Vidor Michele Machado, Liedke Gabriela Salatino, Fontana Mathias Pante, da Silveira Heraldo Luis Dias, Arus Nadia Assein, Lemos André, Vizzotto Mariana Boessio
Oral Radiology, Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Oral Radiology, Department of Stomatology, School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Nov;124(5):500-505. doi: 10.1016/j.oooo.2017.07.008. Epub 2017 Aug 3.
The aim of this study was to evaluate the accuracy of cone beam computed tomography (CBCT) for evaluation of the bone-implant interface in comparison with periapical radiography.
Titanium implants were inserted in 74 bovine rib blocks in intimate contact with bone walls and with a gap of 0.125 mm (simulating failure in the osseointegration process). Periapical radiographs were taken with conventional film, and CBCT scans were acquired with i-CAT (0.2 mm and 0.125 mm voxel) and Kodak (0.2 mm and 0.076 mm voxel) units. Three examiners evaluated the images using a 5-point scale. Diagnostic accuracy was analyzed through sensitivity, specificity, and the area under the receiver operating characteristic (ROC) curve (AUC) with 95% confidence intervals (CIs). Intra- and interexaminer agreements were analyzed through Kendall's concordance test.
Intra- and interexaminer agreements showed satisfactory results. The greatest accuracy was observed with conventional radiography (AUC = 0.963; CI 95% = 0.891-0.993). I-CAT 0.125-mm images showed good accuracy (AUC = 0.885; CI 95% = 0.790-0.947), with no significant difference compared with conventional radiography. Kodak images had high specificity and low sensitivity, presenting more false-negative results.
Conventional radiography showed the highest accuracy for assessment of the bone-implant interface. However, CBCT (i-CAT; 0.125-mm voxel), if available or if performed for preoperative assessment of another implant site, may provide similar accuracy.
本研究旨在与根尖片比较，评估锥形束计算机断层扫描（CBCT）对骨-种植体界面评估的准确性。
将钛种植体植入74个与骨壁紧密接触且间隙为0.125毫米（模拟骨整合过程失败）的牛肋骨块中。用传统胶片拍摄根尖片，并用i-CAT（体素为0.2毫米和0.125毫米）和柯达（体素为0.2毫米和0.076毫米）设备进行CBCT扫描。三名检查者使用5分制对图像进行评估。通过敏感性、特异性和接受者操作特征（ROC）曲线下面积（AUC）及95%置信区间（CI）分析诊断准确性。通过肯德尔一致性检验分析检查者内和检查者间的一致性。
检查者内和检查者间的一致性显示出满意的结果。传统放射成像观察到最高的准确性（AUC = 0.963；95%CI = 0.891 - 0.993）。i-CAT 0.125毫米图像显示出良好的准确性（AUC = 0.885；95%CI = 0.790 - 0.947），与传统放射成像相比无显著差异。柯达图像具有高特异性和低敏感性，呈现更多假阴性结果。
传统放射成像在评估骨-种植体界面方面显示出最高的准确性。然而，CBCT（i-CAT；体素为0.125毫米），如果可用或用于术前评估另一个种植部位，可能提供相似的准确性。
