Measurement of Peri-Implant Bone Width with and without Metal Artifact Reduction Algorithm Using Two Cone-Beam Computed Tomography Software Programs

Morad Hedayatipanah,Fatemeh Salemi,Ashkan Yalpanian,Naser Kamyari

doi:10.1590/pboci.2021.118

Abstract

Objective: To assess the effect of metal artifact reduction (MAR) algorithm of two cone-beam computed tomography (CBCT) software programs on the accuracy of peri-implant bone width measurements . Material and Methods: This in vitro study evaluated 35 bovine rib bone blocks measuring 8 x 8 x 11 mm. Titanium implants were inserted in bone blocks and placed in a wax model of mandible. CBCT scans were obtained with ProMax 3D and Cranex 3D CBCT systems with and without the MAR algorithm. The width of buccal and lingual bone plates surrounding the implant was measured on CBCT scans by two observers. The Cronbach’s alpha was calculated to assess inter-observer agreement. The area under the curve (AUC), sensitivity and specificity values were calculated and compared. Results: The two observers had an excellent agreement. The accuracy of Cranex 3D was higher than that of ProMax 3D (p<0.05). Both CBCT systems showed higher accuracy when the MAR algorithm was not used (p<0.05). Both CBCT systems showed higher accuracy for measuring the width of the lingual plate than buccal plate (p<0.05) . Conclusion: The application of MAR algorithm did not notably increase the measurement accuracy in any CBCT system. Cranex 3D showed generally higher measurement accuracy than ProMax 3D.

Highlights

Dental implants are increasingly used for replacement of lost teeth [1,2]
cone-beam computed tomography (CBCT) scans were obtained with ProMax 3D and Cranex 3D CBCT systems with and without the metal artifact reduction (MAR) algorithm
The results showed that on both ProMax 3D and Cranex 3D CBCT scans, enabling the MAR algorithm resulted in underestimation of bone width compared with no use of MAR

Summary

Introduction

Long-term clinical assessment of dental implants and their supporting structures can provide valuable information regarding the success and failure of implant restorations [3]. Inadequate bone volume or quality can compromise the long-term prognosis of dental implants [4]. Periapical or panoramic radiographic modalities are commonly used for the assessment of dental implant status. These imaging modalities are two-dimensional and provide two-dimensional images of three-dimensional (3D) structures and suffer from superimposition. They do not have adequately high resolution and can lead to erroneous measurements or misinterpretations [5,6]

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Conclusion