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Bastos MF, Visconti MA, Pinto RR, Junqueira RB, Verner FS. Assessing the Impact of the Metal Artifact Reduction Tool on Detecting Furcation Lesions in Maxillary Molars with Different Intracanal Posts: An Ex Vivo Cone-beam Computed Tomography Study. J Endod 2024; 50:835-843. [PMID: 38395388 DOI: 10.1016/j.joen.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Considering the potential image compromise and diagnostic challenges posed by metals, this study aimed to assess the efficacy of the metal artifact reduction (MAR) tool in cone-beam computed tomography examinations for detecting furcation lesions in upper molars treated endodontically and restored with different intracanal posts. METHODS This ex vivo study used 45 endodontically treated maxillary first molars, categorized into the following3 groups (n = 15): control (without intracanal post), metal post, and fiberglass post. Simulations were conducted in the laboratory to replicate alveolar bone, periodontal ligament, and grade I, II, and III furcation lesions. Cone-beam computed tomography scans were obtained with and without the MAR tool, and the furcation lesions were evaluated considering a 5-point Likert scale. Data were analyzed at 5%. RESULTS In the control group, there was no influence of MAR (P > .05); grade II lesions were not diagnosed, and grade III lesions were the most detected (P < .05). In the metal post group with MAR, grade III lesions were diagnosed more frequently than I and II (P < .05) and grade III without MAR (P < .05). In the fiberglass post group, the diagnosis of grade I lesions decreased with MAR (P < .05), and without MAR, grade III was most diagnosed (P < .05); grade III lesions were the most diagnosed (P < .05). CONCLUSIONS The MAR tool was only effective for diagnosing grade III furcation lesions, regardless of the intracanal material. Its application for grade I and II lesions did not contribute to improved diagnosis. Furthermore, in the fiberglass post group with grade I lesions, the MAR tool negatively affected the detection of the lesions.
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Affiliation(s)
- Mayara Fidelis Bastos
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Augusta Visconti
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Rocha Pinto
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Binato Junqueira
- Department of Dentistry, Federal University of Juiz de Fora/GV Campus, Governador Valadares, Brazil
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Barros-Costa M, Nascimento EHL, Correia-Dantas IF, Oliveira ML, Freitas DQ. Potential impact of metal crowns at varying distances from a carious lesion on its detection on cone-beam computed tomography scans with several protocols. Imaging Sci Dent 2024; 54:49-56. [PMID: 38571773 PMCID: PMC10985521 DOI: 10.5624/isd.20230202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 04/05/2024] Open
Abstract
Purpose This study evaluated the impact of artifacts generated by metal crowns on the detection of proximal caries lesions in teeth at various distances using cone-beam computed tomography (CBCT). Additionally, the diagnostic impacts of tube current and metal artifact reduction (MAR) were investigated. Materials and Methods Thirty teeth were arranged within 10 phantoms, each containing 1 first premolar, 1 second premolar, and 1 second molar. A sound first molar (for the control group) or a tooth with a metal crown was placed. Of the 60 proximal surfaces evaluated, 15 were sound and 45 exhibited enamel caries. CBCT scans were acquired using an OP300 Maxio unit (Instrumentarium, Tuusula, Finland), while varying the tube current (4, 8, or 12.5 mA) and enabling or disabling MAR. Five observers assessed mesial and distal surfaces using a 5-point scale. Multi-way analysis of variance was employed for data comparison, with P<0.05 indicating statistical significance. Results The area under the curve (AUC) varied from 0.40 to 0.60 (sensitivity: 0.28-0.45, specificity: 0.44-0.80). The diagnostic accuracy was not significantly affected by the presence of a metal crown, milliamperage, or MAR (P>0.05). However, the overall AUC and specificity were significantly lower for surfaces near a crown (P<0.05). Conclusion CBCT-based caries detection was not influenced by the presence of a metal crown, variations in milliamperage, or MAR activation. However, the diagnostic accuracy was low and was further diminished for surfaces near a crown. Consequently, CBCT is not recommended for the detection of incipient caries lesions.
