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Freire BB, Wanderley VA, Câmara JVF, Santos LA, Ferrari CR, Araujo TT, Chilvarquer I. Effect of a metal artifact reduction algorithm on dehiscence and fenestration detection around zirconia implants with cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 138:316-323. [PMID: 38493025 DOI: 10.1016/j.oooo.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/31/2024] [Accepted: 02/18/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE To assess the efficacy of the metal artifact reduction algorithm (MARA) of the Cranex 3D cone beam computed tomography (CBCT) device in the detection of peri-implant dehiscence and fenestration around zirconia implants. STUDY DESIGN In total, 60 implants were placed in bovine ribs. Dehiscence and fenestration defects were created around the implants, after which 60 CBCT images were obtained with and 60 without activation of MARA. Three radiologists examined the images for the presence of defects. The area under the curve (AUC) from receiver operating characteristic analysis, sensitivity, and specificity were calculated to assess the ability to discriminate the presence vs absence of bone defects. One-way analysis of variance was employed to analyze outcome measures. The significance level was established at 5% (α = 0.05). RESULTS AUC values indicated excellent discrimination of dehiscence on images with MARA activation and an excellent to outstanding range of discrimination with MARA deactivation. For fenestration, MARA activation and deactivation both led to outstanding discrimination. Sensitivity and specificity values revealed that activation of MARA was helpful in distinguishing the presence vs. absence of dehiscence, while both MARA conditions were helpful for fenestration. However, there were no statistically significant differences between MARA activation and deactivation for any outcome measure (P >.05). CONCLUSION CBCT is suitable for detecting peri-implant defects, but MARA application does not significantly affect peri-implant dehiscence and fenestration detection.
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Affiliation(s)
| | - Victor Aquino Wanderley
- Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, Brazil
| | - João Victor Frazão Câmara
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University Hospital, Saarland University, Homburg, Saarland, Germany.
| | - Lethycia Almeida Santos
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Carolina Ruis Ferrari
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Tamara Teodoro Araujo
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Israel Chilvarquer
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Biun J, Dudhia R, Arora H. The influence of metal artifact reduction on the trueness of registration of a cone-beam computed tomography scan with an intraoral scan in the presence of severe restoration artifact. J Prosthodont 2024; 33:700-705. [PMID: 37691179 DOI: 10.1111/jopr.13767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/21/2023] [Accepted: 09/06/2023] [Indexed: 09/12/2023] Open
Abstract
PURPOSE When planning guided implant surgery, highly radiopaque materials such as metals or zirconia produce streaking artifacts ('metal artifact') on cone-beam computed tomography scans, which can impair registration of the intraoral scan. This study aimed to determine the effect of metal artifact reduction on the trueness of registration in the presence of multiple full-coverage zirconia crowns. MATERIALS AND METHODS A 3D-printed maxillary study model was restored with 12 full-coverage zirconia crowns and scanned with an intraoral scanner. Cone-beam computed tomography scans of the study model were acquired, with and without activation of the metal artifact reduction algorithm. Registration of the optical scans was performed using initial point-based registration with surface-based refinement, and the deviation was measured at four pre-defined dental landmarks. Welch's t-test was used to compare the registration error for the metal artifact reduction group with the control group. RESULTS The average registration error was 0.519 mm (95% CI 0.507 to 0.531) with metal artifact reduction deactivated, compared to 0.478 mm (95% CI 0.460 to 0.496) without metal artifact reduction. Therefore, activation of the metal artifact reduction algorithm was associated with a 0.041 mm (95% CI 0.020 to 0.061, p < 0.001) increase in average registration error. CONCLUSIONS The use of the metal artifact reduction algorithm slightly reduced trueness in this in vitro study. Clinicians are advised not to rely on a metal artifact reduction (MAR) algorithm for registration of a cone-beam computed tomography scan with an intraoral scan when planning guided implant surgery in the presence of restoration artifacts.
