Leisner Laura Christine, Tasaka Akinori, Trebing Charlotte Theresa, Hilgenfeld Tim, Kosinski Matthias Adalbert, Kronsteiner Dorothea, Rammelsberg Peter, Schwindling Franz Sebastian
Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany.
Department of Removable Partial Prosthodontics, Tokyo Dental College, Tokyo, Japan.
J Prosthodont Res. 2022 Apr 27;66(2):326-332. doi: 10.2186/jpr.JPR_D_20_00110. Epub 2021 Jul 21.
High-definition cone-beam computed tomography (HD-CBCT) offers superior image quality at the cost of higher radiation dose compared to low-dose CBCT (LD-CBCT). The aim of this study was to investigate whether peri-implant bone lesions can be accurately quantified using LD-CBCT, even when including the influence of surrounding tissues.
Twelve titanium implants restored with all-ceramic crowns were placed in bovine bone, and peri-implant lesions were prepared. Radiographic imaging was performed using IR (intraoral radiography), HD-CBCT and LD-CBCT. To simulate the in-vivo situation, the samples were placed inside a dry human mandible, and a second LD-CBCT imaging was performed (LD-CBCT*). The datasets were presented to four observers in random order. Maximum lesion depth and width were measured in a standardized mesiodistal slice in IR, HD-CBCT, LD-CBCT, and LD-CBCT*. Mean lesion depth and width measurements for each sample in HD-CBCT served as reference.
Interrater agreement was slight for depth and excellent for width in HD-CBCT and both LD modes. For all observers, measurement deviations from HD-CBCT were below 0.3 mm in the LD protocols (LD-CBCT depth: 0.22 ± 0.17 mm, width: 0.22 ± 0.13 mm; LD-CBCT* depth: 0.24 ± 0.23 mm, width: 0.25 ± 0.21 mm) and at 0.4 mm in IR.
Absolute differences between LD-CBCT and HD-CBCT are small, although surrounding tissues decrease LD-CBCT image quality. Within the limitations of an in-vitro trial, LD-CBCT may become an adequate imaging modality for monitoring peri-implant lesions at a substantially decreased radiation dose.
与低剂量锥形束计算机断层扫描（LD-CBCT）相比，高分辨率锥形束计算机断层扫描（HD-CBCT）能提供更高质量的图像，但辐射剂量也更高。本研究的目的是调查即使考虑周围组织的影响，使用LD-CBCT能否准确量化种植体周围骨病变。
将12颗用全瓷冠修复的钛种植体植入牛骨中，并制备种植体周围病变。使用口内放射摄影（IR）、HD-CBCT和LD-CBCT进行影像学检查。为模拟体内情况，将样本置于干燥的人类下颌骨内，并进行第二次LD-CBCT成像（LD-CBCT*）。将数据集以随机顺序呈现给四名观察者。在IR、HD-CBCT、LD-CBCT和LD-CBCT*的标准化近远中切片中测量病变的最大深度和宽度。以HD-CBCT中每个样本的平均病变深度和宽度测量值作为参考。
在HD-CBCT和两种LD模式下，观察者间在深度测量上的一致性为轻微一致，在宽度测量上为优秀一致。对于所有观察者，在LD方案中（LD-CBCT深度：0.22±0.17mm，宽度：0.22±0.13mm；LD-CBCT*深度：0.24±0.23mm，宽度：0.25±0.21mm），与HD-CBCT的测量偏差低于0.3mm，在IR中为0.4mm。
尽管周围组织会降低LD-CBCT的图像质量，但LD-CBCT与HD-CBCT之间的绝对差异较小。在体外试验的局限性内，LD-CBCT可能成为一种足够的成像方式，以显著降低的辐射剂量监测种植体周围病变。
