Influence of 2D vs 3D imaging and professional experience on dental implant treatment planning

Objectives This study investigated whether professional experience and type of image examination (panoramic radiography (PAN) or cone beam computed tomography (CBCT)) could influence the pre-surgical planning for dental implant treatment. Materials and methods Six dentists, from two different levels of experience (senior (Sr) and junior (Jr)) performed simulated pre-surgical planning by using PANs and after 1 month, by using CBCTs, considering implant length (IL), implant width (IW), need for bone graft (BG), and other surgical procedures (OP). Bland-Altman test and Kappa coefficient were used to identify agreements. Results Bland-Altman test showed good agreement in the plans for inter-professional (i.e., Sr vs Jr) comparisons. Bland-Altman plots displayed intra-observer agreement (i.e., differences between PAN and CBCT), showing discrepancy between imaging modalities for IL and a tendency towards selecting larger dental implant options when using PAN and smaller options with CBCT. Kappa showed almost perfect (0.81–1.0) agreement between Jr and Sr for OP (PAN and CBCT). For BG, agreement was substantial (0.61–0.80) when planning was done with PAN and CBCT. Descriptive statistics showed evidence that when Jrs used CBCT, they no longer indicated the BG they had planned when they used PAN. Conclusion There were differences in the pre-surgical planning for treatment with dental implants depending on the professional experience and the type of imaging examination used. Clinical relevance Variation in dental implant planning can affect treatment time, cost, and morbidity in patients.