Evidence map›Paper›PMID 40710602›Full record

ArticleJournal of imaging2025

Opportunistic Diagnostics of Dental Implants in Routine Clinical Photon-Counting CT Acquisitions.

Maurice Ruetters, Holger Gehrig, Christian Mertens, Sinan Sen, Ti-Sun Kim, Heinz-Peter Schlemmer, Christian H Ziener, Stefan Schoenberg, Matthias Froelich, Marc Kachelrieß and 1 more

Abstract read
In one paragraph

Article in Journal of imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Maurice RuettersDepartment of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Holger GehrigDepartment of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Christian MertensDepartment of Oral- and Maxillofacial Surgery, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.ORCID 0000-0002-6305-364X
Sinan SenDepartment of Orthodontics, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, Germany.ORCID 0000-0001-5907-5398
Ti-Sun KimDepartment of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Heinz-Peter SchlemmerDepartment of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
Christian H ZienerDepartment of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.ORCID 0000-0001-8854-7358
Stefan SchoenbergDepartment of Clinical Radiology and Nuclear Medicine, University Hospital Mannheim, Theodor-Kurz-Ufer 1-3, 68167 Mannheim, Germany.
Matthias FroelichDepartment of Clinical Radiology and Nuclear Medicine, University Hospital Mannheim, Theodor-Kurz-Ufer 1-3, 68167 Mannheim, Germany.ORCID 0000-0001-8501-2147
Marc KachelrießMedical Faculty, Heidelberg University, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany.
Stefan SawallMedical Faculty, Heidelberg University, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Two-dimensional imaging is still commonly used in dentistry, but does not provide the three-dimensional information often required for the accurate assessment of dental structures. Photon-counting computed tomography (PCCT), a new three-dimensional modality mainly used in general medicine, has shown promising potential for dental applications. With growing digitalization and cross-disciplinary integration, using PCCT data from other medical fields is becoming increasingly relevant. Conventional CT scans, such as those of the cervical spine, have so far lacked the resolution to reliably evaluate dental structures or implants. This study evaluates the diagnostic utility of PCCT for visualizing peri-implant structures in routine clinical photon-counting CT acquisitions and assesses the influence of metal artifact reduction (MAR) algorithms on image quality. Ten dental implants were retrospectively included in this IRB-approved study. Standard PCCT scans were reconstructed at multiple keV levels with and without MAR. Quantitative image analysis was performed with respect to contrast and image noise. Qualitative evaluation of peri-implant tissues, implant shoulder, and apex was performed independently by two experienced dental professionals using a five-point Likert scale. Inter-reader agreement was measured using intraclass correlation coefficients (ICCs). PCCT enabled high-resolution imaging of all peri-implant regions with excellent inter-reader agreement (ICC > 0.75 for all structures). Non-MAR reconstructions consistently outperformed MAR reconstructions across all evaluated regions. MAR led to reduced clarity, particularly in immediate peri-implant areas, without significant benefit from energy level adjustments. All imaging protocols were deemed diagnostically acceptable. This is the first in vivo study demonstrating the feasibility of opportunistic dental diagnostics using PCCT in a clinical setting. While MAR reduces peripheral artifacts, it adversely affects image clarity near implants. PCCT offers excellent image quality for peri-implant assessments and enables incidental detection of dental pathologies without additional radiation exposure. PCCT opens new possibilities for opportunistic, three-dimensional dental diagnostics during non-dental CT scans, potentially enabling earlier detection of clinically significant pathologies.

Indexed as

dentaldental implantsincidental findingsradiographytomographyX-ray computed

Identifiers

PMID40710602
PMCPMC12295114

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.