Bittar-Cortez J A, Passeri L A, de Almeida S M, Haiter-Neto F
Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Brazil.
Dentomaxillofac Radiol. 2006 Jul;35(4):258-62. doi: 10.1259/dmfr/84778143.
Radiographic assessment of marginal bone height is included in longitudinal control of osseointegrated implants. However, accurate and reproducible results are difficult to obtain. The aim of the present study was to examine the differences between linear measurements in digitized radiographs (DR) and digital subtraction images (DSI) around endosseous implants and the interobserver variability.
The bone height around 30 implants in 22 patients was assessed by 5 observers. Standardized periapical radiographs were obtained just after the surgery and 4 months later. The radiographs were digitized and manipulated by means of EMAGO software, and linear and logarithmic DSIs were produced. Furthermore, the logarithmic subtraction was enhanced with the use of a filter. The observers had the DRs and three methods of subtraction to assess bone height. ANOVA statistical procedures were applied to analyse differences between the observers in the four assessed images and the Tukey test was used to evaluate the differences between the images.
Comparison of the bone height assessments indicated significantly (P<0.05) higher values in the DR than the three methods of DSI. The observers also had a statistically significant variability in this assessment (P=0.00003).
DSI demonstrated lower values of linear measurements of the bone height around endosseous implants, compared with DR. Interobserver variability should be considered when comparing values from follow-up studies.
在骨结合种植体的纵向控制中纳入对边缘骨高度的影像学评估。然而，难以获得准确且可重复的结果。本研究的目的是检查数字化根尖片（DR）和骨内种植体周围数字减影图像（DSI）中线性测量值之间的差异以及观察者间的变异性。
由5名观察者评估22例患者中30枚种植体周围的骨高度。在手术后即刻和4个月后获取标准化根尖片。使用EMAGO软件将根尖片数字化并进行处理，生成线性和对数DSI。此外，通过使用滤波器增强对数减法。观察者使用DR和三种减法方法评估骨高度。应用方差分析统计程序分析四名观察者在四张评估图像中的差异，并使用Tukey检验评估图像之间的差异。
骨高度评估的比较表明，DR中的值显著高于DSI的三种方法（P<0.05）。观察者在该评估中也存在统计学上显著的变异性（P=0.00003）。
与DR相比，DSI显示骨内种植体周围骨高度的线性测量值较低。在比较随访研究的值时应考虑观察者间的变异性。
