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Radiographic assessment of the marginal bone level after implant treatment: a comparison of periapical and Scanora^® detailed narrow beam radiography

Department of Oral Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden

*Correspondence to: C Lindh, Department of Oral Radiology, Faculty of Odontology, Malmö University, Carl Gustafs väg 34, SE-205 06 Malmö, Sweden; Email: christina.lindh{at}od.mah.se

Received 2 April 2002; revised 29 October 2002; accepted 4 December 2002

Objectives: To compare assessments of the marginal bone level around dental implants in the mandible using periapical radiography and Scanora^® detailed narrow beam (DNB) radiography.

Methods: Forty patients treated with Brnemark dental implants in the lower jaw were examined with periapical and Scanora^® DNB radiography. Ten implants were selected from each of the four dental regions (molar, incisor, canine, premolar), and no more than one implant was selected from the same patient. Seven observers assessed the level of the marginal bone on the mesial and distal surfaces of the implants. Three of the observers made all the assessments twice.

Results: Agreement between the methods was 61%. The highest agreement was found in the molar region. In DNB radiography the marginal bone level was observed to be situated more "coronally" in 17% and more "apically" in 22% compared with periapical radiography. The kappa value for interobserver agreement for all observers was 0.33 for periapical radiography and 0.27 for DNB radiography. The weighted kappa value for intraobserver agreement ranged from 0.75 to 0.99 for DNB radiography and from 0.94 to 0.98 for periapical radiography.

Conclusions: Scanora^® multimodal radiography simplifies examination of implants in the mandible, and observer variation is comparable with that in intraoral periapical radiography.

Keywords: tomography, X-ray; radiography, dental; dental implantation; alveolar bone loss