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Low Bone Density Predictability of CBCT and Its Relation to Primary Stability of Tapered Implant Design: A Pilot Study

J Oral Implantol. 2022 Jul 26. doi: 10.1563/aaid-joi-D-21-00159. Online ahead of print.


Research regarding bone density assessment using cone beam computed tomography in low bone density regions is sparse. This in vitro study aimed to evaluate the predictability of cone beam computed tomography for low bone density regions and its correlations with primary implant stability when placing tapered design implants with a stepped osteotomy. Eighteen porcine mandibular condyles were used as simulated low bone density regions. Hounsfield units (HU), obtained via multislice computed tomography, and gray values (GV), obtained via cone beam computed tomography, were measured three times at one-month intervals. The maximum implant insertion torque (MIT) and implant stability quotient (ISQ) were recorded as the taper design implants were placed using a stepped osteotomy. HU and GV were measured as 335.05-803.07 and 389.98-906.40, respectively. For repeated measurements of HU and GV, the intraclass correlation coefficients were 0.989 and 0.980; the corresponding value for mean HU and GV was 0.768. Bland-Altman plots showed a mean difference between HU and GV of -78.15. Pearson correlation coefficients revealed a strong correlation between HU and GV (r=0.91, p<0.01). The mean ± standard deviation values for MIT and ISQ were 36.44 ± 6.64 Ncm and 80.85 ± 2.03, respectively, but no statistically significant correlations were found with GV and HU. Within the study’s limitations, GV showed similar bone density estimation compared to HU in soft bones. Tapered implant placement with a stepped osteotomy achieved stable primary implant stability in soft bones. However, these in vitro results need to be approved in further clinical studies.

PMID:35881816 | DOI:10.1563/aaid-joi-D-21-00159

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