Diagnostic performance of cone beam computed tomography in assessing peri‐implant bone loss: A systematic review

Pelekos, George; Acharya, Aneesha; Tonetti, Maurizio S.; Bornstein, Michael M.

doi:10.1111/clr.13143

Cited by 30 publications

(33 citation statements)

References 83 publications

(241 reference statements)

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“…For very thin structures less than 0.5 mm thick, however, the accuracy of CBCT is limited (Fienitz et al, ). A systematic review reported both over‐ and underestimation of linear CBCT measurements for peri‐implant bone assessments (Pelekos, Acharya, Tonetti, & Bornstein, ). It must, therefore, be emphasized that the absolute values of our linear measurements, which are within the 1‐mm range, might be biased by global errors.…”

Section: Discussionmentioning

confidence: 99%

In vitro diagnostic accuracy of low‐dose CBCT for evaluation of peri‐implant bone lesions

Schwindling

Hilgenfeld

Weber

et al. 2019

Clinical Oral Implants Res

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Objectives To investigate the in vitro diagnostic accuracy of low‐dose cone‐beam computed tomography (LD‐CBCT) for the detection, classification, and measurement of peri‐implant bone lesions. Material and methods Titanium dental implants with all‐ceramic single crowns (n = 24) were inserted into bovine bone. At twelve implants, four types of peri‐implant bone lesions were created. Radiographic imaging was performed using three techniques: LD‐CBCT, high‐definition CBCT (HD‐CBCT), and intraoral radiography (IR). The datasets were presented twice to four observers in a random order. Diagnostic accuracy was measured by calculating sensitivity and specificity, and analyzed using the McNemar's test at a significance level of 0.05. Absolute agreement between the defect sizes was assessed by means of intraclass correlation coefficients (ICC). Results For all three techniques, diagnostic accuracy and reliability for the detection of defects were almost perfect. The following order was found for classification of the different defect types (sensitivity/specificity): HD‐CBCT (0.96/0.99) > LD‐CBCT (0.93/0.98) > IR (0.71/0.95). No significant difference was found between the two CBCT techniques. Their performance was superior to that of IR. With regard to absolute agreement of defect size, LD‐CBCT agreement with HD‐CBCT (ICC, 95% confidence interval) was slight for defect depth (0.342, 0.181–0.625) and substantial for defect width (0.911, 0.775–0.963). Conclusion Intraoral radiography is useful for detecting peri‐implant bone lesions. LD‐CBCT provides additional information regarding the geometry of defects. The even higher diagnostic accuracy of the HD‐CBCT protocol tested needs to be carefully weighed against its radiation dose, which is 14 times higher than that of LD‐CBCT.

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Section: Discussionmentioning

confidence: 99%

In vitro diagnostic accuracy of low‐dose CBCT for evaluation of peri‐implant bone lesions

Schwindling

Hilgenfeld

Weber

et al. 2019

Clinical Oral Implants Res

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“…35 CBCT also showed a limited accuracy measuring vestibular and lingual bone levels. 36 The ex vivo studies (cadaver models) demonstrated good values for sensitivity and specificity for both circumferential and infraosseous defects but lower for dehiscences. 15 The diagnostic outcomes of CBCT imaging of peri-implant bone loss have been related to the type of study and defect morphology.…”

Section: Agreements and Disagreements With Previous Studiesmentioning

confidence: 92%

“…15 The diagnostic outcomes of CBCT imaging of peri-implant bone loss have been related to the type of study and defect morphology. 36 The ex vivo studies (cadaver models) demonstrated good values for sensitivity and specificity for both circumferential and infraosseous defects but lower for dehiscences. 37,38 Contrastingly, CBCT imaging for defect analysis in in vivo animal studies showed positive correlation with histology but have a tendency to over- 17,34 or under-estimate 15,39 the size of the defect.…”

