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. 2022 Dec 17;22(1):615.
doi: 10.1186/s12903-022-02663-8.

Efficacy of low-dose cone beam computed tomography and metal artifact reduction tool for assessment of peri-implant bone defects: an in vitro study

Alaa Shafiek Nomier  1 , Yousria Salah El-Din Gaweesh  1 , Maha R Taalab  1 , Shaimaa Abu El Sadat  2
Affiliations

Efficacy of low-dose cone beam computed tomography and metal artifact reduction tool for assessment of peri-implant bone defects: an in vitro study

Alaa Shafiek Nomier et al. BMC Oral Health. .

Abstract

Background: Early accurate radiographic assessment of peri-implant bone condition is highly important to avoid excessive loss of supporting bone and implant failure. Cone beam computed tomography (CBCT) is the radiographic technique of choice if peri-implant dehiscence and fenestration defects are suspected. The higher radiation dose and the presence of beam hardening artifacts are the main drawbacks of CBCT imaging techniques. This study aims to evaluate the influence of low-dose cone beam computed tomography (LD-CBCT) and metal artifact reduction (MAR) tool on the assessment of peri-implant dehiscence and fenestration.

Methodology: Thirty titanium implants were inserted into bovine rib blocks. Twenty had standardized bone defects (10 with dehiscence and 10 with fenestration), while the remaining 10 were used as control group with no defects. Radiographic examinations held with high-definition CBCT (HD-CBCT) and LD-CBCT with and without application of MAR tool. Images were assessed by four examiners for the presence or absence of peri-implant defects. The area under the area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, and accuracy were calculated for all radiographic protocols.

Results: In the absence of MAR tool, there was no difference in AUC and diagnostic values between LD-CBCT and HD-CBCT for detection of both defects. When the MAR tool was applied, the AUC values, sensitivity, and accuracy were higher in HD-CBCT than in LD-CBCT for the detection of both defects, especially for the dehiscence, while specificity remained the same.

Conclusion: LD-CBCT can be used in the evaluation of peri-implant dehiscence and fenestration without any decrease in diagnostic accuracy. The application of MAR tool decrease the diagnostic ability of both defects, especially for the detection of dehiscence defects.

Keywords: CBCT; Dehiscence; Dental implants; Fenestration; Low-dose protocol; MAR.

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Conflict of interest statement

The authors declare they have no competing interests.

Figures

Fig. 1
Fig. 1
Sample preparation and defect creation. a bovine rib block before implant osteotomy. b–d implant site preparation with drilling sequence. e–g dehiscence defect creation. h, i fenestration defect creation
Fig. 2
Fig. 2
Insertion of titanium implants into the three groups of the blocks (dehiscence, fenestration, control)
Fig. 3
Fig. 3
Sagittal and axial images with simulated peri-implant dehiscence defect obtanied with different four radiographic protocols. a High-dose CBCT without MAR. b Low-dose CBCT without MAR. c High-dose with MAR. d Low-dose CBCT with MAR
Fig. 4
Fig. 4
Sagittal and axial images with simulated peri-implant fenestration defect obtained with different four radiographic protocols. a High-dose CBCT without MAR. b Low-dose CBCT without MAR. c High-dose with MAR. d Low-dose CBCT with MAR
Fig. 5
Fig. 5
Sagittal and axial images with no peri-implant defect obtained with different four radiographic protocols. a High-dose CBCT without MAR. b Low-dose CBCT without MAR. c High-dose with MAR. d Low-dose CBCT with MAR
See this image and copyright information in PMC

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