RESUMO
STATEMENT OF PROBLEM: Misfits at the implant-prosthesis interface may increase complications in dental implants and affect peri-implant tissue health. Periapical radiographs are the most used imaging examinations for detecting misfits at the implant-prosthesis interface, although digital systems have largely replaced film-based radiographs. Whether postprocessing tools such as enhancement filters assist diagnosis by highlighting misfits is unclear. PURPOSE: The purpose of this in vitro study was to assess the influence of enhancement filter application in the diagnostic accuracy of misfit detection at the implant-prosthesis interface. MATERIAL AND METHODS: A total of 32 dental implants were placed in dry human mandibles. A polyester strip was inserted at the implant-prosthesis interface to simulate a 50-µm misfit; prosthetic crowns installed directly on the implant platforms were used as controls. Standard paralleling periapical images were acquired by using a semidirect system (photostimulable phosphor plate) with the application of Highlight, Invert, and Colorization filters, as well as a direct system (metal oxide complementary semiconductor sensor) with filters Sharpness 3, Invert, and Pseudocolorization. Oral radiologists evaluated the images with and without the application of filters. The areas under the receiver operating characteristics curves (Az values), sensitivity, specificity, accuracy, positive predictive value, and negative predictive values were calculated. The Az values were compared with the receiver operating characteristic (ROC) curves comparison test of the Epidat 3.1 software (α=.05). RESULTS: Although images without filter application presented descriptively higher diagnostic values than those with filter application, the Az values for images with and without filter application in both semidirect and direct systems showed no significant differences (P>.05). CONCLUSIONS: Enhancement filter application did not significantly influence the diagnostic accuracy of misfit detection at the implant-prosthesis interface.