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Affiliation(s)
- John Biun
- School of Dentistry, University of Queensland, Herston, Australia
| | - Raahib Dudhia
- School of Dentistry, University of Queensland, Herston, Australia
| | - Himanshu Arora
- School of Dentistry, University of Queensland, Herston, Australia
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Abesi F, Talachi F, Ezoji F. Performance of different cone-beam computed tomography scan modes with and without metal artifact reduction in detection of recurrent dental caries under various restorative materials. Pol J Radiol 2024; 89:e281-e291. [PMID: 39040560 PMCID: PMC11262014 DOI: 10.5114/pjr/188257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/03/2024] [Indexed: 07/24/2024] Open
Abstract
Purpose We aimed to compare the diagnostic performance of different cone-beam computed tomography (CBCT) scan modes with and without the application of a metal artifact reduction (MAR) option under 5 different restorative materials. Material and methods Our research was an in vitro study with 150 caries-free premolars and molars. The teeth were randomly divided into experimental (with artificially induced caries, n = 75) and control (without caries, n = 75) groups and were prepared based on 5 types of restorative materials, including conventional composites (Filtek Z250, Gradia), flow composite, glass ionomer, and amalgam. The teeth were examined under 2 CBCT scan modes (high-resolution [HIRes] and standard) with and without MAR application. Finally, the diagnostic accuracy index values (area under the receiver operating characteristic curve [AUC], sensitivity, and specificity) were calculated. Results The AUC of standard scan mode with the MAR option was significantly lower than that of HIRes with MAR (p = 0.018) and without MAR option (p = 0.011) in detecting recurrent caries. Also, without MAR option, the diagnostic accuracy (AUC) of the standard mode was significantly lower than that of the HIRes (p = 0.020). Similar findings were observed for sensitivity and specificity. Moreover, diagnostic performance of standard and HIRes scan modes with and without MAR in the amalgam group was lower than that in other restorative material groups. Conclusions Diagnostic performance of HIRes CBCT mode was higher than that of standard mode for recurrent caries and remained unaffected by MAR application. However, the accuracy in detecting recurrent caries was lower in the amalgam group compared with other restorative material groups.
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Affiliation(s)
- Farida Abesi
- Dental Materials Research Centre, Department of Oral and Maxillofacial Radiology, Dental Faculty, Babol University of Medical Sciences, Babol, Iran
| | | | - Fariba Ezoji
- Dental Materials Research Centre, Health Research Institute, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
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Soltani P, Devlin H, Etemadi Sh M, Rengo C, Spagnuolo G, Baghaei K. Do metal artifact reduction algorithms influence the detection of implant-related injuries to the inferior alveolar canal in CBCT images? BMC Oral Health 2024; 24:268. [PMID: 38395919 PMCID: PMC10885517 DOI: 10.1186/s12903-024-04043-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 02/17/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The routine application of dental implants for replacing missing teeth has revolutionized restorative and prosthetic dentistry. However, cone beam computed tomography (CBCT) evaluations of structures adjacent to the implants are limited by metal artifacts. There are several methods for reducing metal artifacts, but this remains a challenging task. This study aimed to examine the effectiveness of metal artifact reduction (MAR) algorithms in identifying injuries of implants to the inferior alveolar canal in CBCT images. METHOD In this in vitro study, mono-cortical bone windows were created and the inferior alveolar canal was revealed. Using 36 implants, pilot drill and penetration damage of the implant tip into the canal was simulated and compared to the control implants with distance from the canal. CBCT images were evaluated by four experienced observers with and without the MAR algorithm and compared to direct vision as the gold standard. The values of accuracy, sensitivity, and specificity were obtained and compared by receiver operating characteristic (ROC) curve (α = 0.05). RESULT The area under the ROC curve values for detection of pilot drill injuries varied between 0.840-0.917 and 0.639-0.854 in the active and inactive MAR conditions, respectively. The increase in ROC area was only significant for one of the observers (P = 0.010). For diagnosing penetrative injuries, the area under the ROC curve values was between 0.990-1.000 and 0.722-1.000 in the active and inactive MAR conditions, respectively. The improvement of ROC curve values in active MAR mode was only significant for one of the observers (P = 0.006). CONCLUSION Activation of MAR improved the diagnostic values of CBCT images in detecting both types of implant-related injuries to the inferior alveolar canal. However, for most observers, this increase was not statistically significant.
