Clinical Oral Investigations

, Volume 23, Issue 2, pp 929–936 | Cite as

Influence of 2D vs 3D imaging and professional experience on dental implant treatment planning

  • João Henrique Fortes
  • Christiano de Oliveira-Santos
  • Wilson Matsumoto
  • Raphael Jurca Gonçalves da Motta
  • Camila TirapelliEmail author
Original Article



This study investigated whether professional experience and type of image examination (panoramic radiography (PAN) or cone beam computed tomography (CBCT)) could influence the pre-surgical planning for dental implant treatment.

Materials and methods

Six dentists, from two different levels of experience (senior (Sr) and junior (Jr)) performed simulated pre-surgical planning by using PANs and after 1 month, by using CBCTs, considering implant length (IL), implant width (IW), need for bone graft (BG), and other surgical procedures (OP). Bland-Altman test and Kappa coefficient were used to identify agreements.


Bland-Altman test showed good agreement in the plans for inter-professional (i.e., Sr vs Jr) comparisons. Bland-Altman plots displayed intra-observer agreement (i.e., differences between PAN and CBCT), showing discrepancy between imaging modalities for IL and a tendency towards selecting larger dental implant options when using PAN and smaller options with CBCT. Kappa showed almost perfect (0.81–1.0) agreement between Jr and Sr for OP (PAN and CBCT). For BG, agreement was substantial (0.61–0.80) when planning was done with PAN and CBCT. Descriptive statistics showed evidence that when Jrs used CBCT, they no longer indicated the BG they had planned when they used PAN.


There were differences in the pre-surgical planning for treatment with dental implants depending on the professional experience and the type of imaging examination used.

Clinical relevance

Variation in dental implant planning can affect treatment time, cost, and morbidity in patients.


Cone beam tomography Dental implants Treatment plan Professional experience Digital dentistry 



We would like to thank Clínica DVI (Ribeirão Preto, SP, Brazil), RadioMemory Company (Belo Horizonte, MG, Brazil).

Funding information

The work was supported by the Department of Dental Materials and Prosthodontics and Departament of Stomatology, Public Health, and Forensic Dentistry in the University of São Paulo, SP, Brazil. CAPES (Coordination for the Improvement of Higher Level Education—Personnel) for the financial support provided for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with direct human participants or animals performed by any of the authors. Access to diagnostic image database was approved by institutional research committee approved ethically under the number 47779215.8.0000.5419.

Informed consent

For this type of study, no formal consent is required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • João Henrique Fortes
    • 1
  • Christiano de Oliveira-Santos
    • 2
  • Wilson Matsumoto
    • 1
  • Raphael Jurca Gonçalves da Motta
    • 1
  • Camila Tirapelli
    • 1
    Email author
  1. 1.Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão PretoUniversity of São PauloRibeirão PretoBrazil
  2. 2.Departament of Stomatology, Public Health, and Forensic Dentistry, School of Dentistry of Ribeirão PretoUniversity of São PauloRibeirão PretoBrazil

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