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Affiliation(s)
- Matheus Barros-Costa
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | | | - Iago Filipe Correia-Dantas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Matheus L. Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Naralan ME, Ozdogan A, Guller MT, Miloglu O. Comparison of artifact values of prosthodontic materials with 2 different cone beam computed tomography devices. J Prosthet Dent 2023:S0022-3913(23)00505-X. [PMID: 37716900 DOI: 10.1016/j.prosdent.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 09/18/2023]
Abstract
STATEMENT OF PROBLEM Prosthodontic materials may cause unexpected artifacts in cone beam computed tomography (CBCT) images, but studies quantifying these artifacts are sparse. PURPOSE The purpose of this in vitro study was to compare the artifact expression of fixed prosthodontic materials with different CBCT devices. MATERIAL AND METHODS Ten prosthodontic materials (Co-Cr-Mo alloy, interim acrylic resin, polyetheretherketone, feldspathic ceramic, lithium disilicate glass-ceramic, zirconia-reinforced lithium silicate ceramic, zircon core, and 3 monolithic zirconias) were scanned with 2 CBCT devices. The materials were placed in polymethyl methacrylate resin to simulate clinical conditions. To assess the impact of the devices on artifacts, the gray values of 8 areas in each material image were analyzed. The data were analyzed with the Kruskal-Wallis and Wilcoxon Signed-Rank tests (α=.05). RESULTS Statistically significant differences were found in the artifact expression of the materials (P<.001) and between CBCT devices (P<.001). CONCLUSIONS The artifact expression of polymeric and ceramic materials in CBCT images was less than that of other materials. The milliampere-second (mAs) value of CBCT devices had a significant impact on the artifact level.
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Affiliation(s)
- Muhammed Enes Naralan
- Assistant Professor, Department of Oral, Dental and Maxillofacial Radiology, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Alper Ozdogan
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Mustafa Taha Guller
- Lecturer, Department of Dentistry Services, Vocational School of Health Services, Erzincan Binali Yıldırım University, Erzincan, Turkey.
| | - Ozkan Miloglu
- Professor, Department of Oral, Dental and Maxillofacial Radiology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
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Orhan K, Kocyigit D, Firincioglulari M, Adisen MZ, Kocyigit S. Quantitative assessment of image artifacts from zygoma implants on CBCT scans using different exposure parameters. Proc Inst Mech Eng H 2023; 237:1082-1090. [PMID: 37528643 DOI: 10.1177/09544119231190447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
This study was aimed at quantifying artifacts from zygoma implants in cone-beam computed tomography (CBCT) images using different exposure parameters. Two cadaver heads, one with two zygoma implants on each side and the other for control, were scanned using 18 different exposure parameters. Quantitative analysis was performed to evaluate the hypodense and hyperdense artifact percentages calculated as the percentage of the area. Hyperdense artifacts and hypodense artifacts were detected, followed by the calculation of the hyperdense and hypodense artifact percentages in the image. In the qualitative analysis of the artifacts, the scores used were as follows: absence (0), moderate presence (1), or high presence (2) for hypodense halos, thin hypodense lines, and hyperdense lines. Artifact analysis was performed qualitatively and quantitatively using the post-hoc Tukey and Two-way ANOVA tests. As a result, in the qualitative analyses, zygoma implants showed a significant difference compared to the control group with regard to hyperdense and hypodense artifacts (p < 0.05). There was a significant difference between the means according to the FOV size arithmetic averages (p < 0.05). In terms of voxel size, the difference was found to be significant, where 400 microns showed the highest hypodense artifact while 200 microns showed the lowest hypodense artifact. In conclusion, hypodense and hyperdense artifacts were significantly higher in cadavers with zygoma implants than in controls. As FOV and voxel size increase, more hypodense artifacts are produced by zygoma implants so smaller FOV and voxel sizes should be used to prevent poor image quality of adjacent teeth.
