Accuracy of Digital Versus Conventional Periapical Radiographs to Detect Misfit at the Implant-Abutment Interface

Purpose: Misfit is a risk factor for rehabilitation with implants, and its detection is of fundamental importance to the success of treatment with implants. The use of appropriate radiographic imaging is key for a good prognosis. The aim of this study was to compare the efficacy of film and digital radiographs for the detection of misfit at the implant-abutment interface. Materials and Methods: Digital and conventional (manual and automatic processing) radiography was performed in seven test specimens, each one with a different vertical misfit between the abutment and the platform of the implant. Scanning electron microscopy was used to confirm the misfit and to measure it. Five dental radiologists independently and blindly evaluated the images. Cohen's kappa with linear weighting was calculated to determine interexaminer and intraexaminer concordance. Statistical analyses were performed using the Cochran's Q test and the receiver operating characteristic curve (ROC). Results: Interexaminer analysis showed that the kappa value was equal to 0.74, whereas the average kappa value in the intraexaminer evaluation was 0.90. Digital imaging showed the largest area on the ROC graph, and conventional images with manual processing showed the smallest area. The images obtained through conventional radiography with both manual and automatic processing showed statistically significant differences from the measurement of the gold standard (P .05). Conclusion: Digital imaging can be used to evaluate misfit at the implant-abutment interface. Conventional systems of radiographic imaging do not provide sufficient information to evaluate misfit at the implant-abutment interface. Keywords: dental prosthesis fixed by implants, digital dental radiograph, prosthesis failure