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Mouzinho-Machado S, Borges GB, Pacheco-de-Oliveira-Mota V, de-Azevedo-Vaz SL. Does enhancement filter application increase the diagnostic accuracy of misfit detection at the implant-prosthesis interface? J Prosthet Dent 2024; 131:1136-1143. [PMID: 35570168 DOI: 10.1016/j.prosdent.2022.03.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM Misfits at the implant-prosthesis interface may increase complications in dental implants and affect peri-implant tissue health. Periapical radiographs are the most used imaging examinations for detecting misfits at the implant-prosthesis interface, although digital systems have largely replaced film-based radiographs. Whether postprocessing tools such as enhancement filters assist diagnosis by highlighting misfits is unclear. PURPOSE The purpose of this in vitro study was to assess the influence of enhancement filter application in the diagnostic accuracy of misfit detection at the implant-prosthesis interface. MATERIAL AND METHODS A total of 32 dental implants were placed in dry human mandibles. A polyester strip was inserted at the implant-prosthesis interface to simulate a 50-μm misfit; prosthetic crowns installed directly on the implant platforms were used as controls. Standard paralleling periapical images were acquired by using a semidirect system (photostimulable phosphor plate) with the application of Highlight, Invert, and Colorization filters, as well as a direct system (metal oxide complementary semiconductor sensor) with filters Sharpness 3, Invert, and Pseudocolorization. Oral radiologists evaluated the images with and without the application of filters. The areas under the receiver operating characteristics curves (Az values), sensitivity, specificity, accuracy, positive predictive value, and negative predictive values were calculated. The Az values were compared with the receiver operating characteristic (ROC) curves comparison test of the Epidat 3.1 software (α=.05). RESULTS Although images without filter application presented descriptively higher diagnostic values than those with filter application, the Az values for images with and without filter application in both semidirect and direct systems showed no significant differences (P>.05). CONCLUSIONS Enhancement filter application did not significantly influence the diagnostic accuracy of misfit detection at the implant-prosthesis interface.
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Affiliation(s)
- Sâmia Mouzinho-Machado
- Graduate student, Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Gustavo Bispo Borges
- Predoctoral student, Department of Clinical Dentistry, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Vanessa Pacheco-de-Oliveira-Mota
- Graduate student, Dental Sciences Graduate Program, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Sergio Lins de-Azevedo-Vaz
- Professor, Dental Sciences Graduate Program, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil.
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Rutkunas V, Kules D, Mischitz I, Huber S, Revilla-León M, Larsson C, Janda M. Misfit simulation on implant-supported prostheses with different combinations of engaging and nonengaging titanium bases: Part 3: A radiographic evaluation. J Prosthet Dent 2024:S0022-3913(24)00044-1. [PMID: 38418304 DOI: 10.1016/j.prosdent.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/13/2024] [Accepted: 01/17/2024] [Indexed: 03/01/2024]
Abstract
STATEMENT OF PROBLEM The fit of implant-supported prostheses plays an important role in their mechanical and biological stability. Clinically, the prosthetic fit is typically assessed radiographically, but this method relies on the operator's subjective evaluation. Whether available digital tools could optimize the evaluation of the prosthetic fit is uncertain. PURPOSE The purpose of this in vitro study was to evaluate the influence of an image processing program on the radiographic detection of discrepancies in the active and passive fit of implant-supported prostheses. Two-implant-supported screw-retained prostheses were analyzed by simulating the vertical and horizontal misfits of 3 different implant abutment configurations. MATERIAL AND METHODS Seven casts were fabricated using 2 internal-connection titanium implants: 1 control; 3 with vertical (V) misfit of 50 µm, 100 µm, 150 µm; and 3 with horizontal (H) misfit of 35 µm, 70 µm, 100 µm. Thirty bar-shaped zirconia frameworks were fabricated and divided into 3 groups (n=10) according to their attachment to 2 engaging (E-E), 2 nonengaging (NE-NE), and engaging and nonengaging (E-NE) titanium bases. Digital parallel periapical radiographs were made of each specimen in the passive and active fit situation on each cast (1-screw test), except for the E-E specimens, which were only seated on the control, H35, and H70 casts because the fit on the remaining casts was poor. The mean gray value (MGV) was measured at the chosen regions of interest on the second implant (side B) using the ImageJ software program. Differences in the MGV measurements between the passive and active conditions were tested using a t test (α=.05) and compared the different misfit levels using analysis of variance (1-way ANOVA), followed by the Tukey HSD test (α=.05). RESULTS The highest values for the differences between passive and active fit were found for the V150 and H100 misfit simulations (P<.05). Statistical differences between the MGVs were found with some exceptions: the smallest simulated misfits (H35 and V50) revealed statistically significant MGV differences from the highest simulated misfits (V150, H100) and from the H70 in the groups where an engaging component was present (P>.05). In the horizontal misfit group of NE-NE abutment configuration, H70 revealed no significant difference from the control group cast (P>.05). CONCLUSIONS Measuring MGV differences between passive and active fit could be a promising alternative for detecting 70- to 150-µm gaps in the implant-abutment connection that result from the misfit. However, the procedure was not adequate for detecting <50 µm gaps, cannot be uniformly applied to all types of implant-abutment connections, and requires 2 exposures to X-radiation.
