Impact of peri-implant buccal bone thickness, implant fixture diameter, abutment and/or prosthetic reconstruction material on the accuracy of Cone Beam Computed Tomography to assess peri-implant buccal bone level: an in vitro study in pig jaw

Abstract: Abstract Aim: To evaluate the impact of peri-implant buccal bone thickness, implant fixture diameter, abutment material (Titanium Ti, Zirconium Zr) and/or prosthetic reconstruction material (metal ceramic vs ceramic) on the accuracy of Cone Beam Computed Tomography (CBCT) to assess peri-implant buccal bone level. Materials and methods: Titanium implants were inserted into 36 blocks of pig mandible in a way to create variable buccal bone thicknesses groups, each group with 12 blocks; group 1 (0.5-1 mm), group 2 (>1-1.5 mm) and group 3 (>1.5-2 mm), half of each group received a dehiscence which was created of variable extent. Two groups regarding abutment-crown material; (Ti abutment with CoCr crown, Zr abutment with Zr crown) and implant diameter; (standard/narrow) were assessed. Dehiscences were measured on CBCT image using 2 programs (i-Dixel and Photoshop) and were compared to the gold standard. Results: Thin buccal bone thickness group (0.5-1 mm) had major impact on the accuracy of CBCT to correctly detect and measure the extent of a bony dehiscence. No differences were detected between standard or narrow diameter implant and between TiTi/CoCr combination and TiZr/Zr combination in regards to possibility of CBCT to detect and evaluate accurately the extent of a bony dehiscence. Conclusion: Thin peri-implant buccal bone (≤ 1 mm) has a negative effect on the accuracy of CBCT to assess peri-implant buccal bone level. The possibility to identify and to assess the extent of peri-implant buccal bone dehiscence in CBCT was hardly affected by using different abutments and crown materials and different implant diameters.