Influence of Three-dimensional Imaging on Implant Treatment Planning: Implant Diameter and Length.

Aim: To investigate the influence of the radiographic modalities panoramic radiography (PR) and cone beam computed tomography (CBCT) on selection of implant length and diameter.
Materials and Methods: Potential implant sites (59 sites, 40 patients) with available PRs and CBCTs were selected from the databases of two University dental schools. Six experienced clinicians were asked to select the appropriate implant length and diameter based on PR and CBCT. Results were compared with the actual surgical procedure and intra- /interrater agreement was calculated using Cohen's kappa.
Results: On average, greater implant length was more often planned based on PR (24.2 vs 8.8% with CBCT), while wider implants were generally more frequently planned based on CBCTs (19.9 vs 29.7% with PR). Implant treatment planning based on PR and on CBCT images was equal in 50 to 67%. Compared with the actual surgery, CBCT revealed a higher agreement (46% for implant length), while for PR, 34.4% equal implant length was observed.
Conclusion: The radiographic modality used for implant treatment planning affects implant selection.
Clinical Significance: The CBCT scans are advantageous for choosing the appropriate implant dimension. Caution should be exercised when selecting implant length planned from PR.