Planning of dental implant size with digital panoramic radiographs, CBCT-generated panoramic images, and CBCT cross-sectional images

• Published in: Clinical oral implants research Vol. 25; no. 6; pp. 690 - 695
• Main Authors: Correa, Leticia Ruhland, Spin-Neto, Rubens, Stavropoulos, Andreas, Schropp, Lars, da Silveira, Heloísa Emília Dias, Wenzel, Ann
• Format: Journal Article
• Language: English
• Published: Denmark Blackwell Publishing Ltd 01-06-2014
• Subjects: Adult; Aged; Cone-Beam Computed Tomography; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Dentistry; digital panoramic radiography; Female; Humans; implant planning; implant size; Male; Middle Aged; Patient Care Planning; Preoperative Care; Radiography, Panoramic; Software; implant planning; digital panoramic radiography; implant size; cone beam computed tomography
• ISSN: 0905-7161; 1600-0501; 1600-0501
• DOI: 10.1111/clr.12126

Objectives
To compare the implant size (width and length) planned with digital panoramic radiographs, cone beam computed tomography (CBCT)‐generated panoramic views, or CBCT cross‐sectional images, in four implant systems.
Material and methods
Seventy‐one patients with a total of 103 implant sites in the upper premolar and/or lower molar regions were examined with digital panoramic radiography (D‐PAN) and (CBCT). A metal ball 5 mm in diameter was placed in the edentulous area for the D‐PAN. CBCT data sets were reformatted to a 10‐mm thick CBCT panoramic view (CBCT‐pan) and 1‐mm cross‐sections (CBCT‐cross). Measurements were performed in the images using dedicated software. All images were displayed on a monitor and assessed by three observers who outlined a dental implant by placing four reference points in the site of the implant‐to‐be. Differences in width and length of the implant‐to‐be from the three modalities were analyzed. The implant size selected in the CBCT‐cross images was then compared to that selected in the other two modalities (D‐PAN and CBCT‐pan) for each of the implant systems separately.
Results
The implant‐to‐be (average measurements among observers) was narrower when measured in CBCT‐cross compared with both D‐PAN and CBCT‐Pan. For premolar sites, the width also differed significantly between D‐PAN and CBCT‐pan modalities. The implant‐to‐be was also significantly shorter when recorded in CBCT‐cross than in D‐PAN. In premolar sites, there were no significant differences in implant length among the three image modalities. It mattered very little for the change in implant step sizes whether CBCT‐cross was compared to D‐PAN or CBCT‐pan images.
Conclusion
Our results show that the selected implant size differs when planned on panoramic or cross‐section CBCT images. In most cases, implant size measured in cross‐section images was narrower and shorter than implant size measured in a panoramic image or CBCT‐based panoramic view.