Alt Çene İmplant Çevresi Ölçümlerinde Farklı Dental Radyografik Yöntemlerin Hassasiyetlerinin Karşılaştırılması: In Vitro Çalışma

Abstract

Amaç: Bu in vitro çalışmanın amacı implant çevresi alanların ölçümünde kullanılan çeşitli radyodiagnostik metodların hassasiyetlerini değerlendirmek ve karşılaştırmaktır. Gereç ve Yöntem: İnsan kadavrasına ait alt çeneye 6 adet dental implant yerleştirildi. İmplant ve implant çevresi kemik ölçümleri için hem paralel hem de açıortay tekniği ile elde edilen periapikal radyografiler, dijital ve konvansiyonel panoramik radyografiler kullanıldı. Her implantın ölçüm sonuçları istatistiksel olarak analiz edildi. Bulgular: Gözlemciler arası güvenilirlik için sınıf içi korrelasyon değerleri implant çapı için 0.79, implant uzunluğu için 0.96’dır. 2 gözlemcinin ölçümleri ve anatomik konumlara ilişkin implant ebatları arasında istatistiksel olarak anlamlı bir fark bulunamamıştır. Her gözlemcinin ölçümünün, paralel teknik kullanılarak yapılan ölçümlerde diğer tekniklere göre implantların gerçek ebatlarından anlamlı olarak daha az fark gösterdiği belirlenmiştir (p < 0.05).

Keywords

• Panoramik radyografi, dental implantasyon, paralel teknik, açıortay tekniği, periapikal radyografi

THE COMPARISON OF THE PRECISION OF DIFFERENT DENTAL RADIOGRAPHIC METHODS IN MANDIBULAR PERI-IMPLANTARY MEASUREMENTS: AN IN VITRO STUDY

Abstract

Purpose: The objective of this in vitro study was to investigate and compare the precisions of several radiodiagnostic methods used in dentistry for the measurement of peri-implantary sites.
Materials and Methods: Six dental implants were placed in a human cadaver mandible. Periapical radiographs obtained with the parallel as well as the bisecting angle technique, digital and conventional panoramic radiographs were used for implant and periimplant bone measurements. The measurement results at each implant were statistically analyzed.
Results: The ICC values for the inter-observer reliability were 0.79 for implant diameters and 0.96 for implant lengths. Statistical significance was not detected between the differences of the measurements of the 2 examiners from the original implant dimensions related to anatomic locations. For both of the examiner measurements, significantly less difference from the original implant dimensions was detected in the parallel technique compared to the other techniques (p<0.05).
Conclusion: The present study showed that the most precise peri-implant bone measurements can be obtained from periapical radiographies by using the parallel technique.

Keywords

• Panoramic radiography; dental implantation; parallel technique; bisecting technique; periapical radiography

References

1. Chaytor DV, Zarb GA, Schmitt A, Lewis DW. The longitudinal effectiveness of osseointegrated dental implants. The Toronto study: bone level changes. Int J Periodontics Restorative Dent 1991;11(2):112–125.
2. Monsour PA, Dudhia R. Implant radiography and radiology. Aust Dent J 2008;53 (Suppl 1):11-25.
3. Dula K, Mini R, van der Stelt PF, Buser D. The radiographic assessment of implant patients: decision-making criteria. Int J Oral Maxillofac Implants 2001;16(1):80–89.
4. Mupparapu M, Singer SR. Implant imaging for the dentist. J Can Dent Assoc 2004; 70(1):32.
5. Donatsky O. Osseointegrated dental implants with ball attachments supporting over-dentures in patients with mandibular alveolar ridge atrophy. Int J Oral Maxillofac Implants 1993;8(2):162–166.
6. Boerrigter EM, van Oort RP, Raghoebar GM, Stegenga B, Schoen PJ, Boering G. A controlled clinical trial of implant-retained mandibular overdentures: clinical aspects. J Oral Rehabil 1997;24(3):182–190.
7. Versteegh PA, Van Beek GJ, Slagter AP, Ottervanger JP. Clinical evaluation of man-dibular overdentures supported by multiple-bar fabrication: a follow-up study of two implant systems. Int J Oral Maxillofac Implants 1995;10(5):595–603.
8. Mericske-Stern R, Steinlin Schaffner T, Marti P, Geering AH. Peri-implant mucosal aspects of ITI implants supporting overdentures. A five-year longitudinal study. Clin Oral Implants Res 1994;5(1):9–18.

