Abstract：
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.
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.
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.
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.
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.
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.
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.
摘要：
背景：对种植体周围骨状况进行早期准确的影像学评估对于避免支撑骨过度丢失和种植体失效非常重要。如果怀疑植入物周围开裂和开窗缺陷，锥束计算机断层扫描（CBCT）是首选的射线照相技术。较高的辐射剂量和射束硬化伪影的存在是CBCT成像技术的主要缺点。本研究旨在评估低剂量锥形束计算机断层扫描（LD-CBCT）和金属伪影减少（MAR）工具对评估种植体周围开裂和开窗的影响。
方法：将30个钛植入物插入牛肋骨块中。20例具有标准化的骨缺损（10例开裂，10例开窗），其余10例作为无缺陷的对照组。使用高清晰度CBCT（HD-CBCT）和LD-CBCT进行射线照相检查，无论是否使用MAR工具。由四名检查者评估图像是否存在植入物周围缺陷。受试者工作特征(ROC)曲线(AUC)下面积,灵敏度,特异性，并计算所有射线照相方案的准确性.
结果：在没有MAR工具的情况下，LD-CBCT和HD-CBCT检测两种缺陷的AUC和诊断价值无差异.应用MAR工具时，AUC值，灵敏度,对于两种缺陷的检测，HD-CBCT的准确性高于LD-CBCT，尤其是对于开裂，而特异性保持不变。
结论：LD-CBCT可用于评估种植体周围裂开和开窗，而不会降低诊断准确性。MAR工具的应用降低了两种缺陷的诊断能力，特别是用于检测开裂缺陷。
方法：将30个钛植入物插入牛肋骨块中。20例具有标准化的骨缺损（10例开裂，10例开窗），其余10例作为无缺陷的对照组。使用高清晰度CBCT（HD-CBCT）和LD-CBCT进行射线照相检查，无论是否使用MAR工具。由四名检查者评估图像是否存在植入物周围缺陷。受试者工作特征(ROC)曲线(AUC)下面积,灵敏度,特异性，并计算所有射线照相方案的准确性.
结果：在没有MAR工具的情况下，LD-CBCT和HD-CBCT检测两种缺陷的AUC和诊断价值无差异.应用MAR工具时，AUC值，灵敏度,对于两种缺陷的检测，HD-CBCT的准确性高于LD-CBCT，尤其是对于开裂，而特异性保持不变。
结论：LD-CBCT可用于评估种植体周围裂开和开窗，而不会降低诊断准确性。MAR工具的应用降低了两种缺陷的诊断能力，特别是用于检测开裂缺陷。