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Affiliation(s)
- Kaan Orhan
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara University, Ankara, Turkey
- Medical Design Application and Research Center (MEDITAM), Ankara University, Ankara, Turkey
| | - Doruk Kocyigit
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Kirikkale University, Kirkkale, Turkey
| | - Mujgan Firincioglulari
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Cyprus International University, Nicosia, Cyprus
| | - Mehmet Zahit Adisen
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Kirikkale University, Kirkkale, Turkey
| | - Seda Kocyigit
- Department of Oral and Maxillofacial Surgery, Ministry of Health Turkey, Uskudar, Istanbul, Turkey
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Lagos de Melo LP, Queiroz PM, Moreira-Souza L, Nadaes MR, Santaella GM, Oliveira ML, Freitas DQ. Influence of CBCT parameters on image quality and the diagnosis of vertical root fractures in teeth with metallic posts: an ex vivo study. Restor Dent Endod 2023; 48:e16. [PMID: 37284345 PMCID: PMC10240088 DOI: 10.5395/rde.2023.48.e16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 06/08/2023] Open
Abstract
Objectives The aim of this study was to evaluate the influence of peak kilovoltage (kVp) and a metal artifact reduction (MAR) tool on image quality and the diagnosis of vertical root fracture (VRF) in cone-beam computed tomography (CBCT). Materials and Methods Twenty single-rooted human teeth filled with an intracanal metal post were divided into 2 groups: control (n = 10) and VRF (n = 10). Each tooth was placed into the socket of a dry mandible, and CBCT scans were acquired using a Picasso Trio varying the kVp (70, 80, 90, or 99), and the use of MAR (with or without). The examinations were assessed by 5 examiners for the diagnosis of VRF using a 5-point scale. A subjective evaluation of the expression of artifacts was done by comparing random axial images of the studied protocols. The results of the diagnoses were analyzed using 2-way analysis of variance and the Tukey post hoc test, the subjective evaluations were compared using the Friedman test, and intra-examiner reproducibility was evaluated using the weighted kappa test (α = 5%). Results The kVp and MAR did not influence the diagnosis of VRF (p > 0.05). According to the subjective classification, the 99 kVp protocol with MAR demonstrated the least expression of artifacts, while the 70 kVp protocol without MAR led to the most artifacts. Conclusions Protocols with higher kVp combined with MAR improved the image quality of CBCT examinations. However, those factors did not lead to an improvement in the diagnosis of VRF.
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Affiliation(s)
- Larissa Pereira Lagos de Melo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Polyane Mazucatto Queiroz
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Larissa Moreira-Souza
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Mariana Rocha Nadaes
- Dental Clinic Department, Division of Oral Radiology, Dental School, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Gustavo Machado Santaella
- Department of Diagnosis and Oral Health, University of Louisville, School of Dentistry, Louisville, KY, USA
| | - Matheus Lima Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Helvacioglu-Yigit D, Seki U, Kursun-Cakmak S, Demirturk Kocasarac H, Singh M. Comparative Evaluation of Artifacts Originated by Four Different Post Materials Using Different CBCT Settings. Tomography 2022; 8:2919-2928. [PMID: 36548537 PMCID: PMC9781935 DOI: 10.3390/tomography8060245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/26/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
The aim of this study was to evaluate whether cone beam computed tomography (CBCT) images in the presence of four different post materials, obtained from different kVps with varying resolutions and varying metal artifact reduction (MAR) algorithms, differed in artifact estimation, and to compare tooth regions in terms of artifact value. MATERIALS AND METHODS Forty premolar teeth were used in this study. Root canals were treated, and teeth were randomly distributed into four subgroups (n = 10) for the preparation of post materials: titanium, gold (Nordin), quartz fiber (Bisco DT Light), and glass fiber (Rely X). The CBCT images were taken with two different kVps, three different metal artifact reduction (MAR) algorithm options, and two different resolutions. For each protocol, the effective dose was calculated according to the dose area production (DAP) value. The standard analysis of variance technique and the Tukey multiple comparison adjustment method were used to assess interactions among material types, kVp, MAR, and voxel settings. RESULTS More artifacts were found in the middle third than in the cervical third (p < 0.05). The mean value of artifacts was highest for gold (Nordin), 90 kVp, no MAR, and 100 voxel size. Glass or quartz fiber posts at low resolution, with high MAR and 96 kVp, originated fewer artifacts. Moreover, the use of 90 and 96 kVp with 200 voxel size and high MAR provided the least amount of radiation. CONCLUSION The best setting for radiographic follow-up of post materials on the Planmeca ProMax is 96 kVp with low resolution and high MAR; this setting produced one of the lowest effective doses. CLINICAL SIGNIFICANCE This study estimated the best scanning protocol by lowering the effective dose to a minimum level according to the "as low as reasonably achievable" principle, as well as assessing the tooth region and the post material generating the fewest artifacts, in order to prevent image interpretation challenges such as false-positive and false-negative results stemming from the deterioration of the visibility of the root canal due to perforation, fractures, and voids in the root canal region.
