Sewerin I P, Gotfredsen K, Stoltze K
Department of Radiology, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark.
Clin Oral Implants Res. 1997 Aug;8(4):299-304. doi: 10.1034/j.1600-0501.1997.080408.x.
The absence of a peri-implant radiolucency on radiographs is used as a criterion for implant success. The purpose of the present study was to evaluate the accuracy of diagnosing peri-implant radiolucencies using an experimental model. Astra Tech fixtures were inserted into 20 bony specimens. Later, the fixtures were removed and the prepared cavities were enlarged in 2 steps. The specimens were radiographed under strictly standardized circumstances in the 3 stages ("press-fit" = simulated osseointegration, and "0.1 mm space" and "0.175 mm space" = simulated connective tissue layer). All specimens were radiographed with 2 vertical angulations (0 degree and 15 degrees). Ten observers read the radiographs and evaluated bone-implant relationship on a 5-point scale. The interobserver agreement was low. Specificity was remarkably low, and sensitivity was moderate. A significant difference in diagnostic accuracy was found for 0.175 mm peri-implant-space compared to 0.1 mm space. The diagnostic accuracy was found to be highest for 0.175 mm peri-implant space specimens. It is concluded, that radiography seems to be an unreliable method for diagnosing peri-implant spaces, although accuracy improved at increasing space widths. Strict orthogonal projection angles did not improve diagnostic accuracy.
X线片上种植体周围无透射区被用作种植成功的标准。本研究的目的是使用实验模型评估诊断种植体周围透射区的准确性。将Astra Tech种植体植入20个骨标本中。之后，取出种植体并分两步扩大预备的牙槽窝。在三个阶段（“压配”=模拟骨结合，“0.1 mm间隙”和“0.175 mm间隙”=模拟结缔组织层）在严格标准化的条件下对标本进行X线摄影。所有标本均以两个垂直角度（0度和15度）进行X线摄影。10名观察者阅读X线片并以5分制评估骨-种植体关系。观察者间的一致性较低。特异性显著较低，敏感性中等。与0.1 mm间隙相比，0.175 mm种植体周围间隙的诊断准确性存在显著差异。发现0.175 mm种植体周围间隙标本的诊断准确性最高。得出的结论是，尽管随着间隙宽度增加准确性有所提高，但X线摄影似乎是诊断种植体周围间隙的不可靠方法。严格的正交投照角度并未提高诊断准确性。
