Objective
To compare the diagnostic accuracy of conventional periapical radiography and cone beam computed tomography (CBCT) at detecting peri‐implant bone defects.
Materials and methods
Implants were placed in fresh bovine ribs in osteotomy sites of varying diameter (five with no peri‐implant space, five with a 0.35 mm space, five with a 0.675 mm space) and imaged using (i) digital long cone periapical radiographs (LCPAs), (ii) limited volume CBCT using 3D Accuitomo 80® and (iii) large volume CBCT using i‐CAT Next Generation®. Images from each were randomly presented to nine examiners on two occasions. Confidence in diagnosing the presence or absence of a peri‐implant radiolucency was recorded on a five‐point scale. Receiver Operating Characteristic (ROC) analysis and Kappa tests were performed.
Results
Digital LCPAs were better at diagnosing a peri‐implant bone defect when the peri‐implant space was 0.35 mm (P < 0.02). As the peri‐implant space increased to 0.675 mm, there was no significant difference in diagnostic accuracy between the three imaging methods. Sensitivity of LCPAs (100) and Accuitomo (97.8) was better than i‐CAT (64.4) (P < 0.02). LCPAs and i‐CAT had significantly better specificity and positive predictive value than Accuitomo. The negative predictive value of LCPA was significantly better than i‐CAT. LCPAs showed better intra‐examiner and inter‐examiner agreement than CBCT.
Conclusion
Within the limitations of this study, LCPAs are a reliable and valid method of detecting circumferential peri‐implant bone defects and performed significantly better than CBCT.