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Affiliation(s)
- Dilek Helvacioglu-Yigit
- College of Dental Medicine, QU Health, Qatar University, Doha 2713, Qatar
- Correspondence: ; Tel.: +974-50011251
| | - Umut Seki
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Kocaeli University, Kocaeli 41190, Turkey
| | - Sebnem Kursun-Cakmak
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara 1487, Turkey
| | - Husniye Demirturk Kocasarac
- BeamReaders Inc., Kennewick, WA 99336, USA
- Department of Dentomaxillofacial Radiology, Kocaeli Health and Technology University, Kocaeli 41000, Turkey
| | - Maharaj Singh
- College of Nursing, Marquette University, Milwaukee, WI 53233, USA
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Effect of the Field of View Size on CBCT Artifacts Caused by the Presence of Metal Objects in the Exomass. Int J Dent 2022; 2022:2071108. [PMID: 36117513 PMCID: PMC9481401 DOI: 10.1155/2022/2071108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/08/2022] [Accepted: 08/26/2022] [Indexed: 11/29/2022] Open
Abstract
Materials and Methods In this in vitro experimental study, titanium implants, teeth with cobalt-chromium (Co-Cr) intracanal posts, and teeth with mesio-occluso-distal (MOD) amalgam restorations were placed in an empty socket of the extracted third molar of a human mandible. These metallic materials were differently arranged in the exomass (zone outside of the FOV). A polypropylene tube containing dipotassium phosphate was placed in the empty socket of the right canine tooth in a dry human mandible. CBCT scans were taken with a NewTom VGI (Verona, Italy) scanner using a 6 × 6 cm and an 8 × 8 cm FOV. The histogram tool of OnDemand software (Cybermed, Seoul, Korea) was used to select circles with a 1.5 mm diameter as the (ROI) at the center of the homogenous solution of dipotassium phosphate tube on the axial plane. The mean gray value (GV) and its standard deviation (SD) in the region of interest (ROI) were calculated (P > 0.05). The data were analyzed by SPSS 26. Results The reduction in the size of the FOV significantly decreased the mean GV (P < 0.001). Metal objects in the exomass significantly decreased the mean GV (P < 0.001), and minimum mean GV and maximum SD were recorded for amalgam, followed by Co-Cr intracanal posts, and titanium implants. The unilateral presence of a metal object was associated with a higher mean GV and lower SD (P < 0.001). Conclusion Using a smaller FOV increases the size of the exomass, which may negatively affect the image quality. Metal objects in the exomass decrease the GV of CBCT scans and adversely affect the image quality.
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Shokri A, Vafaee F, Haghighat L, Shahabi S, Farhadian M, Jamalpour MR. Comparison of the amount of artifacts induced by zirconium and titanium implants in cone-beam computed tomography images. BMC Med Imaging 2022; 22:156. [PMID: 36057551 PMCID: PMC9440550 DOI: 10.1186/s12880-022-00884-5] [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: 03/30/2022] [Accepted: 08/29/2022] [Indexed: 11/18/2022] Open
Abstract
Background This study aimed to compare the amount of artifacts induced by the titanium and zirconium implants on cone-beam computed tomography (CBCT) and assess the effect of different exposure settings on the image quality for both materials.