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Affiliation(s)
- Parisa Soltani
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Hugh Devlin
- The Dental School, The University of Bristol, Bristol, UK
- Department of Restorative Dentistry, School of Dentistry, Jordan University, Amman, Jordan
| | - Milad Etemadi Sh
- Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Carlo Rengo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov University, Moscow, 119991, Russia
| | - Kimia Baghaei
- Student Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Hezar- Jarib Ave, Isfahan, Iran.
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Asnaashari M, Sadeghipour M, Bahrani Z, Valizadeh S, Moshfeghi M. The Effect of Changes in the Angular Position of Implants on Metal Artifact Reduction in Cone-Beam Computed Tomography Images: A Scoping Review. Radiol Res Pract 2023; 2023:5539719. [PMID: 37554657 PMCID: PMC10406552 DOI: 10.1155/2023/5539719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/07/2023] [Accepted: 07/20/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE Dental implant artifacts can compromise the quality of cone-beam computed tomography (CBCT) scans and challenge radiographic detection in surrounding regions. This literature review was conducted to examine the impact of implant angle modification on reducing metal artifacts in CBCT scans. MATERIALS AND METHODS A scoping review of literature was carried out in PubMed, Embase, Scopus, and Cochrane databases. RESULTS Different spatial planes, including alpha, beta, gamma, and phi, along with 0°, 5.2°, 9.8°, 14.5°, 15°, 30°, 45°, 60°, 75°, and 90° angles were studied. Changes in the angular position of implants may reduce metal artifacts and improve the quality of CBCT scans. CONCLUSIONS Rotating implants within the alpha plane and angling them at 90° in the alpha plane enables reducing dental implant artifacts.
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Affiliation(s)
- Maedeh Asnaashari
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Sadeghipour
- Department of Community Oral Health, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Bahrani
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Solmaz Valizadeh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahkameh Moshfeghi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Goodarzi Pour D, Emami Meybodi E, Sodagar K, Emami Meybodi ZA, Safari S. Effect of metal artifact removal modes on the accuracy of linear measurement around titanium implants by applying different voltages: an original article. BMC Med Imaging 2023; 23:74. [PMID: 37277737 DOI: 10.1186/s12880-023-01025-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 05/23/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND This study aims to evaluate the effects of the artifact removal algorithm on linear measurements of the buccal cortical plate by altering the voltage. METHODS Ten titanium fixtures were inserted at the site of central, lateral, canine, premolars and molars of dry human mandibles. Vertical height of buccal plate was measured using a digital caliper as a gold standard. Mandibles were scanned with 54 and 58 kVp. Other parameters were constant. Images were reconstructed with none, low, medium and high artifact removal modes. Two Oromaxillofacial radiologists evaluated and measured the buccal plate height using Romexis software. Statistical package for the social sciences (SPSS) version 24 was used for data analysis. RESULTS In medium and high modes, the difference between 54 and 58 kVp was significant (p < 0.001). No significance was noted by using low ARM (artifact removal mode) at the 54 kVp and 58 kVp. CONCLUSION Using artifact removal in low voltage decreases the accuracy of linear measurement and buccal crest visibility. By using high voltage, artifact removal would have no significant effect on accuracy of linear measurements.