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Affiliation(s)
- Vygandas Rutkunas
- Professor, Department of Prosthodontics, Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; and Director, Digitorum Research Center, Vilnius, Lithuania
| | - Daniel Kules
- Postgraduate student, Department of Periodontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; and Researcher, Digitorum Research Center, Vilnius, Lithuania
| | - Ingrida Mischitz
- Dental Research Assistant, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - Sandra Huber
- Attending, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - Marta Revilla-León
- Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash.; Faculty and Director, Digital Dentistry, Kois Center, Seattle, Wash.; and Affiliate Professor, Graduate Prosthodontics, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass
| | - Christel Larsson
- Associate Professor, Faculty of Odontology, Malmö University, Malmö, Sweden; and Associate Visiting Professor, Faculty of Dentistry, Department of Prosthetic Dentistry, Riga Stradins University, Riga, Latvia
| | - Martin Janda
- Assistant Professor, Faculty of Odontology, Malmö University, Malmö, Sweden.
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de Oliveira Mota VP, Braga MS, Loss AA, Mello HN, Rosetti EP, de-Azevedo-Vaz SL. Detection of misfits at the abutment-prosthesis interface in the esthetic zone: Implications of the radiographic technique and the magnitude of the misfit. J Prosthet Dent 2023; 130:239.e1-239.e9. [PMID: 37455164 DOI: 10.1016/j.prosdent.2023.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 07/18/2023]
Abstract
STATEMENT OF PROBLEM Misfits in the abutment-prosthesis interface represent a setback for implant-supported prostheses. Periapical radiographs have been used as an auxiliary method in the evaluation of prosthesis fit to the abutments; however, the evidence supporting the use of this method is still restricted to studies of low to moderate quality. Furthermore, studies on the diagnostic accuracy of different periapical techniques used to detect misfits in the abutment-prosthesis interface, especially in the esthetic zone, are lacking. PURPOSE The purpose of this in vitro study was to assess the discrimination power of 3 periapical radiographic techniques in detecting misfits at the abutment-prosthesis interface in the esthetic zone and evaluate whether the magnitude of the misfit influenced the diagnosis. MATERIAL AND METHODS A total of 15 implants with an internal conical connection were installed in the central incisor region in polyamide jaws. Custom ceramic copings for cemented crowns were made by using a computer-aided design and computer-aided manufacturing (CAD-CAM) system. Misfits of 50, 100, and 150 µm were simulated by interposing 1, 2, or 3 50-μm-thick polyester strips at the abutment-prosthesis interface; the absence of the strip represented the control group. Digital radiographs were obtained by using film holders for the following periapical techniques: bisecting angle (PBA), standard paralleling (PSP), and modified paralleling (PMP). Two radiologists and 1 prosthodontist evaluated a total of 180 radiographs. The values of the area under the receiver operating characteristic curve (Az) were regarded as a measure of diagnostic accuracy and subjected to the Friedman test with post hoc Durbin-Conover (α=.05). RESULTS The PSP (Az=0.873) had higher Az values than the PBA (Az=0.753) for the 50-μm misfits (P<.05). Larger misfits resulted in greater accuracy than smaller misfits (P<.05). Interactions between the factors radiographic technique and misfit magnitude resulted in statistically significant differences for all comparisons (P<.05), except between the PSP for the 100-μm misfits (Az=0.976) and the PMP for the 150-μm misfits (Az=0.998). CONCLUSIONS The PSP was more accurate than the PBA in detecting the 50-µm misfits at the abutment-prosthesis interface; larger misfits resulted in more accurate diagnoses, regardless of the technique used.
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Affiliation(s)
- Vanessa Pacheco de Oliveira Mota
- Graduate student, Dental Sciences Graduate Program, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Manuella Soussa Braga
- Undergraduate student, Department of Clinical Dentistry, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Amanda Alves Loss
- Undergraduate student, Department of Clinical Dentistry, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Hugo Nogueira Mello
- Graduate student, Dental Sciences Graduate Program, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Elizabeth Pimentel Rosetti
- Professor, Dental Sciences Graduate Program, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Sergio Lins de-Azevedo-Vaz
- Professor, Dental Sciences Graduate Program, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil.
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