Methods In this experimental study, 30 zirconium and 30 titanium implants were placed in bovine rib bone blocks. CBCT images were taken in two different fields of view (FOV: 4 × 6 cm2 and 6 × 8 cm2) and at two resolutions (133 µ and 200 µ voxel size). Subsequently, two observers assessed the images and detected the amount of artifacts around the implants through gray values. Data were analyzed by paired t test and independent t test using SPSS 21 and the 0.05 significance level. Results The results showed that titanium implants caused lower amounts of artifacts than zirconium implants, which was statistically significant (P < 0.001). The larger FOV (6 × 8 cm2) resulted in a lower amount of artifacts in both groups, although the results were only statistically significant in the zirconium group (P < 0.001). The amount of artifacts was increased when using the 133 µ voxel size in both groups, which was only significant in the zirconium group (P < 0.001). Conclusion Our results suggest that zirconium implants induce higher amounts of artifacts than titanium ones. We also concluded that the artifacts could be minimized using the larger FOV and voxel size.
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Affiliation(s)
- Abbas Shokri
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fariborz Vafaee
- Department of Prosthodontics, Dental Implants Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Shiva Shahabi
- Dental Implants Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Farhadian
- Department of Biostatistics, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Reza Jamalpour
- Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, Hamadan University of Medical Sciences, Shaheed Fahmideh Avenue, Hamadan, 6517838636, Iran.
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Exploring the use of enhanced cone-beam CT technique to diagnose vertical root fracture. J Mech Behav Biomed Mater 2022; 130:105175. [DOI: 10.1016/j.jmbbm.2022.105175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 11/20/2022]
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AlMohareb RA, Barakat RM, Mehanny M. Quantitative Analysis of Cone-Beam Computed Tomography Artifacts Induced by Nonmetallic Root Canal Filling Materials Using Different Fields of View: In Vitro Study. SCANNING 2022; 2022:4829475. [PMID: 35282567 PMCID: PMC8888051 DOI: 10.1155/2022/4829475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/03/2021] [Accepted: 11/06/2021] [Indexed: 06/14/2023]
Abstract
Cone-beam computed tomography (CBCT) imaging artifacts can hinder accurate diagnosis of several conditions. The aim of this study was to quantify CBCT artifacts created by nonmetallic root canal filling materials using two fields of view (FOV). Root canals of twenty extracted maxillary central incisors (n = 20) were instrumented and randomly divided into four equal groups: canals in Group 1 were filled with gutta-percha, canals in Group 2 with mineral trioxide aggregate (MTA) and gutta-percha, canals in Group 3 with gutta-percha and glass-fiber posts, and canals in Group 4 with MTA and glass-fiber posts. Each tooth was mounted on a silicon block and scanned three times using a CBCT machine, first with a prefilling scan (control) and then with postfilling scans, using two different FOV (40∗50 mm and 80∗50 mm). Imaging software was used to measure grayscale pixel values of canal cross sections. Data were analyzed using t-test and paired t-test statistical tests, with statistical significance set at p ≤ 0.05. Dentin at the apical and middle third of the teeth showed a significant decrease in minimum grayscale values in association with gutta-percha (p = 0.027, p = 0.034). However, a wide 80∗50 FOV showed a significant increase in maximum grayscale values of coronal (p = 0.048) and apical dentin (p = 0.049). Glass-fiber posts in middle third cross sections also corresponded to an increase in maximum grayscale values (p = 0.018). Gutta-percha produced dark band artifacts in the root's middle and apical thirds, whereas white streak artifacts were produced by gutta-percha in the coronal third and glass-fiber posts in the coronal and middle thirds when imaged with a wider FOV. A smaller FOV is therefore recommended for CBCT imaging, as it produces fewer artifacts.
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Affiliation(s)
- Rahaf A AlMohareb
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Reem M Barakat
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Mohamed Mehanny
- Basic Dental Science, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Hinchy NV, Anderson NK, Mahdian M. Metal artifact reduction using common dental materials. Dentomaxillofac Radiol 2022; 51:20210302. [PMID: 34406821 PMCID: PMC8802694 DOI: 10.1259/dmfr.20210302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES To determine the effect of different dental lab materials on cone beam computed tomography (CBCT) metal artifact at different resolutions. METHODS A total of seven common dental lab materials were molded to a dental sextant of four extracted, restored teeth. In addition to base alone (control), each material was scanned using the Carestream 9600 CBCT unit at three resolutions - 0.3 mm, 0.15 mm, and 0.075 mm - at manufacturer established exposure parameters. A single, representative axial view of each trial was evaluated for metal artifact both quantitatively by histogram analysis and qualitatively by profile plot analysis in ImageJ. RESULTS No statistically significant differences between the control and the dental materials were found; however, post-hoc tests showed significance between Blu-mousse® and polyvinyl siloxane with dental materials and control, predominantly in lower resolutions. CONCLUSIONS The current study provides initial evidence on the influence of dental materials have on CBCT metal artifact as described by beam hardening, photon starvation, scatter, and noise, especially at lower resolutions. Blu-Mousse® and polyvinyl siloxane reduced the perceived beam hardening and photon starvation artifact the greatest, relative to other materials, at all three resolutions and lower resolutions, respectively.
