Tzortzakis N-G, Damaskos S, Dimakopoulou K, Chatzipetros E, Angelopoulos C
Department of Oral Diagnosis and Radiology Faculty of Dentistry, National and Kapodistrian University of Athens 2 Thivon Str, 115 27, Goudi, Athens, Greece
Med Oral Patol Oral Cir Bucal. 2025 May 1;30(3):e322-e332. doi: 10.4317/medoral.26777.
Data on the radiographic interpretation of peri-implantitis is still controversial. Thus, our study aimed to: a) investigate the detectability rate of ex-vivo induced peri-implant bone defects (PBDs) between observers using two different imaging methods; Cone Beam Computed Tomography (CBCT) and Periapical Radiographs (PAs), b) investigate the observers' agreement on their ability to detect PBDs according to their level of expertise and, c) determine the sensitivity and specificity of the imaging methods used to detect induced PBDs.
Two dried human mandibles were used in which ten dental implants were placed and eight PBDs were created simulating clinical conditions. Radiographic examination using PAs and two CBCT modes [CBCT/N (normal/0.3mm3), and CBCT/HR (HiRes/0.15mm3)] was performed at all experimental stages. All PBDs were recorded for their dimensions using a dental periodontal probe as they were used as a gold standard (GS). Finally, 145 images (49 PAs, 48 CBCT/N, and 48 CBCT/HR) were created and evaluated by nine independent observers. Three oral radiologists (OR), three implantologists (IS), and three general practitioners (GP).
PBDs were detected at a higher rate by ORs compared to ISs, and GPs. However, the rate of their agreement, did not reach the nominal level of significance (z-test p-value> 0.05), and also between observers of the same expertise, and between the different imaging methods used: CBCT and PAs (z-test p-value> 0.05). In total, the sensitivity of the CBCTs and PAs method was 95% and 80.5%, respectively. While the specificity for all methods was lower, 57%, 62.2% and 50.4% for CBCT/N, CBCT/H and PAs methods, respectively.
Although CBCT performs better than PAs in ex-vivo induced PBDs, further research is needed to evaluate if the present results can be extrapolated to other clinical scenarios and defect configurations.
关于种植体周炎的影像学解读数据仍存在争议。因此，我们的研究旨在：a）使用两种不同的成像方法，即锥形束计算机断层扫描（CBCT）和根尖片（PA），调查观察者对离体诱导种植体周围骨缺损（PBD）的检出率；b）根据观察者的专业水平，调查他们在检测PBD能力方面的一致性；c）确定用于检测诱导性PBD的成像方法的敏感性和特异性。
使用两块干燥的人类下颌骨，其中植入了10颗牙种植体，并模拟临床情况制造了8处PBD。在所有实验阶段均使用PA和两种CBCT模式[CBCT/N（标准/0.3mm³）和CBCT/HR（高分辨率/0.15mm³）]进行影像学检查。使用牙周探针记录所有PBD的尺寸，将其用作金标准（GS）。最后，创建了145张图像（49张PA、48张CBCT/N和48张CBCT/HR），并由9名独立观察者进行评估。其中包括三名口腔放射科医生（OR）、三名种植专科医生（IS）和三名全科医生（GP）。
与IS和GP相比，OR检测到PBD的比率更高。然而，他们的一致率未达到名义显著性水平（z检验p值>0.05），在相同专业的观察者之间以及所使用的不同成像方法（CBCT和PA）之间也是如此（z检验p值>0.05）。总体而言，CBCT和PA方法的敏感性分别为95%和80.5%。虽然所有方法的特异性较低，CBCT/N、CBCT/H和PA方法的特异性分别为57%、62.2%和50.4%。
尽管在离体诱导的PBD中，CBCT的表现优于PA，但仍需要进一步研究，以评估目前的结果是否可以外推到其他临床场景和缺损形态。
