Evaluation of a Novel Cone Beam Computed Tomography Scanner for Bone Density Examinations in Preoperative 3D Reconstructions and Correlation with Primary Implant Stability
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Titel:
Evaluation of a Novel Cone Beam Computed Tomography Scanner for Bone Density Examinations in Preoperative 3D Reconstructions and Correlation with Primary Implant Stability
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<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Bone density examination (<jats:styled-content style="fixed-case">BDE</jats:styled-content>) using preoperative cone beam computed tomography (<jats:styled-content style="fixed-case">CBCT</jats:styled-content>) might be used to predict primary implant stability in implant patients.</jats:p></jats:sec><jats:sec><jats:title>Purpose</jats:title><jats:p>The aim of the study was to validate a novel <jats:styled-content style="fixed-case">CBCT</jats:styled-content> scanner in vitro with regard to <jats:styled-content style="fixed-case">BDE</jats:styled-content> in preoperative scans and to analyze the in vivo correlation of <jats:styled-content style="fixed-case">CBCT</jats:styled-content> scan results with primary implant stability measurements.</jats:p></jats:sec><jats:sec><jats:title>Materials and Methods</jats:title><jats:p>A <jats:styled-content style="fixed-case">CBCT</jats:styled-content> scanner was validated in vitro with regard to spatial uniformity and linearity of <jats:styled-content style="fixed-case">CT</jats:styled-content> numbers (<jats:styled-content style="fixed-case">H</jats:styled-content>ounsfield units, <jats:styled-content style="fixed-case">HU</jats:styled-content>) by using a series of phantoms and plastic and hydroxyapatite specimens of various densities. Forty‐nine patients (27 female and 22 male, mean age 55.6 ± 9.8) were scanned prior to and 1 to 6 months after the placement of 155 dental implants of different lengths and diameters. Mean and peak insertion torque (<jats:styled-content style="fixed-case">IT</jats:styled-content>) in <jats:styled-content style="fixed-case">Ncm</jats:styled-content> were registered during implant placement. Resonance frequency analysis (<jats:styled-content style="fixed-case">RFA</jats:styled-content>) measurements in <jats:styled-content style="fixed-case">ISQ</jats:styled-content> units were performed after placement. The second scan was used to export and superimpose the exact positions of bone and implants into the first scan. Virtual probes with the same length as the actual implant were automatically placed at the implant sites, and mean <jats:styled-content style="fixed-case">HU</jats:styled-content> values were measured in a 1 mm–wide circular corridor from the tip of the threads and out.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The in vitro validation showed high uniformity and linearity of <jats:styled-content style="fixed-case">CT</jats:styled-content> numbers (<jats:styled-content style="fixed-case">HU</jats:styled-content>). The clinical study showed significant correlations between bone density and <jats:styled-content style="fixed-case">ISQ</jats:styled-content>, mean <jats:styled-content style="fixed-case">IT</jats:styled-content>, and peak <jats:styled-content style="fixed-case">IT</jats:styled-content>, respectively.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The <jats:styled-content style="fixed-case">W</jats:styled-content>hite<jats:styled-content style="fixed-case">F</jats:styled-content>ox <jats:styled-content style="fixed-case">CBCT</jats:styled-content> scanner measures bone density with high accuracy. There is a correlation between bone density and primary implant stability as assessed with <jats:styled-content style="fixed-case">IT</jats:styled-content> and <jats:styled-content style="fixed-case">RFA</jats:styled-content> measurements. The findings suggest that <jats:styled-content style="fixed-case">BDE</jats:styled-content> may be used as an additional feature in treatment‐planning software to estimate primary stability at predetermined implant sites.</jats:p></jats:sec>