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Affiliation(s)
- Daryoush Goodarzi Pour
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Kosar Sodagar
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sanaz Safari
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Nomier AS, Gaweesh YSED, Taalab MR, El Sadat SA. Efficacy of low-dose cone beam computed tomography and metal artifact reduction tool for assessment of peri-implant bone defects: an in vitro study. BMC Oral Health 2022; 22:615. [PMID: 36528573 PMCID: PMC9759909 DOI: 10.1186/s12903-022-02663-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Early accurate radiographic assessment of peri-implant bone condition is highly important to avoid excessive loss of supporting bone and implant failure. Cone beam computed tomography (CBCT) is the radiographic technique of choice if peri-implant dehiscence and fenestration defects are suspected. The higher radiation dose and the presence of beam hardening artifacts are the main drawbacks of CBCT imaging techniques. This study aims to evaluate the influence of low-dose cone beam computed tomography (LD-CBCT) and metal artifact reduction (MAR) tool on the assessment of peri-implant dehiscence and fenestration. METHODOLOGY Thirty titanium implants were inserted into bovine rib blocks. Twenty had standardized bone defects (10 with dehiscence and 10 with fenestration), while the remaining 10 were used as control group with no defects. Radiographic examinations held with high-definition CBCT (HD-CBCT) and LD-CBCT with and without application of MAR tool. Images were assessed by four examiners for the presence or absence of peri-implant defects. The area under the area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, and accuracy were calculated for all radiographic protocols. RESULTS In the absence of MAR tool, there was no difference in AUC and diagnostic values between LD-CBCT and HD-CBCT for detection of both defects. When the MAR tool was applied, the AUC values, sensitivity, and accuracy were higher in HD-CBCT than in LD-CBCT for the detection of both defects, especially for the dehiscence, while specificity remained the same. CONCLUSION LD-CBCT can be used in the evaluation of peri-implant dehiscence and fenestration without any decrease in diagnostic accuracy. The application of MAR tool decrease the diagnostic ability of both defects, especially for the detection of dehiscence defects.
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Affiliation(s)
- Alaa Shafiek Nomier
- grid.7155.60000 0001 2260 6941Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521 Egypt
| | - Yousria Salah El-Din Gaweesh
- grid.7155.60000 0001 2260 6941Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521 Egypt
| | - Maha R. Taalab
- grid.7155.60000 0001 2260 6941Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521 Egypt
| | - Shaimaa Abu El Sadat
- grid.7269.a0000 0004 0621 1570Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
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Alhossaini SJ, Neena AF, Issa NO, Abouelkheir HM, Gaweesh YY. Accuracy of markerless registration methods of DICOM and STL files used for computerized surgical guides in mandibles with metal restorations: An in vitro study. J Prosthet Dent 2022:S0022-3913(22)00636-9. [PMID: 36372586 DOI: 10.1016/j.prosdent.2022.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 11/12/2022]
Abstract
STATEMENT OF PROBLEM Digital imaging and communications in medicine (DICOM) files together with surface scans must be accurately registered in virtual implant planning software programs to match real-life dimensions and ensure correct plan transfer through computer-aided manufactured surgical guides. PURPOSE The purpose of this in vitro study was to evaluate the accuracy of 3 different registration methods of DICOM data with and without metal restorations and a metal artifact reduction (MAR) tool for surface scans. MATERIAL AND METHODS Thirteen dentate mandibles were assigned to each group of this study (n=39). Baseplate wax was adapted to the bone surfaces of each mandible, and 5 radiopaque markers were attached. A desktop scanner was used to obtain control scans. The groups of metal-free mandibles (MFM) and mandibles with metal restorations (MRM) were scanned to obtain DICOM data without a MAR tool. Additional DICOM data for the MRM were obtained with the MAR tool (MRM-MAR). Point-based registration (PBR), best-fit registration (BFR), and automatic registration (AR) were used to align standard tessellation language (STL) and DICOM data, and 3 data sets were exported. Radiographic markers on each data set were compared with those on the control scan, and positional deviations were calculated and statistically evaluated with 1-way ANOVA followed by multiple pairwise comparisons, independent samples t test, and 2-way ANOVA (α=.05). RESULTS Within each group, PBR had the lowest deviation values with statistical significance in the MFM and the MRM-MAR groups (P<.001). AR showed failure in the MRM and the MRM-MAR groups. Statistically significant differences were found on comparing the average deviations among the 3 groups for PBR only (P<.001). No association was found between deviation values and the presence or absence of metal restoration, while a positive association was found with the type of registration method (P<.001). CONCLUSIONS PBR had the highest accuracy level compared with AR and BFR methods. An increase in the number of calculations resulted in more deviation values. The MAR tool had a positive effect on PBR in mandibles with metal restorations.
