Measurement of Peri-Implant Bone Width with and without Metal Artifact Reduction Algorithm Using Two Cone-Beam Computed Tomography Software Programs

Objective:  To assess the effect of metal artifact reduction (MAR) algorithm of two cone-beam computed tomography (CBCT) software programs on the accuracy of peri-implant bone width measurements .  Material and Methods:  This in vitro study evaluated 35 bovine rib bone blocks measuring 8 x 8 x 11 mm. Titanium implants were inserted in bone blocks and placed in a wax model of mandible. CBCT scans were obtained with ProMax 3D and Cranex 3D CBCT systems with and without the MAR algorithm. The width of buccal and lingual bone plates surrounding the implant was measured on CBCT scans by two observers. The Cronbach’s alpha was calculated to assess inter-observer agreement. The area under the curve (AUC), sensitivity and specificity values were calculated and compared.  Results: The two observers had an excellent agreement. The accuracy of Cranex 3D was higher than that of ProMax 3D (p<0.05). Both CBCT systems showed higher accuracy when the MAR algorithm was not used (p<0.05). Both CBCT systems showed higher accuracy for measuring the width of the lingual plate than buccal plate (p<0.05) .  Conclusion:  The application of MAR algorithm did not notably increase the measurement accuracy in any CBCT system. Cranex 3D showed generally higher measurement accuracy than ProMax 3D.