Are dental magnetic resonance imaging and ultrasonography techniques reliable alternatives for treatment planning dental implants? A systematic review and meta-analysis.
Hengjia Zhang, Joe Donaldson, Vitor C M Neves, James Scott
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Abstract
Background: The rising global demand for dental implant highlights the necessity for precise imaging techniques that minimise patient risk of radiation exposure. While the cone -beam Computed Tomography (CBCT) remains the gold standard, its ionizing radiation exposure raises safety concerns. This systematic review and meta-analysis aim to evaluate the accuracy of non-ionizing alternatives, Magnetic Resonance Imaging (MRI) and Ultrasonography (US), in dental implantology.
Methods: Databases (MEDLINE, Scopus, Cochrane) were searched for studies (2014-2024) using predefined PICO criteria. Risk of bias was assessed via QUADAS-2. Meta-analysis employed fixed/random-effects models to synthesize quantitative data on geometric deviations and soft-tissue accuracy.
Results: Twelve studies were included in this study. While MRI generally exhibited greater deviation in implant tip placement at 0.3 mm (95% CI -0.08, 0.68), its overall accuracy remained comparable to CBCT. MRI showed a higher mean deviation at the implant entry level of 0.38 mm (95% CI 0.04, 0.71) and for implant angulation with a mean difference of 0.81 degree (95% CI -0.50, 2.12), indicating less precision under specific conditions. Conversely, Ultrasonography demonstrated superior performance in soft tissue accuracy with a smaller deviation compared to CBCT, at just 0.04 mm (95% CI -0.04, 0.13).
Conclusion: MRI and ultrasonography offer reliable non-ionizing alternatives for dental implant planning, with MRI matching CBCT in hard-tissue accuracy and ultrasonography excelling in soft tissue assessment. Further standardisation of protocols is needed to address variability in clinical workflows.
Clinical trial number: The Clinical Trial Number is not applicable in this systematic review. This study was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO) online with the identification number CRD42024610741.
背景：全球种植体需求的增长凸显了精确成像技术的必要性，以最大限度地减少患者的辐射暴露风险。虽然锥形束计算机断层扫描（CBCT）仍然是黄金标准，但其电离辐射暴露引起了安全问题。本系统综述和荟萃分析旨在评估非电离替代方案，磁共振成像（MRI）和超声成像（US）在牙科种植中的准确性。方法：采用预先设定的PICO标准检索MEDLINE、Scopus、Cochrane数据库中2014-2024年的研究。偏倚风险通过QUADAS-2进行评估。meta分析采用固定/随机效应模型综合几何偏差和软组织精度的定量数据。结果：本研究共纳入12项研究。虽然MRI通常在种植体尖端放置0.3 mm时显示更大的偏差（95% CI -0.08, 0.68），但其总体准确性仍与CBCT相当。MRI显示种植体进入水平的平均偏差较高，为0.38 mm (95% CI 0.04, 0.71)，种植体成角的平均偏差为0.81度（95% CI -0.50, 2.12），表明在特定条件下精度较低。相反，与CBCT相比，超声检查在软组织准确性方面表现优异，偏差较小，仅为0.04 mm （95% CI -0.04, 0.13）。结论：MRI和超声为牙种植体规划提供了可靠的非电离替代方案，MRI在硬组织评估方面与CBCT相匹配，超声在软组织评估方面优于CBCT。需要进一步标准化方案，以解决临床工作流程的可变性。临床试验编号：临床试验编号不适用于本系统评价。本研究已在国际前瞻性系统评价注册库（PROSPERO）在线前瞻性注册，识别号为CRD42024610741。
期刊介绍：
The International Journal of Implant Dentistry is a peer-reviewed open access journal published under the SpringerOpen brand. The journal is dedicated to promoting the exchange and discussion of all research areas relevant to implant dentistry in the form of systematic literature or invited reviews, prospective and retrospective clinical studies, clinical case reports, basic laboratory and animal research, and articles on material research and engineering.
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