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Intraoral radiography lacks accuracy for the assessment of peri-implant bone level: a controlled clinical study
Ghent University, Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent, Belgium.
University of Leuven, Faculty of Medicine, Department of Imaging and Pathology, Omfs Impath research group, University Hospitals Leuven Department of Maxillofacial Surgery, Leuven, 3000, Belgium; Karolinska Institutet, Department of Dental Medicine, Stockholm, Sweden.ORCID iD: 0000-0002-3461-0363
Ghent University, Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent, Belgium.
Ghent University, Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent, Belgium.
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2017 (English)In: European Journal of Oral Implantology, ISSN 1756-2406, E-ISSN 1756-2414, Vol. 10, no 4, p. 435-441Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim of this study was to compare clinical and radiographic bone level assessments to intra-surgical bone level registration around implants with peri-implantitis and to identify the clinical variables rendering peri-implant bone level assessment accuracy. Materials and methods: The study sample included 50 implants with peri-implantitis in 23 patients. Registration methods included probing of the vertical distance between the implant/abutment interface and the bottom of the pocket (= VPD), intraoral radiography, bone sounding without flap elevation and intra-surgically assessed interproximal bone level. The latter was considered the true bone level (gold standard). Twenty clinicians evaluated all radiographs. Results: VPD and intraoral radiography resulted in a significant underestimation of the true bone level by 1.0 mm (95% CI: 0.495-1.585; P < 0.001) and 2.3 mm (95% CI: 1.650-2.980; P < 0.013) respectively. Bone sounding without flap elevation did not differ significantly from the true bone level (mean difference 0.2 mm; 95% CI: -0.775 - 0.335; P = 0.429). Duplicate magnification registration of 50 implants resulted in excellent intra- and inter-rater reliability (ICC intra <= 0.99; ICC inter = 0.964; P < 0.001). Radiographic underestimation was significantly affected by defect depth (P < 0.001). Variation among clinicians was substantial (mean underestimation range 1.1 mm to 3.8 mm); however, clinical experience had no impact on radiographic underestimation (P = 0.796). Conclusions: Bone sounding without flap elevation was the best predictor of peri-implant bone level, whereas intraoral radiography was the most inferior. Consequently, peri-implantitis may be under-diagnosed if examination is only based on radiographs.

Place, publisher, year, edition, pages
Quintessence , 2017. Vol. 10, no 4, p. 435-441
Keywords [en]
bone defect, clinical experience, implant, intraoral radiography, peri-implantitis
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-39395ISI: 000423125400007PubMedID: 29234750Scopus ID: 2-s2.0-85037745925OAI: oai:DiVA.org:mau-39395DiVA, id: diva2:1519656
Available from: 2021-01-19 Created: 2021-01-19 Last updated: 2024-06-17Bibliographically approved

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Jacobs, ReinhildeDe Bruyn, Hugo
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