A Comparative Investigation of Multi-Source and Clinical Cone Beam Computed Tomography in Predicting Dental Implant Stability with Porcine Model

Accurate assessment of bone quality is pivotal for successful dental implant therapy, where primary stability, commonly indicated by insertion torque, serves as a critical predictor of implant longevity. This study evaluated whether a novel multisource cone beam computed tomography (ms-CBCT) design offers a more accurate correlation between bone density—approximated by Hounsfield Unit (HU) values—and implant insertion torque compared to conventional single-source CBCT for implant planning. A total of 12 dental implant sites were imaged by both ms-CBCT and conventional CBCT. HU values were calculated by averaging voxel values in the vicinity of each planned implant location. Insertion torque was recorded intraoperatively using a digital torque wrench. Correlation analyses (Pearson’s r) assessed the strength of the association between insertion torque and HU values from each imaging modality. ms-CBCT-derived HU showed a higher and statistically significant correlation with insertion torque (R² = 0.8306, p = 1.42E-5) than that of the conventional CBCT (R² = 0.5524, p = 0.0056). However, the inter-group t-test did not reach statistical significance (p = 0.146), likely due to the limited sample size. These findings nonetheless suggest that ms-CBCT may better approximate local bone quality relevant to primary implant stability. By mitigating scatter and cupping beam artifacts, ms-CBCT enhances HU accuracy and achieves a stronger correlation with implant insertion torque. These findings highlight ms-CBCT’s clinical potential to improve patient-specific implant planning, reduce failure rates, and refine treatment protocols in implant dentistry.