Impact of conventional tomography on prediction of the appropriate implantsize

Aim. The purpose of this study was to evaluate the efficacy of conventional cross-sectional tomography in predicting the appropriate implant size. Methods. The implant length and width of 46 patients referred for single to oth implant treatment were determined presurgically by periapical + panoram ic images (record 1) and after surgery by periapical + panoramic images + t omograms (record 2). These dimensions were compared with the dimensions of the implants actually installed record 3), as well as the dimensions assess ed to be the "appropriate" ones according to defined criteria for success ( record 4). Results. In 70% of the cases, the implant length or width, or both, was cha nged after the tomogram was available. The implant dimensions determined wi th tomography were maintained at surgery in 87% of the cases. In only 33% o f the cases did the implant size predicted without tomography correspond wi th the size of the installed implants. The agreement between records 2 and 3 was significantly higher than between records I and 3 (P < .001). Similar ly, the agreement between records 2 and 4 was significantly higher than bet ween records I and 4 (P < .001). Conclusions. This study demonstrated that the use of tomograms increases th e efficacy of periapical + panoramic images, with respect to the prediction of appropriate implant size, by a factor of 2.5. Therefore, conventional c ross-sectional tomography is recommended for treatment planning before inst allation of single tooth implants.