Reliability of Orthopantomography and Cone-beam Computed Tomography in Presurgical Implant Planning: A Clinical Study.

Abstract

Preoperative diagnosis and treatment planning are fundamental requirements to ensure success rate of implant. Cone-beam computed tomography (CBCT) provides all three dimensions and has been proved as a tool for radiology, especially in the success of implant. This study was conducted to evaluate the reliability of orthopantomography (OPG) and CBCT in presurgical implant planning. The study was conducted on 110 partially or completely edentulous adult patients (male 50 and female 60). Patient information regarding name, age, gender, and so forth was recorded. Thorough clinical examination was done to locate the edentulous site for the placement of implant. All patients were subjected to OPG and CBCT. The OPG was taken with digital panoramic unit (Planmeca) operating at 120 kVp, 2 mA, and exposure time of 17 seconds. The CBCT was taken using NewTom machine with field of view 11 × 8 cm and resolution of 0.3 × 0.3 × 0.3 mm operating at 120 kVp at 5 mA. NNT software with slice thickness of 0.1 mm was used in this study. Measurement of bone height and distance from anatomical structures was done on OPG, whereas bone height and bone width were measured on CBCT scan in all three planes, such as coronal plane, sagittal plane, and axial plane. The measurement was done by two experienced observers. The present study comprised 110 patients (male 50 and female 60). About 102 (16.7%) implants were placed in anterior region, and 508 (83.3%) implants were placed in posterior region. Implant site was incisor region (55), canine (30), premolar (250), and molar (275). The difference was significant (p < 0.01). Variations are usually observed in presurgical planning with CBCT and OPG. The length and width of implant remained unchanged in 90 and 85% of the cases respectively. In 8% of cases, OPG revealed more length of implant than CBCT, whereas only in 2% cases CBCT revealed more length of implant than OPG. The difference was significant (p < 0.05). When we compared the diameter, OPG revealed more diameter in 10% of cases, whereas CBCT only revealed 5% of cases. The difference was significant (p < 0.05). Observer found CBCT as effective in 95% of cases and ineffective in only 5% of cases, whereas OPG was effective in 78% of cases and ineffective in 22% of cases. The different was significant (p < 0.05). The CBCT being three-dimensional provides detailed information that two-dimensional radiographs cannot offer, which aids in precision to further improve the entire implant process. In recent times, implant has become the treatment of choice for edentulous patients. The CBCT has increased the success rate of implant due to its high resolution, ability to demonstrate anatomical structures more effectively than other radiographic diagnostic tools.