Imaging Sci Dent.  2014 Jun;44(2):121-128. 10.5624/isd.2014.44.2.121.

Does cone-beam CT alter treatment plans? Comparison of preoperative implant planning using panoramic versus cone-beam CT images

• Guerrero M
• Noriega J
• Castro C
• Jacobs R

• KMID: 1799593
• DOI: http://doi.org/10.5624/isd.2014.44.2.121

Abstract

PURPOSE
The present study was performed to compare the planning of implant placement based on panoramic radiography (PAN) and cone-beam computed tomography (CBCT) images, and to study the impact of the image dataset on the treatment planning.
MATERIALS AND METHODS
One hundred five partially edentulous patients (77 males, 28 females, mean age: 46 years, range: 26-67 years) seeking oral implant rehabilitation were referred for presurgical imaging. Imaging consisted of PAN and CBCT imaging. Four observers planned implant treatment based on the two-dimensional (2D) image datasets and at least one month later on the three-dimensional (3D) image dataset. Apart from presurgical diagnostic and dimensional measurement tasks, the observers needed to indicate the surgical confidence levels and assess the image quality in relation to the presurgical needs.
RESULTS
All observers confirmed that both imaging modalities (PAN and CBCT) gave similar values when planning implant diameter. Also, the results showed no differences between both imaging modalities for the length of implants with an anterior location. However, significant differences were found in the length of implants with a posterior location. For implant dimensions, longer lengths of the implants were planned with PAN, as confirmed by two observers. CBCT provided images with improved scores for subjective image quality and surgical confidence levels.
CONCLUSION
Within the limitations of this study, there was a trend toward PAN-based preoperative planning of implant placement leading towards the use of longer implants within the posterior jaw bone.

Keyword

Cone-Beam Computed Tomography; Dental Implants; Radiography, Panoramic

MeSH Terms

Cone-Beam Computed Tomography*
Dataset
Dental Implants
Female
Humans
Jaw
Male
Radiography, Panoramic
Rehabilitation
Dental Implants

Figure

• 

  Fig. 1 The implant planning process is performed using panoramic radiography (PAN) (A) and cone-beam computed tomography (CBCT). (B) Images of a 32-year-old woman. After careful evaluation of the 3D data, an appropriate treatment plan is developed, as seen in the cross-sectional images. The bone width is not evident on the PAN image, whereas a possible fenestration can be predicted thanks to the availability of CBCT.

• 

  Fig. 2 A graph shows the intra-observer concordance of implant lengths (Bland-Altman).

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