Diagnostic accuracy of cone‑beam computed tomography with modified grayscale range for detection of buccal cortical plate defects adjacent to dental implants

This study assessed the diagnostic accuracy of cone‑beam computed tomography (CBCT) with a modified grayscale range for the detection of buccal cortical plate defects adjacent to dental implants.

In this in vitro experimental study, titanium implants were inserted in 168 fresh bovine bone blocks with 1–1.5 mm of buccal cortical plate thickness. The blocks were randomly divided into four groups (n = 42). No defect was created in the control blocks. In the three experimental groups, cortical plate defects were randomly created in the cervical, middle, or apical third by a round bur with a 2‑mm diameter (n = 42). All blocks underwent CBCT with and without change in the grayscale range. Two observers evaluated all images regarding the presence/absence of defects. Kappa test is used for the agreement of the observers. The diagnostic accuracy of the two modalities was compared by calculating the area under the receiver operating characteristic curve (AUC) (P ≤ 0.05). The sensitivity and specificity values were also compared.

The AUC was not significantly different between the two modalities with and without altered grayscale range (0.754 vs. 0.762, respectively, P = 0.716). The diagnostic sensitivity of CBCT with and without change in the grayscale range was 51% and 52%, respectively, with a specificity of 100% for both. The diagnostic accuracy of CBCT with and without altered grayscale range had no significant difference for apical and middle third defects (P > 0.05) and was significantly higher than that for the cervical third defects (P < 0.05).

Changing the grayscale range does not improve the diagnostic accuracy of CBCT for the detection of buccal cortical plate defects adjacent to dental implants.