The Reliability of CBCT to Assess Quality of Augmented Bone After Lateral Sinus Floor Elevation With Xenografts: A Retrospective Analysis

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research Pub Date : 2025-04-30 DOI:10.1111/cid.70029

Xixuan Wang, Wenyan Zhao, Menglin Liao, Yunfei Liu, Chengzhe Ban, Gang Fu, Qingqing Wu

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Abstract

Objetives

This study aimed to explore the reliability of cone beam computed tomography (CBCT) in evaluating the quality of augmented bone after lateral sinus floor elevation (LSFE) with xenografts.

Materials and Methods

Thirty-six patients with lost maxillary molars were included, with half of whom received LSFE with xenografts and staged implant placement, and the other half showed no vertical bone defects and underwent implant placement directly. A total of 36 implants were included, with 18 implants in each group. A CBCT exam was taken before implant placement to acquire data on mineral quality at the future implant site, including bone mineral density (BMD), various microstructure indices, and gray values (GVs) within different threshold ranges. Augmented bone biopsies were collected during implant preparation. The microstructure indices and histological characteristics of the biopsies were evaluated by micro computed tomography (μCT) and histological staining. An implant-oriented volume of interest for CBCT analysis was established to co-locate the CBCT-measured data and the biopsy-related data using 3DSlicer. A Spearman rank correlation test was used to analyze the relationship between CBCT-measured data and the biopsy-related data.

Results

μCT-measured microstructure indices of the augmented bone (BV/TV and Tb.Th) were significantly correlated with new bone area (BV/TV, p = 0.035, r = 0.498; Tb.Th, p = 0.027, r = 0.520). No correlation was found between the CBCT-measured and μCT-measured microstructure indices. CBCT-measured BMD and microstructure indices hardly showed any correlation with histological indices (p > 0.05). When the threshold was set from 0 to 50, the mean GVs were significantly, positively correlated with new bone area (p = 0.041, r = 0.486), and bone substitute area was positively correlated to the mean GVs of higher threshold (range 60–255, p = 0.048, r = 0.472; range 70–255, p = 0.009, r = 0.593).

Conclusions

CBCT without bone substitute segmentation was not reliable for evaluating the quality of xenogenic augmented bone after LSFE. The influence of the xenogenic substitute on CBCT analysis can be reduced by setting a low GV threshold. The bone substitute segmentation strategy may present a new way to increase the reliability of CBCT in evaluating xenogenic augmented bone.

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CBCT评估异种侧窦底抬高后骨增强质量的可靠性：回顾性分析

目的探讨锥束计算机断层扫描（CBCT）在评估异种骨移植侧窦底抬高（LSFE）后增强骨质量中的可靠性。材料与方法选取36例上颌磨牙缺失患者，其中一半患者行LSFE +异种移植+分期种植，另一半患者无垂直骨缺损直接种植。共纳入种植体36枚，每组18枚。种植体放置前进行CBCT检查，获取未来种植体部位的矿物质质量数据，包括骨矿物质密度（BMD）、各种显微结构指标和不同阈值范围内的灰度值（gv）。在种植体准备期间收集增强骨活检。采用显微计算机断层扫描（μCT）和组织染色对活检组织的显微结构指标和组织学特征进行评价。建立了CBCT分析感兴趣的植入体导向体积，使用3DSlicer将CBCT测量数据和活检相关数据共同定位。采用Spearman秩相关检验分析cbct测量数据与活检相关数据之间的关系。结果μ ct测量增强骨微结构指标（BV/TV和Tb.Th）与新生骨面积(BV/TV, p = 0.035, r = 0.498；结核病。p = 0.027, r = 0.520)。cbct测量值与μ ct测量值之间无相关性。cbct测量的骨密度和微结构指标与组织学指标几乎没有相关性（p > 0.05）。阈值为0 ~ 50时，平均GVs与新骨面积呈显著正相关（p = 0.041, r = 0.486），较高阈值时，骨替代面积与平均GVs呈显著正相关(60 ~ 255,p = 0.048, r = 0.472；范围70-255，p = 0.009, r = 0.593)。结论不进行骨替代物分割的CBCT评价异种增殖骨LSFE术后质量不可靠。通过设置较低的GV阈值，可以降低异种替代品对CBCT分析的影响。骨替代物分割策略为提高CBCT评估异种增强骨的可靠性提供了一种新的方法。

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来源期刊

Clinical Implant Dentistry and Related Research 医学-牙科与口腔外科

CiteScore

6.00

自引率

13.90%

发文量

103

审稿时长

4-8 weeks

期刊介绍： The goal of Clinical Implant Dentistry and Related Research is to advance the scientific and technical aspects relating to dental implants and related scientific subjects. Dissemination of new and evolving information related to dental implants and the related science is the primary goal of our journal. The range of topics covered by the journals will include but be not limited to: New scientific developments relating to bone Implant surfaces and their relationship to the surrounding tissues Computer aided implant designs Computer aided prosthetic designs Immediate implant loading Immediate implant placement Materials relating to bone induction and conduction New surgical methods relating to implant placement New materials and methods relating to implant restorations Methods for determining implant stability A primary focus of the journal is publication of evidenced based articles evaluating to new dental implants, techniques and multicenter studies evaluating these treatments. In addition basic science research relating to wound healing and osseointegration will be an important focus for the journal.