Section: Reliability Of Cone-beam Computed Tomography (Cbct) To Assmentioning

confidence: 92%

Morphology and severity of peri‐implantitis bone defects

Monje

Pons

Ínsua

et al. 2019

Clin Implant Dent Rel Res

122

146

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Background: Peri-implant defect morphology has shown to potentially impact upon the reconstructive outcomes for the management of peri-implantitis. Given the role that defect morphology plays upon the decision-making in the treatment of peri-implantitis, the present study aimed at assessing the morphology and severity of peri-implantitis bone defects and to insight on the patient-, implant-and site-related variables associated to these. Material and Methods:A cone-beam computed tomography study was carried out to classify peri-implantitis defects according to the type of defect, number of remaining bony walls and severity according to the extension of vertical bone loss.Three major defect categories were proposed: class I-infraosseous; class II-horizontal;class III-combined of class I and II. These were then subclassified into: (a) dehiscence; (b) 2/3-wall; and (c) circumferential-type defect. According to the severity the defects were further subclassified into: A: advanced; M: moderate; and S: slight. In addition, 20 site-, implant-, and patient-related variables were analyzed by generalized estimating equations (GEEs) of multilevel logistic regression models.Results: Based on an a priori power calculation, 332 implants were screened in 47 peri-implantitis patients. Of these, 158 peri-implantitis implants were eligible. The most prevalent defect morphology type was class Ib (55%) followed by class Ia (16.5%), and class IIIb (13.9%). On the contrary, the less frequent defect was class II (1.9%). The most frequent degree of severity was M (50.6%) with S (10.1%) being the least prevalent. Buccal bone loss was significantly greater compared to the other bony walls in class I and class III defects. Age was associated with the type of defect.Age and smoking habit were associated with the morphology of the defects, while smoking habit, type of prosthesis and distance to adjacent implant were associated with the severity of the defects (vertical bone loss).Conclusion: Peri-implantitis defects frequently course with an infraosseous component and often with buccal bone loss. Certain patient-, implant-, and site-specific variables are related with defect morphology and severity. However, morphological patterns for periimplantitis bone defects could not be proven (NCT NCT03777449).K E Y W O R D S alveolar bone, dental implants, diagnostic, implant stability, peri-implantitis, peri-implant mucositis

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“…CBCT can also have a relevant role in the determination of defect morphology, and it may play an essential role in therapeutic decision making. 24 Anatomically, peri-implant defects can be grouped similar to periodontal osseous defects, thus being primarily classified as "suprabony/horizontal" or "intrabony/vertical." Intrabony/ vertical defects can further be categorized as a one-, two-, or three-walled defect (►Fig.…”

Section: Infectionmentioning

confidence: 99%

Cone Beam Computed Tomography Imaging in Dental Implants: A Primer for Clinical Radiologists

Bernaerts

Barbier

Abeloos

et al. 2020

Semin Musculoskelet Radiol

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With the introduction of cone beam computed tomography (CBCT) into dentistry in the 1990s, radiologists have become more frequently involved in dental implant planning. This article describes the information that should be included in a radiology report to achieve a successful implantation. The justification to use CBCT during the preoperative planning phase is based on the need to evaluate patient-specific anatomy in detail (general condition of the jaw, bone quantity, and bone quality), the application of more advanced surgical techniques (maxillary sinus augmentation procedure, zygomatic implants), and the integrated presurgical planning and virtual patient approach. Postoperatively, CBCT is used when implant retrieval is anticipated and two-dimensional radiographs have not provided sufficient information, for evaluation of graft healing, or to assess complications, mostly related to neurovascular trauma.

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Diagnostic performance of cone beam computed tomography in assessing peri‐implant bone loss: A systematic review

Abstract: In vitro, CBCT performs well in detecting peri-implant circumferential-intrabony or fenestration defects but less in depicting dehiscences. Influencing factors due to other site-related and technical parameters on the diagnostic outcome need to be addressed further in the future studies.

Cited by 30 publications

References 83 publications

In vitro diagnostic accuracy of low‐dose CBCT for evaluation of peri‐implant bone lesions

In vitro diagnostic accuracy of low‐dose CBCT for evaluation of peri‐implant bone lesions

Morphology and severity of peri‐implantitis bone defects

Cone Beam Computed Tomography Imaging in Dental Implants: A Primer for Clinical Radiologists

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