Assessment of bone level in implantology using two radiographic methods

Objectives: The aim of the present study was to compare the reliability during assessments of the marginal bone level around implants as visualised in intraoral and panoramic radiographs. Methods: Two independent observers assessed, in both intraoral and panoramic radiographs, at what thread of the implant the marginal bone level attached. A light box and a magnifying viewer were used and the distal and mesial surface of 115 mandibular implants was assessed in a random order. The instruction to the observers in how to assess the bone level was basic. The observer agreement during repeated assessments was calculated for both types of radiographs using percentage in agreement and weighted kappa statistics. Results: The agreement between observers for the two readings were: 40-42% for intraoral radiographs and 47% for panoramic radiographs. Weighted kappa analysis showed 0.50-0.58 for intraoral radiographs and 0.60-0.62 for panoramic radiographs. Conclusion: Panoramic radiographs are as reliable as intraoral radiographs in implantology to assess the marginal bone level in the mandible.