Diagnostic efficacy of a modified low-dose acquisition protocol for the preoperative evaluation of mini-implant sites

Purpose: The objective of this study was to compare the outcomes of surgical mini-implant placement when potential mini-implant sites were scanned using a lower-dose $180^{\circ}$ acquisition protocol versus a conventional $360^{\circ}$ acquisition protocol. Materials and Methods: Ten dentate human skulls were used to provide sites for potential mini-implant placement. The sites were randomly divided into 2 groups: $360^{\circ}$ and $180^{\circ}$ cone-beam computed tomography (CBCT) acquisition protocols. A small-volume $180^{\circ}$ CBCT scan and a $360^{\circ}$ CBCT scan of each site were acquired using a Morita Accuitomo-170 CBCT machine and then a mini-implant was placed. A follow-up $360^{\circ}$ CBCT scan was done as a gold standard to evaluate the location of the mini-implant and root perforation. Two raters evaluated the scans. Results: Ninety-eight percent of the mini-implants placed did not perforate any root structure. Two percent of the sites had an appearance suggestive of perforation. On a Likert scale, both raters agreed that their subjective evaluation of the diagnostic quality of the protocols, ability to make and read measurements of the sites, and preferences for the specified diagnostic task were comparable. The Cohen kappa showed high inter-rater and intrarater agreement. Conclusion: In this ex vivo study, we found that the $180^{\circ}$ rotational acquisition was as effective as the conventional $360^{\circ}$ rotational acquisition for the preoperative evaluation of potential mini-implant sites.