Radiographic Evaluation of Implant Impression Component Misfit

Abstract

Statement of Problem: Radiographs are commonly used to detect misfit of implant components, but various factors including implant connection and component opacity could affect this decision. Purpose: The purpose of this study was to evaluate the diagnostic capability of senior students and experienced dentists on the adaptation of implant and impression coping in different vertical and horizontal angled radiographs. Materials and Methods: The implant and the impression coping were attached to each other; once without any gap and once with a gap of 0.5 mm. Totally, 40 digital X-rays were taken with vertical inclinations of 0, 5, 10, 15, 20, 25, 30 degrees in positive and negative directions, and the rest were horizontally inclined with the same values. Forty senior students and twenty experienced dentists observed the radiographs. Their diagnoses were compared with the real status of components. Results: No significant difference was observed between the performance of students and experts (P=0.74). Statistical T-test analysis revealed that the directions (inclinations toward the implants or the impression copings) does not result in any significant difference in diagnoses of students (P=0.29) and dentists (P= 0.15). Nevertheless, general linear model showed the radiograph angulations had a significant impact on the diagnoses of students (P=0.003) and dentists (P<.001). Youden factor revealed that there was not a consistent trend regarding sensitivity and specificity of vertically angled radiographs; however, sensitivity and in particular, specificity decreased as a result of horizontal angle inclination. Conclusion: Increasing vertical angulations of the radiographs for diagnosing the adaptation of implant components is likely to reduce diagnostic capability of clinicians, even experienced ones. Specificity is more affected than sensitivity in both horizontally and vertically angled radiographs.

Keywords

• Dental implant, Impression coping, Gap, Radiography, Angulation, Experience