The Use of cone Beam computed Tomography in Assessing the Insertion of Bone conduction hearing Implants

Tim George Ate Calon*, Martin Lars Johansson, Elske Larissa van den Burg, Anna Maria Louisa Janssen, Marc van Hoof, Robert Jan Stokroos

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective: This study aimed to compare postoperative cone beam CT (CBCT) imaging to implant stability quotient (ISO) measurement and direct caliper measurements as a suitable technique to assess bone conduction hearing implant (BCHI) seating and insertion depth.

Methods: in vitro, BCHIs were completely (n = 9) and partially inserted (n = 9) in bone blocks of different densities and subsequently scanned. Scans were processed using 3DSlicer 4.3.1 and Mathematica 10.3. ISO measurements were obtained for all BCHIs mounted with different abutment lengths (9, 12, and 14 mm). CBCT imaging was performed for patients with a clinical indication.

Results: In vitro, 95% prediction intervals for partially inserted and completely inserted BCHIs were determined. ISO values significantly decreased with partial insertion, low -density artificial bone, and longer abutment lengths. Evaluation of in vitro and in vivo 3D models allowed for assessment of insertion depth and inclination.

Conclusion: CBCT imaging allows to study implant seating and insertion depth after BCHI surgery. This can be useful when visual confirmation is limited. It is possible to distinguish a partial BCHI insertion from a complete insertion in artificial bone blocks. This technique could prove to be a valuable research tool. In vitro, ISO values for Ponto BCHIs relate to abutment length, insertion depth, and artificial bone density.

Original languageEnglish
Article number38
Number of pages9
JournalFrontiers in Surgery
Publication statusPublished - 24 Jul 2017


  • bone-anchored hearing implants
  • radiology
  • BAHA
  • Osstell
  • implant stability
  • resonance frequency analysis

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