Assessment of Peri-implant Buccal Bone Thickness Using Digital Imaging Techniques: A Systematic Review and Meta-analysis

Lauren Bohner1, 2, *, Marcel Hanisch2, Israel Chilvarquer3, Johannes Kleinheinz2, Pedro Tortamano1
1 Department of Prosthodontics, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
2 Department of Craniomaxillofacial Surgery, Hospital University Münster, Germany
3 Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil

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© 2020 Bohner et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Prosthodontics, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, 05508-000 São Paulo, SP, Brazil; Tel: +55 11 3091 7885, Fax: +55 11 3091 7640; E-mail:



This systematic review aimed to answer the following focused question: Do the currently available imaging techniques provide accuracy in the assessment of peri-implant buccal bone thickness?


A search strategy was conducted in eight electronic databases, followed by an additional manual search in grey literature and references of selected articles. Studies evaluating the accuracy of imaging techniques to measure peri-implant buccal bone thickness were included. Individual risk of bias was assessed by the Quality Assessment Tool for Diagnostic Accuracy Studies-2 (QUADAS-2). Meta-analysis was performed to evaluate CBCT accuracy. The overall effect size was determined by means of the Z-test. Q test was used to evaluate the homogeneity of effect sizes among studies and I2 was applied to determine the variance within studies.


After an initial screening, 83 studies were further selected for full reading and 13 of them were considered eligible for this review. In sum, the accuracy of Cone-beam Computed Tomography (CBCT), of ultrasound, and of computed tomography were assessed. There was no statistically significant difference between CBCT and the gold standard (p=0.81). The mean difference between measurements of bone thickness obtained by CBCT and the goldstandard was -0.0.3mm [95%CI -0.29;0.253mm].


CBCT showed acceptable accuracy for assessing peri-implant bone. No meaningful conclusion could be drawn about other techniques.

Keywords: Dental implants, diagnostic imaging, cone-beam computed tomography, diagnostic x-ray, ultrasonic imaging.