The impact of implant-related characteristics on dental implant blooming: An in vitro study

Aim To assess, in vitro, variables potentially influencing implant blooming using a human-like imaging phantom and 3D-printed mandibles. Material and Methods Sixty implants were inserted in 3D-printed mandibles in 26 different configurations in order to examine the impact of implant diameter, presence of a cover screw, implant design/material, implant position, and the presence of additional implants on implant blooming using two cone-beam computed tomography (CBCT) devices (Accuitomo [ACC] and NewTom [NWT]). Two observers measured the amount of implant blooming in both buccolingual and mesiodistal directions. Inter-rater agreement and descriptive statistics, grouped by implant characteristic and CBCT device, were calculated. Results Both CBCT devices increased implant diameter (a mean increase of 9.2% and 11.8% for titanium, 20.3% and 24.4% for zirconium, for ACC and NWT, respectively). An increase in implant diameter did not increase the amount of blooming, whereas placing a cover screw did (from 8.0% to 10.9% for ACC, and from 10.0% to 15.6% for NWT). Moreover, implant design, anatomical region, and the presence of another implant also affected the extent of the blooming. Conclusions Dental implants show a clear diameter increase on CBCT, with the effect being more pronounced for zirconium than for titanium implants. Similar effects are likely to occur in the clinical setting, potentially masking nonosseointegration, reducing the dimensions of peri-implant defects, and/or causing underestimation of the buccal bone thickness.

Automated summary

This study assessed the factors influencing implant blooming using a human-like imaging phantom and 3D-printed mandibles. The results showed that implant diameter, presence of a cover screw, implant design/material, implant position, and the presence of additional implants all affected the extent of implant blooming. The study also found that the effect of implant diameter was more pronounced for zirconium implants.