OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
West China College of Stomatology, State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Disease, Sichuan University, Chengdu, China.
BMC Med Imaging. 2021 Feb 10;21(1):23. doi: 10.1186/s12880-021-00557-9.
Early detection of marginal bone loss is vital for treatment planning and prognosis of teeth and implant. This study was conducted to assess diagnostic accuracy of CBCT compared to intra-oral (IO) radiography for detection, classification, and measurement of peri-implant bone defects in an animal model.
Fifty-four mandible blocks with implants were harvested from nine male health adult beagle dogs with acquisition of IO, CBCT and micro-CT images from all samples. Peri-implant bone defects from 16 samples were diagnosed using micro-CT and classified into 3 defect categories: dehiscence (n = 5), infrabony defect (n = 3) and crater-like defect (n = 8). Following training and calibration of the observers, they asked to detect location (mesial, distal, buccal, lingual) and shape of the defect (dehiscence, horizontal defect, vertical defect, carter-like defect) utilizing both IO and CBCT images. Both observers assessed defect depth and width on IO, CBCT and micro-CT images at each side of peri-implant bone defect via CT-analyzer software. Data were analyzed using SPSS software and a p value of < 0.05 was considered as statistically significant.
Overall, there was a high diagnostic accuracy for detection of bone defects with CBCT images (sensitivity: 100%/100%), while IO images showed a reduction in accuracy (sensitivity: 69%/63%). Similarly, diagnostic accuracy for defect classification was significantly higher for CBCT, whereas IO images were unable to correctly identify vestibular dehiscence, with incorrect assessment of half of the infrabony defects. For accuracy of measuring defect depth and width, a higher correlation was observed between CBCT and gold standard micro-CT (r = 0.91, 95% CI 0.86-0.94), whereas a lower correlation was seen for IO images (r = 0.82, 95% CI 0.67-0.91).
The diagnostic accuracy and reliability of CBCT was found to be superior to IO imaging for the detection, classification, and measurement of peri-implant bone defects. The application of CBCT adds substantial information related to the peri-implant bone defect diagnosis and decision-making which cannot be achieved with conventional IO imaging.
早期发现边缘骨丢失对于牙齿和种植体的治疗计划和预后至关重要。本研究旨在评估 CBCT 与口腔内（IO）放射照相术相比，在动物模型中检测、分类和测量种植体周围骨缺损的诊断准确性。
从 9 只健康成年比格犬的 54 个下颌骨块中采集样本，从所有样本中获取 IO、CBCT 和微 CT 图像。从 16 个样本中的种植体周围骨缺损使用微 CT 进行诊断，并将其分类为 3 种缺损类型：骨开裂（n=5）、骨内缺损（n=3）和火山口状缺损（n=8）。在对观察者进行培训和校准后，他们要求利用 IO 和 CBCT 图像来检测缺损的位置（近中、远中、颊侧、舌侧）和形状（骨开裂、水平缺损、垂直缺损、火山口状缺损）。两位观察者分别使用 CT 分析仪软件在 IO、CBCT 和微 CT 图像上评估每个种植体周围骨缺损侧的缺损深度和宽度。使用 SPSS 软件进行数据分析，p 值<0.05 被认为具有统计学意义。
总体而言，CBCT 图像对骨缺损的检测具有很高的诊断准确性（敏感性：100%/100%），而 IO 图像的准确性则降低（敏感性：69%/63%）。同样，CBCT 对缺损分类的诊断准确性显著更高，而 IO 图像无法正确识别颊侧骨开裂，对一半的骨内缺损的评估不正确。对于测量缺损深度和宽度的准确性，CBCT 与金标准微 CT 之间的相关性更高（r=0.91，95%CI 0.86-0.94），而 IO 图像的相关性较低（r=0.82，95%CI 0.67-0.91）。
与 IO 成像相比，CBCT 对种植体周围骨缺损的检测、分类和测量的诊断准确性和可靠性更高。CBCT 的应用增加了与种植体周围骨缺损诊断和决策相关的大量信息，而这是常规 IO 成像无法实现的。
