Evaluation of Radiographic Technique Using a New Customized Film Holder for Dental Implant Assessment

Efficacy of a radiographic film holder adapter in generating radiographs of dental implants with improved geometric accuracy and sharpness

STATEMENT OF PROBLEM

Some radiographic film holders produce radiographs with geometric distortion that may interfere with diagnosis. However, whether the distortion can be corrected by adjusting the design of the radiographic film holder is unclear.

PURPOSE

The purpose of the study was to develop an adapter for a radiographic film holder model aiming to generate radiographs with greater sharpness and a more accurate geometric representation of dental implants.

MATERIAL AND METHODS

The 2-piece adapter was designed using the SketchUp software program and was 3-dimensionally (3D) printed. Implants with internal conical connections were installed in 19 maxillary prototypes in the central incisor region. Five dentists obtained 285 digital periapical radiographs with 3 different radiographic film holders: standard Cone Indicator, Rinn XCP, and adapted Cone Indicator. They then evaluated the radiographic sharpness of the implants threads and their dimensions using the ImageJ software program. The data were analyzed using the Friedman test with the Durbin-Conover post hoc test and MANOVA with the Tukey post hoc test (α=.05).

RESULTS

On the mesial surface of the implants, the threads were sharper for the adapted than for the standard Cone Indicator radiographic film holder (P<.05). The adapted Cone Indicator showed a smaller difference between the radiographic and actual implant diameters compared with the Rinn XCP and standard Cone Indicator radiographic film holders (P<.05).

CONCLUSIONS

The developed adapter provided radiographs of dental implants with improved sharpness and geometric accuracy.

A technique to fabricate a custom CAD-CAM periapical radiographic film holder for implant assessment

Standardized radiographs produced by using the paralleling technique play an important role in monitoring prosthetic misfit and marginal bone levels around endosseous implants. Under clinical conditions, parallel adjustment of the film with respect to the implant requires the use of positioning devices. This article describes the fabrication of a custom computer-aided design and computer-aided manufacturing (CAD-CAM) device suitable for implants adjacent to natural teeth.

Effect of different implant placement depths on crestal bone levels and soft tissue behavior: A 5-year randomized clinical trial

OBJECTIVES

This randomized clinical trial analyzed the long-term (5-year) crestal bone changes and soft tissue dimensions surrounding implants with an internal tapered connection placed in the anterior mandibular region at different depths (equi- and subcrestal).

MATERIALS AND METHODS

Eleven edentulous patients were randomly divided in a split-mouth design: 28 equicrestal implants (G1) and 27 subcrestal (1-3 mm) implants (G2). Five implants were placed per patient. All implants were immediately loaded. Standardized intraoral radiographs were used to evaluate crestal bone (CB) changes. Patients were assessed immediately, 4, 8, and 60 months after implant placement. The correlation between vertical mucosal thickness (VMT) and soft tissue recession was analyzed. Sub-group analysis was also performed to evaluate the correlation between VMT and CB loss. Rank-based ANOVA was used for comparison between groups (α = .05).

RESULTS

Fifty-five implants (G1 = 28 and G2 = 27) were assessed. Implant and prosthetic survival rate were 100%. Subcrestal positioning resulted in less CB loss (-0.80 mm) when compared to equicrestal position (-0.99 mm), although the difference was not statistically significant (p > .05). Significant CB loss was found within the G1 and G2 groups at two different measurement times (T4 and T60) (p < .05). Implant placement depths and VMT had no effect on soft tissue recession (p > .05).

CONCLUSIONS

There was no statistically significant difference in CB changes between subcrestal and equicrestal implant positioning; however, subcrestal position resulted in higher bone levels. Neither mucosal recession nor vertical mucosa thickness was influenced by different implant placement depths.

Effect of different implant placement depths on crestal bone levels and soft tissue behavior: a randomized clinical trial

OBJECTIVES

This randomized clinical trial analyzed crestal bone changes and soft tissue dimensions surrounding implants with an internal tapered connection placed in the mandible anterior region at different depths (equicrestal and subcrestal).

MATERIALS AND METHODS

Eleven edentulous patients (five implants per patient) were randomly divided in a split-mouth design: G1, 28 equicrestal implants; and G2, 27 subcrestal implants. All implants were immediately loaded. Correlation between keratinized tissue width (KTW) and vertical mucosa thickness (MT) with soft tissue recession was analyzed. Intraoral radiographs were used to evaluate crestal bone changes. Patients were assessed immediately, 4-, and 8-months after implant placement. Rank-based ANOVA-type statistical test was used for comparison between groups (α = 0.05).

RESULTS

Fifty-five implants (G1 = 28 and G2 = 27) were assessed in 11 patients. Implant survival rate was 100% for both groups. Both tested implant placement depths presented similar crestal bone loss (P > 0.05). Significant crestal bone loss for each group was found in the different measurement times (T4 and T8) (P < 0.05). Implant placement depths, KTW, and vertical MT had no effect on soft tissue recession (P > 0.05).

CONCLUSIONS

Different implant placement depths do not influence crestal bone changes. Soft tissue behavior is not influenced by different implant placement depths or by the amount of keratinized tissue.