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Affiliation(s)
- Nicole V Hinchy
- Division of Diagnostic Imaging, Department of Prosthodontics and Digital Technology, Stony Brook University School of Dental Medicine, Stony Brook, NY, USA
| | - Nina K Anderson
- Department of Orthodontics and Dentofacial Orthopedics, Stony Brook University School of Dental Medicine, Stony Brook, NY, USA
| | - Mina Mahdian
- Division of Diagnostic Imaging, Department of Prosthodontics and Digital Technology, Stony Brook University School of Dental Medicine, Stony Brook, NY, USA
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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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Wang AHT, Panzarella FK, Fontana CE, Junqueira JLC, da Silveira Bueno CE. Effect of cone-beam computed tomography metal artefact reduction on incomplete subtle vertical root fractures. Imaging Sci Dent 2022; 53:11-19. [PMID: 37006793 PMCID: PMC10060756 DOI: 10.5624/isd.20220106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose This study compared the accuracy of detection of incomplete vertical root fractures (VRFs) in filled and unfilled teeth on cone-beam computed tomography images with and without a metal artefact reduction (MAR) algorithm. Materials and Methods Forty single-rooted maxillary premolars were selected and, after endodontic instrumentation, were categorized as unfilled teeth without fractures, filled teeth without fractures, unfilled teeth with fractures, or filled teeth with fractures. Each VRF was artificially created and confirmed by operative microscopy. The teeth were randomly arranged, and images were acquired with and without the MAR algorithm. The images were evaluated with OnDemand software (Cybermed Inc., Seoul, Korea). After training, 2 blinded observers each assessed the images for the presence and absence of VRFs 2 times separated by a 1-week interval. P-values<0.05 were considered to indicate significance. Results Of the 4 protocols, unfilled teeth analysed with the MAR algorithm had the highest accuracy of incomplete VRF diagnosis (0.65), while unfilled teeth reviewed without MAR were associated with the least accurate diagnosis (0.55). With MAR, an unfilled tooth with an incomplete VRF was 4 times more likely to be identified as having an incomplete VRF than an unfilled tooth without this condition, while without MAR, an unfilled tooth with an incomplete VRF was 2.28 times more likely to be identified as having an incomplete VRF than an unfilled tooth without this condition. Conclusion The use of the MAR algorithm increased the diagnostic accuracy in the detection of incomplete VRF on images of unfilled teeth.
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Affiliation(s)
- Andréa Huey Tsu Wang
- Division of Endodontics, Research Institute, São Leopoldo Mandic Dental School, Campinas, Brazil
| | - Francine Kühl Panzarella
- Division of Oral Radiology, Research Institute, São Leopoldo Mandic Dental School, Campinas, Brazil
| | - Carlos Eduardo Fontana
- Division of Endodontics, Centre for Health Sciences, Pontifical Catholic University of Campinas, Campinas, Brazil
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Bhandi S, Mashyakhy M, Abumelha AS, Alkahtany MF, Jamal M, Chohan H, Raj AT, Testarelli L, Reda R, Patil S. Complete Obturation-Cold Lateral Condensation vs. Thermoplastic Techniques: A Systematic Review of Micro-CT Studies. MATERIALS (BASEL, SWITZERLAND) 2021; 14:4013. [PMID: 34300930 PMCID: PMC8304925 DOI: 10.3390/ma14144013] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 01/31/2023]
Abstract
To prevent re-infection and provide a hermetic seal of the root canal system, an endodontist must aim to produce a void-free obturation. This review aimed to compare the completeness of root canal obturation between the two most prevalent methods-cold lateral condensation and warm gutta-percha techniques-using micro-CT (PROSPERO reg no. 249815). MATERIALS AND METHODS A search of Scopus, Embase, PubMed (Medline via PubMed), and Web of Science databases was done without any time restriction according to the PRISMA protocol. Articles that compared both techniques and were published in English were included. Data was extracted and the risk of bias was assessed using an adapted tool based on previous studies. RESULTS A total of 141 studies were identified by the search. Following the screening and selection of articles, 9 studies were included for review. Data was extracted manually and tabulated. Most studies had a moderate risk of bias. None determined operator skill in both methods before comparison. The data extracted from the included studies suggests that both techniques produce voids in the obturation. The thermoplasticized gutta-percha techniques may result in fewer voids compared to cold lateral condensation. CONCLUSION Considering the limitations of the included studies, it was concluded that neither technique could completely obturate the root canal. Thermoplasticized gutta-percha techniques showed better outcomes despite a possible learning bias in favor of cold lateral condensation. Establishing operator skills before comparison may help reduce this bias.
