Diagnostic Accuracy of Inverted and Unprocessed Digitized Periapical Radiographs for Detection of Peri-Implant Defects

<p><strong>Objectives: </strong>This study aimed to compare the diagnostic accuracy of inverted and unprocessed digitized periapical radiographs for detection of peri-implant defects.</p><p><strong>Materials and Methods:</strong> A total of 30 osteotomy sites were prepared in three groups of control, study group 1 with 0.425 mm defects and study group 2 with 0.725 mm defects using the SIC and Astra Tech drill systems with 4.25mm and 4.85mm diameters. Small and large defects were randomly created in the coronal 8mm of 20 implant sites; implants (3.4mm diameter, 14.5mm length) were then placed. Thirty periapical (PA) radiographs were obtained using Digora imaging system (Soredex Corporation, Helsinki, Finland), size 2 photostimulable storage phosphor (PSP) plate sensors (40.0mm×30.0mm) and Scanora software. Unprocessed images were inverted using Scanora software by applying image inversion and a total of 60 images were obtained and randomly evaluated by four oral and maxillofacial radiologists. Data were analyzed using the t-test.</p><p><strong>Results:</strong> Significant differences were observed in absolute and complete sensitivity and specificity of the two imaging modalities for detection of small and large defects (P&lt;0.05). Unprocessed digital images had a higher mean in terms of absolute sensitivity for detection of small defects, complete sensitivity for detection of large peri-implant defects and definite rule out of defects compared with inverted images.</p><p><strong>Conclusion:</strong> Unprocessed digital images have a higher diagnostic value for detection of small and large peri-implant defects and also for definite rule out of defects compared with inverted images.