Influence of image-viewers and artifacts on implant length measurements in cone-beam computed tomography: an in vitro study.

This preclinical in vitro study compared the accuracy of implant lengths measured in two different image-viewers, and examined whether implant-induced artifacts affected the implant length measurements on CBCT images. A resin edentulous mandibular model, with multiple adjacent implants in the posterior segments, was acquired with a CBCT machine. In two different image-viewers, two observers independently measured the implant length. Vertical measurements on CBCT images were carried out twice at each session, and repeated one week later. The results demonstrated no significant differences between actual and measured implant lengths. The differences in the mean error for vertical measurements using the two different image-viewers (cross-sectional images: OsiriX viewer = -0.01 ± 0.03 mm, NewTom viewer = -0.05 ± 0.09 mm, p-value = 0.056; sagittal images: OsiriX viewer = -0.03 ± 0.04 mm; NewTom viewer = -0.04 ± 0.10 mm, p-value = 0.24) were not statistically significant. This in vitro investigation suggests that the accuracy of implant length measurements on CBCT images was not influenced by image-viewers or by the presence of implant-induced artifacts. The presence of multiple adjacent implants in the posterior segments of the mandible is not likely to impact the measurements made between the implant apex and vital structures on CBCT images.