The influence of dental implants in periapical and panoramic radiographs and cone beam computed tomography images: a clinical study.

The aim of this study was to analyze the influence of dental implants on the radiographic density of the peri-implant region in tomographic and radiographic examinations. A sample of 21 dental implants from 10 patients with Branemark-protocol prostheses was evaluated based on postoperative control images, including periapical radiography (paralleling technique), panoramic radiography, and cone beam computed tomography (CBCT). The density means of 6 defined areas near dental implants were calculated and compared considering their locations and the different imaging examinations. The CBCT examinations showed significantly different densities among the measured areas (P < 0.001), while there were no significant differences among the density means of the various areas in periapical radiographs (P = 0.430) and panoramic radiographs (P = 0.149). The highest mean densities were observed in areas closer to the implants in all the examinations: CBCT (127.88 and 120.71), panoramic (106.51 and 106.09), and periapical (120.32). The sagittal CBCT images were measured in 2 different sections, and in both sections those areas closer to implants showed mean densities that were significantly higher than means from more distant areas (P < 0.001). Means from distant areas on CBCT slice imaging were significantly lower than the densities of the same areas on periapical and panoramic examinations. The changes in mean radiographic density values in the peri-implant region confirmed the interference of dental implants in radiographic and tomographic images. CBCT images suffered the greatest interference from dental implants.