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Affiliation(s)
- Sara J Alhossaini
- Postgraduate student, Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt
| | - Akram F Neena
- Lecturer of Prosthodontics, Department of Prosthodontics, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt.
| | - Noha O Issa
- Associate Professor of Oral and Maxillofacial Radiology, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Cairo, Cairo, Egypt
| | - Hassan M Abouelkheir
- Professor of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt
| | - Yasmine Y Gaweesh
- Lecturer of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt
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Demirturk Kocasarac H, Koenig LJ, Ustaoglu G, Oliveira ML, Freitas DQ. CBCT image artefacts generated by implants located inside the field of view or in the exomass. Dentomaxillofac Radiol 2022; 51:20210092. [PMID: 34289314 PMCID: PMC8802698 DOI: 10.1259/dmfr.20210092] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES To compare artefacts in cone-beam computed tomography (CBCT) arising from implants of different materials located either inside the field of view (FOV) or in the exomass, and to test different image-acquisition parameters to reduce them. METHODS CBCT scans of a human mandible prepared with either a titanium, titanium-zirconium, or zirconia implant were acquired with the Planmeca ProMax utilizing FOV sizes of 8 × 5 cm and 4 × 5 cm, which placed the implant inside the FOV (8 × 5 cm) or in the exomass (4 × 5 cm). The scanning parameters considered three conditions of metal artefact reduction (MAR), disabled, low, and high, and 2 kVp levels (80 and 90). The standard deviation (SD) of grey values of regions of interest was obtained. The effects of implant material, implant position, MAR condition, kVp level, and their interactions were evaluated by Analysis of Variance (α = 5%). RESULTS The zirconia implant produced the highest SD values (more heterogeneous grey values, corresponding to greater artefact expression), followed by titanium-zirconium, and titanium. In general, implants in the exomass produced images with higher SD values than implants inside the FOV. MAR was effective in decreasing SD values, especially from the zirconia implant, only when the implant was inside the FOV. Images with 80 kVp had higher SD values than those with 90 kVp, regardless of the other factors (p < 0.05). CONCLUSIONS Implants in the exomass lead to greater artefact expression than when they are inside the FOV. Special attention should be paid to scanning parameters that reduce metal-related artefacts, such as MAR activation and increasing kVp. This is especially important with a zirconia implant inside the FOV.
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Affiliation(s)
- Husniye Demirturk Kocasarac
- Division of Oral and Maxillofacial Radiology, Department of General Dental Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, United States
| | - Lisa J Koenig
- Division of Oral and Maxillofacial Radiology, Department of General Dental Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, United States
| | - Gulbahar Ustaoglu
- Department of Periodontics, Bolu Abant Izzet Baysal University Faculty of Dentistry, BAIBU Golkoy Yerleskesi, Merkez/Bolu, Turkey
| | - Matheus Lima Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Lv HX, Rong R, Sa Y. Radiopaque fiducial markers as an aid to fabrication of an implant surgical guide for a patient with orthodontic brackets: A dental technique. J Prosthet Dent 2021:S0022-3913(21)00455-8. [PMID: 34556334 DOI: 10.1016/j.prosdent.2021.07.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
Designing implant surgical guides for patients undergoing orthodontics merely by merging data imaging and communications in medicine (DICOM) files generated from cone beam computed tomography (CBCT) images and standard tessellation language (STL) files generated from surface scanners is challenging because of the inaccuracy caused by metal artifacts. The present technique describes a straightforward and effective method of fabricating a surgical guide with the aid of fiducial markers made from cotton swabs and flowable resin. The implant surgical guide is designed by using a software program after the superimposition of digital scan and CBCT data. This chairside technique provides an accurate, convenient, and cost-effective option for the clinician.
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Affiliation(s)
- Hao-Xin Lv
- Director, Department of Oral Implantology, Suzhou doctor dental clinic Co. LTD, Suzhou, PR China
| | - Rong Rong
- Graduate student, Department of Prosthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Yue Sa
- Associate professor, Department of Prosthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China.
