Diagnostic performance of cone beam computed tomography in assessing peri‐implant bone loss: A systematic review.

Abstract: Objectives: To evaluate the diagnostic performance of cone beam computed tomography (CBCT) in the assessment of peri‐implant bone loss and analyze its influencing factors. Materials and Methods: Clinical and preclinical studies reporting diagnostic outcomes of CBCT imaging of peri‐implant bone loss compared to direct reference measurements were sought by searching five electronic databases, PubMed, MEDLINE, EMBASE, Web of Science, and CINAHL Plus, and OpenGrey. QUADAS‐2 criteria were adapted for quality analysis of the included studies. A qualitative synthesis was performed. Two meta‐analysis models (random‐effects and mixed‐effects) summarized the area under receiver operating characteristic (AUC) curve observations reported in the selected studies. The mixed‐effects meta‐analysis model evaluated three possible influencing factors, “defect type,” “defect size,” and “study effect.” Results: The initial search yielded 3,716 titles, from which 18 studies (13 in vitro and 5 animal) were included. Diagnostic accuracy of CBCT was fair to excellent in detecting in vitro circumferential‐intrabony and fenestration defects, but moderate to low for peri‐implant dehiscences, and tended to be higher for larger defect sizes. Both, over‐ and underestimation of linear measurements were reported for the animal models. The meta‐analyses included 37 AUC observations from eight studies. The random‐effects model showed significant heterogeneity. The mixed‐effects model exhibited also significant but lower heterogeneity, and “defect type” and “study effect” significantly influenced the variability of AUC observations. Conclusion: In vitro, CBCT performs well in detecting peri‐implant circumferential‐intrabony or fenestration defects but less in depicting dehiscences. Influencing factors due to other site‐related and technical parameters on the diagnostic outcome need to be addressed further in the future studies. [ABSTRACT FROM AUTHOR]