Year: 2025
Type: article
Abstract: PURPOSE: To assess the diagnostic performance of photon-counting computed tomography (PCCT) in the imaging of peri-implant bone structures and to compare it quantitatively and qualitatively to cone-beam computed tomography (CBCT). METHODS: Thirty titanium implants were placed in ten porcine mandibles. CBCT and PCCT scans were acquired and compared quantitatively regarding image noise and CT-values. Additionally bone thickness was compared to a gold standard at 60 standardized locations by one calibrated investigator in both modalities. Measurement accuracy was assessed by Bland-Altman analysis. Two experienced raters performed qualitative assessments of anatomic structures around the implant using a 5-point visibility scale. These included the bone-implant interface around the implant surface, the bone at the implant shoulder as well as the oral and vestibular bone lamella. Inter-rater agreement was assessed using ICC. RESULTS: Across all evaluated implants, CT-values in a soft-tissue region of interest adjacent to the implant increased by 11.7 ± 3.9% for CBCT acquisitions, whereas they decreased by 5.3 ± 1.3% for PCCT acquisitions. Similarly, image noise in the respective ROIs is increased by a factor of 63 ± 13% in case of CBCT acquisitions and only by 23 ± 5% in case of PCCT acquisitions. Bone thickness deviations were smaller for PCCT (mean ± SD: 0.06 ± 0.08 mm) than for CBCT (0.39 ± 0.34 mm). Qualitative assessments consistently favored PCCT (p < 0.05) with excellent inter-rater reliability (ICC > 0.75 ) in almost all categories. CONCLUSIONS: PCCT enables superior visualization of peri-implant bone structures with fewer artifacts and improved diagnostic accuracy.
Language: English
Subfield: Oral Surgery
Field: Dentistry
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,290
Funder: Universitätsklinikum Heidelberg
OpenAlex ID: W4413054428