographs showed an overestimation compared to MBL assessments on corresponding CBCT images and histological sections, PA radiographs can be considered a reliable technique for peri-implant bone-level evaluations following reconstructive surgical therapy of experimental peri-implantitis.

Keywords: cone-beam computed tomography; experimental peri-implantitis; histology; marginal bone level; radiography; reconstructive therapy.

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Conflict of interest statement

Dr. Berglundh reports grants from Swedish Research Council (VR), grants from TUA research funding, Gothenburg, Sweden, non‐financial support from Geistlich Biomaterials, Switzerland, non‐financial support from Dentsply Implants IH AB, Sweden, during the conduct of the study. Grants and Personal fees from Dentsply Implants IH AB, Mölndal, Sweden, outside the submitted work. Dr. Abrahamsson reports non‐financial support from Dentsply Sirona, non‐financial support from Geistlich Pharma AG, during the conduct of the study. Grants from Dentsply Sirona, outside the submitted work. Dr. Almohandes, Dr. Lund, Dr. Carcuac and Dr. Petzold have nothing to disclose.

Figures

FIGURE 1
FIGURE 1
Implant site documented by a CBCT image (a), PA radiograph (b) and histological section (c). A/F, abutment /fixture (implant) border; B, the most coronal bone‐to‐implant contact
FIGURE 2
FIGURE 2
Illustration (a) showing the orientation of the histological sections. CBCT section (b) illustrating the orientation of CBCT cuts that correspond to histological sections (white line) and other lateral cuts (dotted lines). Bucco‐lingual (c) and mesio‐distal (d) CBCT image. Metallic markers were placed at the buccal and mesial aspects of each block (b and c). A mesio‐distal cut was made at the top of implant abutment (d)
FIGURE 3
FIGURE 3
Plots illustrating correlations between MBL‐data obtained from histological sections (X axis) and corresponding CBCT images (Y axis) at mesial (a), distal (b), buccal (c) and lingual (d) aspects
FIGURE 4
FIGURE 4
Bland‐Altman plots representing the average of MBL data (X axis) and the difference in data (Y axis) between histological sections and corresponding CBCT images at (a) mesial, (b) distal, (c) buccal and (d) lingual aspects. Mean (black line), standard deviation (dotted lines) and simple linear regression (red line) of differences
FIGURE 5
FIGURE 5
(a and b) Plots illustrating correlations between maximum MBL from CBCT images (X axis) and MBL‐data obtained from PA radiographs (Y axis) on mesial (a), distal (b) aspects. (c and d) Bland‐Altman plots representing the average of MBL data (X axis) and the difference in data (Y axis) between PA radiographs and maximum MBL in CBCT images at (c) mesial, (d) distal aspects. Mean (black line), standard deviation (dotted lines) and simple linear regression (red line) of differences
FIGURE 6
FIGURE 6
(a and b) Plots illustrating correlations between MBL‐data obtained from histological sections (X axis) and corresponding PA radiographs (Y axis) at mesial (a) and distal (b) aspects. (c and d) Bland‐Altman plots representing the average of MBL data (X axis) and the difference in data (Y axis) between histological sections and corresponding PA radiographs at mesial (c) and distal (d) aspects. Mean (black line), standard deviation (dotted lines) and simple linear regression (red line) of differences
FIGURE 7
FIGURE 7
Bland‐Altman plots representing the average of MBL data (X axis) and the difference in data (Y axis) between histological sections and corresponding CBCT images for Group C (a), Group T1 (b), Group T2 (c), Group T3 (d) sites. Mean (black line), standard deviation (dotted lines) and simple linear regression (red line) of differences
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