Accuracy of cone‐beam computed tomography is limited at implant sites with a thin buccal bone: A laboratory study

Domic, Danijel; Bertl, Kristina; Ahmad, Salman; Schropp, Lars; Hellén‐Halme, Kristina; Stavropoulos, Andreas

doi:10.1002/jper.20-0222

Cited by 14 publications

(11 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present case, where a pneumocephalus developed during submucosal debridement of a peri-implantitis lesion with an airpolishing device, the following pathway for the intracranial entrance of the air is suspected based on the localization of air, registered in the diagnostic CT taken after the procedure. Based on this CT scan, and although it is acknowledged that the detection of a thin buccal bone wall in CT/CBCT scans is largely inaccurate (Domic et al, 2021), it appears that the implant in position 27 had an intact buccal bone at its marginal aspect (Figure 6a). However, it had a very deep periimplant bone defect at its mesial aspect, extending almost to the apex of the implant, that is, into the augmented sinus space (Figure 6b,c).…”

Section: Discussionmentioning

confidence: 94%

Pneumocephalus as result of nonsurgical peri‐implantitis treatment with an air‐polishing device for submucosal debridement—A case report

Bruckmann

Gahleitner

et al. 2022

Clinical & Exp Dental Res

Self Cite

View full text Add to dashboard Cite

Background: A subcutaneous emphysema is an infrequent but potentially lifethreatening complication after dental treatment involving instruments functioning with pressurized air. Emphysemata after the use of high-speed handpieces and airsyringes are well documented, however, more recently several reports on emphysemata produced by air-polishing devices during management of periimplant biological complications have appeared. To the best of our knowledge, direct development of pneumocephalus after a dental procedure has never been reported before. Introduction of air likely contaminated with oral bacteria to the intracranial space bares the risk of developing meningitis.Case Presentation: This case report describes the spreading of a subcutaneous emphysema into the intracranial space (i.e., development of a pneumocephalus) after treatment of a peri-implantitis lesion with an air-polishing device equipped with the nozzle for submucosal debridement. A subcutaneous emphysema was noticed during the use of an air-polishing device and the subsequent computed tomography (CT) examination revealed a quite unexpected spreading of the emphysema into the intracranial space. The patient was admitted to the hospital for close surveillance, CT follow-up, and intravenous antibiotics to prevent the development of meningitis due to the introduction of air-likely contaminated with oral bacteriainto the intracranial space. After 3 days, the patient was discharged in good condition without any further complications. Conclusion:In case of an extensive subcutaneous emphysema as result of a dental procedure, a more extended radiographic examination including the mediastinal and cranial space should be considered, to assess the risk for potentially life-threatening complications.

show abstract

Section: Discussionmentioning

confidence: 94%

Pneumocephalus as result of nonsurgical peri‐implantitis treatment with an air‐polishing device for submucosal debridement—A case report

Bruckmann

Gahleitner

et al. 2022

Clinical & Exp Dental Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…Shiratori et al 12 found no significant difference between measurements on CBCT and gold standard measurements. Domic et al 13 conclude that reliability of CBCT measurements of BBL are dependent on BBT. Lower BBT resulting in less reliable measurements of BBL.…”

Section: Resultsmentioning

confidence: 99%

The accuracy of probing, ultrasound and cone‐beam CT scans for determining the buccal bone plate dimensions around oral implants – A systematic review