9. Spiekermann H, Jansen VK, Richter EJ. A 10-year follow-up study of IMZ and TPS implants in the edentulous mandible using bar-retained overdentures. Int J Oral Maxillofac Implants 1995;10(2):231–243.
10. Leimola-Virtanen R, Peltola J, Oksala E, Helenius H, Happonen RP. ITI titanium plasma-sprayed screw implants in the treatment of edentulous mandibles: a follow-up study of 39 patients. Int J Oral Maxillofac Implants 1995;10(3):373–378.
11. Akesson L, Hakansson J, Rohlin M, Zöger B. An evaluation of image quality for the assessment of the marginal bone level in panoramic radiography. A comparison of radiographs from different dental clinics. Swed Dent J 1993;17(1-2):9–21.
12. Batenburg RHK, Stellingsma K, Raghoebar GM, Vissink A. Bone height measure-ments on panoramic radiographs: the effect of shape and position of edentulous mandibles. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;84(4): 430-435.
13. Batenburg RH, Meijer HJ, Geraets WG, van der Stelt PF. Radiographic assessment of changes in marginal bone around endosseous implants supporting mandibular overdentures. Dentomaxillofac Radiol 1998;27(4):221-224.
14. Schuck P. Assessing reproducibility for interval data in health related quality life questionnaires: which coefficient should be used? Qual Life Res 2004;13(3):571–586.
15. Celik E, Polat-Ozsoy O, Toygar Memikoglu TU. Comparison of cephalometric measurements with digital versus conventional cephalometric analysis. Eur J Orthod 2009;31(3):241-246.
16. Naoumova J, Lindman R. A comparison of manual traced images and corresponding scanned radiographs digitally traced. Eur J Orthod 2009;31(3):247-253.
17. Adell R, Eriksson B, Lekholm U, Brånemark PI, Jemt T. Long-term follow-up study of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants 1990;5(4):347-359.
18. Albrektsson T, Sennerby L. State of the art in oral implants. J Clin Periodontol 1991;18(6):474-481.
19. Brägger U, Burgin W, Fourmoussis I, Lang NP. Image processing
20. for the evaluation of dental implants. Dentomaxillofac Radiol 1992;21(4):208-212.
21. Duyck J, Rønold HJ, Van Oosterwyck H, Naert I, Vander Sloten J, Ellingsen JE. The influence of static and dynamic loading on marginal bone reactions around osseointegrated implants: an animal experimental study. Clin Oral Implants Res 2001;12(3):207-218.
22. Sewerin IP, Gotfredsen K, Stoltze K. Accuracy of radiographic diagnosis of peri-implant radiolucencies--an in vitro experiment. Clin Oral Implants Res 1997;8(4):299-304.
23. Misch CE, Perel ML, Wang HL, Sammartino G, Galindo-Moreno P, Trisi P, Steigmann M, Rebaudi A, Palti A, Pikos MA, Schwartz-Arad D, Choukroun J, Gutierrez-Perez JL, Marenzi G, Valavanis DK. Implant success, survival, and failure: the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference. Implant Dent 2008;17(1):5-15.
24. Akesson L. Panoramic radiography in the assessment of marginal bone level. Swed Dent J Suppl 1991;78:1–129.
25. Persson RE, Tzannetou S, Feloutzis AG, Brägger U, Persson GR, Lang NP. Compari-son between panoramic and intra-oral radiographs for the assessment of alveolar bone levels in a periodontal maintenance population. J Clin Periodontol 2003;30(9):833–839.
26. Kullman L, Al Asfour A, Zetterqvist L, Andersson L. Comparison of radiographic bone height assessments in panoramic and intraoral radiographs of implant patients. Int J Oral Maxillofac Implants 2007;22(1):96–100.
27. Vazquez L, Nizamaldin Y, Combescure C, Nedir R, Bischof M, Dohan Ehrenfest DM, Carrel JP, Belser UC. Accuracy of vertical height measurements on direct digital pano-ramic radiographs using posterior mandibular implants and metal balls as reference objects. Dentomaxillofac Radiol 2013;42(2):20110429.
28. Schropp L, Stavropoulos A, Gotfredsen E, Wenzel A. Calibration of radiographs by a reference metal ball affects preoperative selection of implant size. Clin Oral Investig 2009;13(4):375–381.
29. Schulze R, Krummenauer F, Schalldach F, d’Hoedt B. Precision and accuracy of measurements in digital panoramic radiography. Dentomaxillofac Radiol 2000;29(1): 52–56.
30. Park JB. The evaluation of digital panoramic radiographs taken for implant dentistry in daily practice. Med Oral Patol Oral Cir Bucal 2010;15(4):e663–666.
31. Kim YK, Park JY, Kim SG, Kim JS, Kim JD. Magnification rate of digital panoramic radiographs and its effectiveness for pre-operative assessment of dental implants. Dentomaxillofac Radiol 2011;40(2):76–83.
32. Chiapasco M. Early and immediate restoration and loading of implants in completely edentulous patients. Int J Oral Maxillofac Implants 2004;19 Suppl:76-91.
33. Zechner W, Watzak G, Gahleitner A, Busenlechner D, Tepper G, Watzek G. Rotational panoramic versus intraoral rectangular radiographs for evaluation of peri-implant bone loss in the anterior atrophic mandible. Int J Oral Maxillofac Implants 2003;18(6):873– 878.
34. Vazquez L, Nizam Al Din Y, Christoph Belser U, Combescure C, Bernard JP. Reliability of the vertical magnification factor on panoramic radiographs: clinical implications for posterior mandibular implants. Clin Oral Impl Res 2011;22(12):1420-1425.
35. Tronje G, Welander U, McDavid WD, Morris CR. Image distortion in rotational panoramic radiography. I. General considerations. Acta Radiol Diagn (Stockh) 1981; 22(3A):295–299.
36. Tronje G, Eliasson S, Julin P, Welander U. Image distortion in rotational panoramic radiography. II. Vertical distances. Acta Radiol Diagn (Stockh) 1981;22(4):449–455.
37. McDavid WD, Dove SB, Welander U, Tronje G. Dimensional reproduction in direct digital rotational panoramic radiography. Oral Surg Oral Med Oral Pathol 1993;75(4): 523–527.
38. Peker I, Gungor K, Semiz M, Tekdemir I. Localization of mental and mandibular foramens on the conventional and digital panoramic images. Coll Antropol 2009;33(3):857-862.
39. Sewerin IP. Errors in radiographic assessment of marginal bone height around osseointegrated implants. Scand J Dent Res 1990;98(5):428-433.
40. Van der Stelt PF. Computer assisted interpretation in radiographic diagnosis. Dent Clin North Am 1993;37(4):683-696.
41. Kim TS, Obst C, Zehaczek S, Geenen C. Detection of bone loss with different X-ray techniques in periodontal patients. J Periodontol 2008;79(7):1141-1149.