In vitro assessment of artifacts induced by titanium, titanium–zirconium and zirconium dioxide implants in cone-beam computed tomography

Sancho-Puchades M, Hämmerle CHF, Benic GI. In vitro assessment of artifacts induced by titanium, titanium–zirconium and zirconium dioxide implants in cone-beam computed tomography. Clin. Oral Impl. Res. 00, 2014; 1–7. doi: 10.1111/clr.12438

 

Abstract

Aim

The aim of this study was to test whether or not the intensity of artifacts around implants in cone-beam computed tomography (CBCT) differs between titanium, titanium–zirconium and zirconium dioxide implants.

Materials and methods

Twenty models of a human mandible, each containing one implant in the single-tooth gap position 45, were cast in dental stone. Five test models were produced for each of the following implant types: titanium 4.1 mm diameter (Ti_4.1), titanium 3.3 mm diameter (Ti_3.3), titanium–zirconium 3.3 mm diameter (TiZr_3.3) and zirconium dioxide 3.5–4.5 mm diameter (ZrO_3.5–4.5) implants. For control purposes, three models without implants were produced. Each model was scanned using a CBCT device. Gray values (GV) were recorded at eight circumferential positions around the implants at 0.5 mm, 1 mm and 2 mm from the implant surface (GV_Test). GV were assessed in the corresponding volumes of interest (VOI) in the control models without implants (GV_Control). Differences of gray values (ΔGV) between GV_Test and GV_Control were calculated as percentages. One-way ANOVA and post hoc tests were applied to detect differences between implant types.

Results

Mean ΔGV for ZrO_3.5–4.5 presented the highest absolute values, generally followed by TiZr_3.3, Ti_4.1 and Ti_3.3 implants. The differences of ΔGV between ZrO_3.5–4.5 and the remaining groups were statistically significant in the majority of the VOI (P ≤ 0.0167). ΔGV for TiZr_3.3, Ti_4.1 and Ti_3.3 implants did not differ significantly in the most VOI. For all implant types, ΔGV showed positive values buccally, mesio-buccally, lingually and disto-lingually, whereas negative values were detected mesially and distally.

Conclusions

Zirconium dioxide implants generate significantly more artifacts as compared to titanium and titanium–zirconium implants. The intensity of artifacts around zirconium dioxide implants exhibited in average the threefold in comparison with titanium implants.