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      Predictability of bone density at posterior mandibular implant sites using cone-beam computed tomography intensity values

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          Abstract

          Objective:

          The aim of this study was to investigate the predictability of bone density at posterior mandibular implant sites using cone-beam computed tomography (CBCT) intensity values.

          Materials and Methods:

          CBCT cross-sectional images for 436 posterior mandibular implant sites were selected for the study. Using Invivo software (Anatomage, San Jose, California, USA), two observers classified the bone density into three categories: low, intermediate, and high, and CBCT intensity values were generated.

          Results:

          Based on the consensus of the two observers, 15.6% of sites were of low bone density, 47.9% were of intermediate density, and 36.5% were of high density. Receiver-operating characteristic analysis showed that CBCT intensity values had a high predictive power for predicting high density sites (area under the curve [AUC] =0.94, P < 0.005) and intermediate density sites (AUC = 0.81, P < 0.005). The best cut-off value for intensity to predict intermediate density sites was 218 (sensitivity = 0.77 and specificity = 0.76) and the best cut-off value for intensity to predict high density sites was 403 (sensitivity = 0.93 and specificity = 0.77).

          Conclusions:

          CBCT intensity values are considered useful for predicting bone density at posterior mandibular implant sites.

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          Most cited references32

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          The excessive loss of Branemark fixtures in type IV bone: a 5-year analysis.

          The predictability of branemark implants has been well documented. High success rates in the maxilla and mandible in fully and partially edentulous patients can be expected. A host of factors may be attributed to the etiology of fixture loss. However, the quality of bone stands out as the single greatest determinant in fixture loss. Types I, II, and III bone offer good strength. Type IV bone has a thin cortex and poor medullary strength with low trabecular density. Ninety percent of 1,054 implants placed were in Types I, II, and III bone. Only 3% of these fixtures were lost; of the 10% of the fixtures placed in Type IV bone, 35% failed. Presurgical determination of Type IV bone may be one method to decrease implant failure.
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            Bone classification: an objective scale of bone density using the computerized tomography scan.

            Dental implants are subject to masticatory loads of varying magnitude. Implant performance is closely related to load transmission at the bone-to-implant interface where bone quality will be highly variable. The type and architecture of bone is known to influence its load bearing capacity and it has been demonstrated that poorer quality bone is associated with higher failure rates. To date, bone classifications have only provided rough subjective methods for pre-operative assessment, which can prove unreliable. The results of an extensive analysis of computerized tomography scans using Simplant software (Columbia Scientific Inc., Columbia, MD, USA) demonstrate that an objective scale of bone density based on the Houndsfield scale, can be established and that there is a strong correlation between bone density value and subjective quality score (P = 0.002) as well as between the bone density score and the region of the mouth (P < 0.001).
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              • Record: found
              • Abstract: not found
              • Article: not found

              Density of bone: effect on treatment plans, surgical approach, healing, and progressive boen loading.

              C E Misch (1989)
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                Author and article information

                Journal
                Eur J Dent
                Eur J Dent
                EJD
                European Journal of Dentistry
                Medknow Publications & Media Pvt Ltd (India )
                1305-7456
                1305-7464
                Jul-Sep 2017
                : 11
                : 3
                : 311-316
                Affiliations
                [1 ]Department of Oral Surgery and Medicine, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
                [2 ]Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
                [3 ]Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
                Author notes
                Correspondence: Dr. Mustafa Alkhader Email: mmalkhader@ 123456just.edu.jo
                Article
                EJD-11-311
                10.4103/ejd.ejd_14_17
                5594958
                28932139
                d0d7808f-9bac-4905-9946-e52c21a7eb67
                Copyright: © 2017 European Journal of Dentistry

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                Categories
                Original Article

                Dentistry
                bone density,cone-beam computed tomography,dental implants,predictability
                Dentistry
                bone density, cone-beam computed tomography, dental implants, predictability

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