The effect of voxel size and artifact reduction tool in two cone-beam computed tomography scanners on the accuracy of bone graft loss detection around titanium and zirconium dental implants

Abstract

Cone-Beam Computed Tomography (CBCT) is indicated in the evaluation of peri-implant bone tissue, however dental implants are sources of imaging artifacts in these examinations, which may compromise the evaluation. Therefore, the aim of this study will be to investigate the influence of voxel size and application of the artifact reduction tool in CBCT exams for the evaluation of bone graft materials adjacent to dental implants. Thus, 12 titanium and 12 zirconium implants will be installed in dry mandibles. The initial drilling will be performed with an 8mm diameter trephine drill 5mm deep. The following drilling for the installation of the implants will be done up to a 3.5mm diameter drill and 10mm depth, thus creating a 2mm gap between the implant and the bone block on all its faces. The gaps will be filled with xenogeneous particulate bone graft. In half of the sample, the gap around the implants will be completely filled. In the other half the grafting material will be removed up to the third implant spiral on the buccal surface. CBCT images will be acquired in two different scanners, varying voxel size and applying the artifact reduction tool. The images will be evaluated by 5 specialists in oral radiology. For each exam, the evaluators will assign a score for the presence of the graft loss according to a 5-point scale. The diagnostic values will be calculated and compared between variables by analysis of variance with a 5% significance level. This study is expected to contribute to determining the impact of different CBCT exposure protocols in the evaluation of bone grafts adjacent to dental implants. (AU)