Journal of Maxillofacial and Oral Surgery

, Volume 17, Issue 4, pp 520–530 | Cite as

Effect of Milliamperage Reduction on Pre-surgical Implant Planning Using Cone Beam Computed Tomography by Surgeons of Varying Experience

  • N. El SahiliEmail author
  • S. David-Tchouda
  • S. Thoret
  • I. Nasseh
  • A. Berberi
  • T. Fortin
Original Article



Differences in CBCT units and the lack of standardization result in exposure to radiation doses beyond what is required for diagnostic purposes, especially when planning the surgical placement of dental implants.


To assess the influence of low- and high-dose milliamperage settings on CBCT images for objective and subjective implant planning among senior specialists (5 years of experience) and juniors (fresh graduates).

Materials and Methods

Two dry skulls (4 hemi-maxillary segments of the maxilla and 4 hemi-maxillary segments of the mandible) were scanned under low (2 mA) and high (6.3 mA) dosage settings using the Carestream CS 9300 machine. Cross-sectional slices of both image qualities were evaluated by the 5 seniors and the 5 juniors for subjective image utility for implant planning and for objective linear bone measurements.


There were no significant differences in bone measurements taken on high- or low-dose images by all seniors and by the majority of juniors (p > 0.05). In qualitative image assessments, there was independence between assessment and image quality for almost all observers. For planning posterior mandibular implant placement, increased dosage improved concordance and kappa values between low- and high-dose images for senior observers (from K = 0.287 at low dose to K = 0.718 at high does) but not for juniors (K = 0.661 and K = 0.509 for low and high dose, respectively).


Reduction in milliamperage did not affect diagnostic image quality for objective bone measurements and produced sufficient concordance for qualitative assessment. Judicious optimization of milliamperage settings based on individual diagnostic requirements can result in significant dose reduction without compromising diagnostic decision-making.


Cone beam computed tomography Implant-placement planning Image resolution Radiation dose alteration 



We would like to thank Mrs. Sophie THORET, statistician at the Grenoble University Hospital Innovation Unit and Dr. Ali JANBAIN of the Graduate School of Science and Technology at the Lebanese University.

Compliance with Ethical Standards

Conflict of interest

The authors report no conflict of interest related to this study.


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Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2017

Authors and Affiliations

  • N. El Sahili
    • 1
    Email author
  • S. David-Tchouda
    • 2
  • S. Thoret
    • 3
  • I. Nasseh
    • 4
  • A. Berberi
    • 5
  • T. Fortin
    • 6
  1. 1.School of DentistryLebanese UniversityBeirutLebanon
  2. 2.Medico-economic Evaluation Unit, University Hospital of Grenoble, France/ThEMAS TIMC, UMR CNRS 5525Grenoble Joseph Fourier UniversityGrenobleFrance
  3. 3.Investigation Clinical Center of Grenoble, INSERMGrenobleFrance
  4. 4.Department of Oral and Maxillofacial Surgery, School of DentistryLebanese UniversityBeirutLebanon
  5. 5.Department of Oral and MaxilloFaciale Surgery, School of DentistryLebanese UniversityBeirutLebanon
  6. 6.Department of Oral SurgeryDental University of Lyon, University Claude Bernard, Lyon 1, France. UJF-Grenoble 1/CNRS/TIMC-IMAG UMR 5525GrenobleFrance

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