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Salemi F, Jamalpour MR, Eskandarloo A, Tapak L, Rahimi N. Efficacy of Metal Artifact Reduction Algorithm of Cone-Beam Computed Tomography for Detection of Fenestration and Dehiscence around Dental Implants. J Biomed Phys Eng 2021; 11:305-314. [PMID: 34189119 PMCID: PMC8236107 DOI: 10.31661/jbpe.v0i0.2102-1284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/02/2021] [Indexed: 11/30/2022]
Abstract
Background: Beam hardening and scattering artifacts from high-density objects such as dental implants adversely affect the image quality and subsequently the detection of fenestration or dehiscence around dental implants. Objective: This study aimed to assess the efficacy of metal artifact reduction (MAR) algorithm of two cone-beam computed tomography (CBCT) systems for detection of peri-implant fenestration and dehiscence. Material and Methods: In this experimental study, thirty-six titanium implants were placed in bone blocks of bovine ribs. Fenestration and dehiscence were created in the buccal bone around implants.
CBCT images were obtained using Cranex 3D and ProMax 3D CBCT systems with and without MAR algorithm. Two experienced radiologists observed the images. Data were analyzed using SPSS software.
The Kappa coefficient of agreement, the area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, and accuracy of different imaging modalities were calculated and analyzed. Results: In both CBCT systems, the use of MAR algorithm decreased the area under the ROC curve and subsequently the diagnostic accuracy for the detection of fenestration and dehiscence.
The sensitivity, specificity and accuracy of both CBCT systems were higher in absence of the MAR algorithm. The specificity of ProMax 3D for detection of fenestration was equal with/without the MAR algorithm. Conclusion: Although CBCT is suitable for detection of peri-implant defects, the application of the MAR algorithm does not enhance the detection of peri-implant fenestration and dehiscence.
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Affiliation(s)
- Fatemeh Salemi
- PhD, Department of Oral & Maxillofacial Radiology, School of Dentistry, Hamadan university of Medical Science, Hamadan, Iran
| | - Mohamad Reza Jamalpour
- MScD, Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, School of Dentistry, Hamadan university of Medical Science. Hamadan, Iran
| | - Amir Eskandarloo
- PhD, Department of Oral & Maxillofacial Radiology, School of Dentistry, Hamadan university of Medical Science, Hamadan, Iran
| | - Leili Tapak
- PhD, Department of Biostatistics, School of Health Modeling of Noncommunicable Diseases Research Center, Health Sciences & Technology Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Narges Rahimi
- DMD, General Dentist, Hamadan University of Medical Sciences, Hamadan, Iran
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Do the number of basis images and metal artifact reduction affect the production of artifacts near and far from zirconium dental implants in CBCT? Clin Oral Investig 2021; 25:5281-5291. [PMID: 33625608 DOI: 10.1007/s00784-021-03836-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study aimed to evaluate the influence of the number of basis images and the metal artifact reduction (MAR) tool on the production of artifacts near and far from a zirconium implant in cone-beam computed tomography (CBCT). MATERIALS AND METHODS CBCT scans of a mandible were acquired before and after insertion of an implant, using 450 and 720 basis images, with and without MAR activation. The mean and standard deviation (SD) of the gray values of the regions of interest (ROIs) located on the cortices adjacent to the implant and at different distances from it (in the soft tissue) were calculated. The mean of the gray values was used to calculate the absolute contrast difference (ACD) between the control and implant scans. RESULTS In general, the number of basis images did not affect the SD and the ACD values of the buccal and lingual ROIs (p > 0.05). The implant increased the SD in the lingual cortical plate (p < 0.05). In this case, MAR activation decreased SD (p < 0.05). All ROIs located at different distances from the implant showed higher SD on scans acquired with 450 basis images (p < 0.05), regardless of MAR condition. CONCLUSIONS A higher number of basis images reduces the magnitude of artifacts but does not influence the image quality in bone cortical plates. MAR improves the image in the areas most affected by artifacts. CLINICAL RELEVANCE The number of basis images is known as a factor capable of influencing the image quality and radiation dose for the patient. Therefore, it is important to investigate its effect on the expression of artifacts in the CBCT images.
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