Imaging Sci Dent.  2014 Sep;44(3):213-220. 10.5624/isd.2014.44.3.213.

Preoperative implant planning considering alveolar bone grafting needs and complication prediction using panoramic versus CBCT images

• Guerrero M
• Noriega J
• Jacobs R

• KMID: 1974485
• DOI: http://doi.org/10.5624/isd.2014.44.3.213

Abstract

PURPOSE
This study was performed to determine the efficacy of observers' prediction for the need of bone grafting and presence of perioperative complications on the basis of cone-beam computed tomography (CBCT) and panoramic radiographic (PAN) planning as compared to the surgical outcome.
MATERIALS AND METHODS
One hundred and eight partially edentulous patients with a need for implant rehabilitation were referred for preoperative imaging. Imaging consisted of PAN and CBCT images. Four observers carried out implant planning using PAN image datasets, and at least one month later, using CBCT image datasets. Based on their own planning, the observers assessed the need for bone graft augmentation as well as complication prediction. The implant length and diameter, the need for bone graft augmentation, and the occurrence of anatomical complications during planning and implant placement were statistically compared.
RESULTS
In the 108 patients, 365 implants were installed. Receiver operating characteristic analyses of both PAN and CBCT preoperative planning showed that CBCT performed better than PAN-based planning with respect to the need for bone graft augmentation and perioperative complications. The sensitivity and the specificity of CBCT for implant complications were 96.5% and 90.5%, respectively, and for bone graft augmentation, they were 95.2% and 96.3%, respectively. Significant differences were found between PAN-based planning and the surgery of posterior implant lengths.
CONCLUSION
Our findings indicated that CBCT-based preoperative implant planning enabled treatment planning with a higher degree of prediction and agreement as compared to the surgical standard. In PAN-based surgery, the prediction of implant length was poor.

Keyword

Dental Implants; Cone-Beam Computed Tomography; Alveolar Bone Grafting; Radiography, Panoramic

MeSH Terms

Alveolar Bone Grafting*
Bone Transplantation
Cone-Beam Computed Tomography
Dataset
Dental Implants
Humans
Radiography, Panoramic
Rehabilitation
ROC Curve
Sensitivity and Specificity
Transplants
Dental Implants

Figure

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  Fig. 1 Receiver operating characteristic (ROC) analysis reveals an excellent diagnostic accuracy of CBCT for the planning of complications and the diagnosis of bone graft augmentation with an area under the curve (AUC) of 0.94.

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  Fig. 2 A. CBCT shows the posterior superior alveolar artery before creating a lateral window into the maxillary sinus. B. The artery is seen during the sinus lift procedure located at 15 mm from the alveolar crest as diagnosed with CBCT.

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