Dhondt

Quirynen

Tarce

et al. 2022

J of Periodontal Research

View full text Add to dashboard Cite

Objective The objective of this review was to assess the accuracy of available means of determining the BBT (buccal bone thickness) and/or BBL (buccal bone level). This was translated into the following research question: What is the accuracy of the available means of visualizing the BBP (buccal bone plate) to establish the BBT and/or the BBL, when compared to control measurements? As control measurements histomorphometric measurements, direct measurements and cone‐beam computed tomography (CBCT) measurements in the absence of metal are accepted. Background Data: Methods The literary search was performed by searching the databases of MEDLINE, Embase, and Web of Science, up to July 13, 2021. Types of studies included were clinical, in vitro and animal trials, specifically looking into the bone level and/or bone thickness of the buccal bone plate at oral implants. Reference lists were hand searched for relevant articles. Two reviewers performed the data extraction and analysis. Only studies using reliable control measurements to evaluate the accuracy of the tested means of visualizing BBT and/or BBL were included for analysis. The QUADAS‐2 tool was used to perform bias analysis on the relevant studies. Extracted data was tabulated to show the differences between test and control measurements for BBT and BBL. For in vitro studies on CBCT measurements of BBT meta‐analysis could be performed. Results A total of 1176 papers were identified in the search. Twenty‐two articles were used for data extraction and qualitative analysis. Of these studies nine were animal studies, 9 were in vitro studies and four were human studies. Six animal studies and three human studies provided data on probing. CBCT and sonography as techniques for visualizing the buccal bone plate. Probing at implant sites seems to provide data that correlates with a consistent distance from the BBP. Meta‐analysis for probing studies could not be performed due to heterogeneity in the setups of these studies. Eleven studies on CBCT were eligible for inclusion. Of these three were animal studies, the remaining 8 studies were all in vitro studies. Meta‐analysis was performed on the accuracy of CBCT for in vitro studies, finding a significant underestimation of the BBT when compared to control measurements by a mean difference of −0.15 mm with 95%CI [−0.26,−0.03]. Three studies were identified on measurement of BBT and/or BBL by sonography. This included one human study and two in vitro studies. The identified studies show a low error when determining the buccal bone level or thickness using sonography. All included studies possess a high risk of bias according to risk of bias analysis, mostly due to selection of the patient. Conclusion A strong limitation of this systematic review is the inclusion of different studies with heterogeneous designs. Within the limits of this analysis it cannot be concluded that probing is an accurate way of visualizing the BBP. CBCT cannot yet be recommended as a standard diagnostic tool for follow‐up of the BBP at oral...

show abstract

“…Additionally, it has been suggested that the dimension of bone structures measuring less than 1 mm might be underestimated when using CBCT, 36 due to the fact that an accuracy of greater than 0.5 mm cannot be expected 38 . More recently, Domic and colleagues concluded that detection of the buccal bone level around implants is largely inaccurate in cases where the buccal bone is ≤1 mm thick 41 …”

Section: Discussionmentioning

confidence: 99%

Hard tissue dimensional changes following implant removal due to peri‐implantitis: A retrospective study

Pons

Carreño

Amerio

et al. 2021

Clin Implant Dent Rel Res

View full text Add to dashboard Cite

Background The current evidence regarding the alterations experienced by the alveolar ridge (hard tissue changes) after implant removal due to peri‐implantitis is limited. Purpose To assess the hard tissue dimensional changes following implant removal due to peri‐implantitis. Material and methods Clinical records were examined to identify patients with implants that had to be removed due to a hopeless prognosis secondary to peri‐implantitis due to expendability of peri‐implantitis implants for functional reasons. Patients with preoperative and postoperative cone‐beam computed tomography (CBCT) scans were included. Patient‐related, implant‐related, and surgery‐related factors were assessed based on the clinical records. Linear measurements were made to evaluate the influence of bone plate thickness (BPT), ridge width (RW), and ridge height (RH) at various levels upon the outcome of implant removal. A descriptive statistical analysis of the quantitative and qualitative variables was performed. Correlations of the variables with the primary outcome (dimensional changes) were tested using univariate and multivariate analyses (multinomial random intercept mixed model linear regressions). Results A total of 26 patients (nimplants = 79) met the eligibility criteria. The mean decrease in RW at 1 and 3 mm below the crest was 11.3% and 4.4%, respectively (P < 0.001). Buccal and lingual RH was significantly reduced by 2.2% and 6.3%, respectively (P < 0.001). Few patient‐related, implant‐related, and surgery‐related factors appeared to have an impact upon the hard tissue dimensional changes. Bone regeneration simultaneous to implant removal minimized the dimensional changes of the ridge both vertically (5% lesser buccal RH reduction) and horizontally (12% lesser RW reduction) when compared with spontaneous healing. The use of a reverse‐torque removal kit seemed to be critical in limiting the dimensional changes of the ridge. Conclusions Minimal hard tissue changes can be expected following implant removal due to peri‐implantitis. Simultaneous bone regeneration procedures and the use of a removal kit may considerably reduce the impact upon the dimensional changes (NCT04534361).

show abstract

Accuracy of cone‐beam computed tomography is limited at implant sites with a thin buccal bone: A laboratory study

Cited by 14 publications

References 32 publications

Pneumocephalus as result of nonsurgical peri‐implantitis treatment with an air‐polishing device for submucosal debridement—A case report

Pneumocephalus as result of nonsurgical peri‐implantitis treatment with an air‐polishing device for submucosal debridement—A case report

The accuracy of probing, ultrasound and cone‐beam CT scans for determining the buccal bone plate dimensions around oral implants – A systematic review

Hard tissue dimensional changes following implant removal due to peri‐implantitis: A retrospective study

Contact Info

Product

Resources

About