Peri-Implantitis Clinical Trial
Official title:
The Morphology of the Peri-Implantitis Defects: A Cone-Beam Computed
To study the morphology of the peri-implant defects using cone-beam computed tomography based
on a priori case definition of peri-implantitis (≥3mm of radiographic bone loss +
inflammatory clinical parameters)
Diagnosis of peri‐implantitis requires:
- Presence of bleeding and/or suppuration on gentle probing.
- Increased probing depth compared to previous examinations.
- Presence of bone loss beyond crestal bone level changes resulting from initial bone
remodeling.
In the absence of previous examination data diagnosis of peri‐implantitis can be based on the
combination of:
- Presence of bleeding and/or suppuration on gentle probing.
- Probing depths of ≥6 mm.
- Bone levels ≥3 mm apical of the most coronal portion of the intraosseous part of the
implant.
Nowadays, several radiographic techniques are available to investigate the peri-implant bone
morphology by two-dimensional radiographs such as panoramic radiography and intraoral
radiography, or three-dimensional techniques such as computer tomography and cone beam
computer tomography (CBCT) (Harris et al. 2012). CBCT provides high-contrast 3D visualization
of bone beds; however, artifacts caused by the metallic character of implants could disguise
information around implants. The diagnostic outcomes of CBCT imaging of peri-implant bone
loss have been related to the type of study and defect morphology (Pelekos et al., 2018). The
ex vivo studies (cadaver models), considering sensitivity and specificity reported good
values for both circumferential and infrabony defects but lower for dehiscences
(de-Azevedo-Vaz et al., 2013, Kamburoglu et al., 2013). Contrastingly, CBCT imaging for
defect analysis in animal studies showed positive correlation with histology but tend to
overestimate (Fienitz et al., 2012, Golubovic et al., 2012) or underestimate (Corpas Ldos et
al., 2011, Ritter et al., 2014) the size of the defect. This variability in the measurement
is mainly dependent on the different configuration, location or size of the defect. and also
by the scattering, beam hardening artifacts, energy settings, exposure time, field of view.
Hence, it is aimed at assessing the morphology of the peri-implant defects using CBCT
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