Implant-to-root dimensions projected by panoramic radiographs inthe maxillary canine-premolar region: implications for dental implant treatment

Abstract

Backgound This study aimed to\xa0compare panoramic radiography (PAN) and cone beam computed tomography (CBCT) determinations of implant-to-root dimensions (IRD) in anterior and posterior maxillary regions, and\xa0to help determine in which instances\xa0increased radiation exposure from CBCT scans\xa0may be justified. Methods IRD measured by\xa0PAN (PAN-D) from implant-to-root sites (central incisor, lateral incisor, canine, first premolar, and second premolar) was collected from 418 implant sites in 110 adults. The CBCT technique was used as the reference method for the estimation of IRD. The PAN analysis equations were developed using stepwise multiple regression analysis and the Bland–Altman approach was applied to assess the agreement between PAN and CBCT methods. Results The odds ratio that an implant at the canine-to-first premolar (9.7:1) (P\u2009=\u20090.000) or at the first premolar-to-second premolar region (4.5:1) (P\u2009=\u20090.000) belongs to the underestimation group was strong and highly significant. The root mean square\xa0error (RMSE) and pure error (PE) were highest for the canine-to-first premolar (RMSE\u2009=\u20090.886\xa0mm, PE\u2009=\u20090.45\xa0mm) and the first premolar-to-second premolar region (4.5:1) (RMSE\u2009=\u20090.944\xa0mm, PE\u2009=\u20090.38\xa0mm). Conclusions This study provides evidence of site-specific underestimations of available horizontal bone dimensions for implants when assessed by PAN. These data suggest that the canines and first and second premolars may have to\xa0be excluded\xa0when assessing root angulations via PAN.