Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 14040-904, Brazil.
Departament of Stomatology, Public Health, and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 14040-904, Brazil.
Clin Oral Investig. 2019 Feb;23(2):929-936. doi: 10.1007/s00784-018-2511-1. Epub 2018 Jun 16.
This study investigated whether professional experience and type of image examination (panoramic radiography (PAN) or cone beam computed tomography (CBCT)) could influence the pre-surgical planning for dental implant treatment.
Six dentists, from two different levels of experience (senior (Sr) and junior (Jr)) performed simulated pre-surgical planning by using PANs and after 1 month, by using CBCTs, considering implant length (IL), implant width (IW), need for bone graft (BG), and other surgical procedures (OP). Bland-Altman test and Kappa coefficient were used to identify agreements.
Bland-Altman test showed good agreement in the plans for inter-professional (i.e., Sr vs Jr) comparisons. Bland-Altman plots displayed intra-observer agreement (i.e., differences between PAN and CBCT), showing discrepancy between imaging modalities for IL and a tendency towards selecting larger dental implant options when using PAN and smaller options with CBCT. Kappa showed almost perfect (0.81-1.0) agreement between Jr and Sr for OP (PAN and CBCT). For BG, agreement was substantial (0.61-0.80) when planning was done with PAN and CBCT. Descriptive statistics showed evidence that when Jrs used CBCT, they no longer indicated the BG they had planned when they used PAN.
There were differences in the pre-surgical planning for treatment with dental implants depending on the professional experience and the type of imaging examination used.
Variation in dental implant planning can affect treatment time, cost, and morbidity in patients.
本研究旨在探讨专业经验和影像检查类型（全景放射摄影（PAN）或锥形束计算机断层扫描（CBCT））是否会影响牙种植术前规划。
6 名牙医，分别具有不同经验水平（高级（Sr）和初级（Jr）），通过使用 PAN 进行模拟术前规划，1 个月后使用 CBCT 进行规划，考虑种植体长度（IL）、种植体宽度（IW）、是否需要骨移植（BG）和其他手术程序（OP）。采用 Bland-Altman 检验和 Kappa 系数来评估一致性。
Bland-Altman 检验显示不同专业之间（即 Sr 与 Jr）的规划具有良好的一致性。Bland-Altman 图显示了观察者内的一致性（即 PAN 与 CBCT 之间的差异），表明 IL 的两种成像方式之间存在差异，并且使用 PAN 时倾向于选择较大的牙种植体选项，而使用 CBCT 时则选择较小的选项。Kappa 显示 Jr 和 Sr 之间在 OP（PAN 和 CBCT）方面具有近乎完美的（0.81-1.0）一致性。对于 BG，当使用 PAN 和 CBCT 进行规划时，一致性为高度（0.61-0.80）。描述性统计数据表明，当 Jr 使用 CBCT 时，他们不再指示当他们使用 PAN 时计划的 BG。
根据专业经验和使用的影像检查类型，牙种植术前规划存在差异。
牙种植体规划的差异可能会影响患者的治疗时间、成本和发病率。