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Affiliation(s)
- Shilpa Bhandi
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia; (S.B.); (M.M.); (H.C.)
| | - Mohammed Mashyakhy
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia; (S.B.); (M.M.); (H.C.)
| | - Abdulaziz S. Abumelha
- Department of Restorative Dental Science, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Mazen F. Alkahtany
- Department of Restorative Dental Science, Division of Endodontics, College of Dentistry, King Saud University, Riyadh 11362, Saudi Arabia;
| | - Mohamed Jamal
- Department of Endodontics, Hamdan Bin Mohamed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health Care City, Dubai 505055, United Arab Emirates;
| | - Hitesh Chohan
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia; (S.B.); (M.M.); (H.C.)
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | - Luca Testarelli
- Department of Oral and Maxillo Facial Sciences, University of Rome La Sapienza, 00161 Rome, Italy; (L.T.); (R.R.)
| | - Rodolfo Reda
- Department of Oral and Maxillo Facial Sciences, University of Rome La Sapienza, 00161 Rome, Italy; (L.T.); (R.R.)
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
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Barros de Oliveira ML, Junqueira RB, Kamburoğlu K, Eratam N, Çakmak EE, Sönmez G, Küçük Ö, Verner FS. Assessment of the Metal Artifact Reduction Tool for the Detection of Root Isthmus in Mandibular Molars with Intraradicular Posts in Cone-beam Computed Tomographic Scans. J Endod 2021; 47:1583-1591. [PMID: 34265325 DOI: 10.1016/j.joen.2021.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/21/2021] [Accepted: 07/03/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION This study evaluated the performance of the metal artifact reduction (MAR) tool in cone-beam computed tomographic scans using different fields of view (FOVs) in the detection of a root isthmus in mandibular molars with intraradicular posts. METHODS Twenty-eight teeth were scanned by micro-computed tomographic imaging (gold standard images). Thereafter, specimens were allocated into the following groups: gutta-percha (teeth without posts, n = 10), a prefabricated metal post (n = 9), and a fiberglass post (n = 9). Cone-beam computed tomographic scans were taken using 8 acquisition protocols, varying the size of the FOV (10 × 5.5 cm and 5 × 5.5 cm) and the MAR tool (disabled, low, normal, and high modes). A root isthmus was evaluated considering a 5-point scale. Data were analyzed considering a 5% significance level. RESULTS Intra- and interexaminer agreement varied from moderate to substantial. The frequency of correct diagnosis varied significantly in all groups regardless of the image acquisition protocol selected (P < .05). In the gutta-percha group, there was no difference in the accuracy, sensitivity, and specificity values between the tested protocols. In the metal and fiberglass post groups, the accuracy values were higher with the "disabled" and "low" modes of the MAR tool regardless of the FOV size. This was also observed for the sensitivity values in the metal post group (P < .05). CONCLUSIONS The size of the FOV did not affect the performance of the MAR tool in the diagnosis of a root isthmus in molars with intraradicular posts. Our findings suggest that the use of the tool in the "normal" and "high" modes is contraindicated for this purpose.
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Affiliation(s)
- Manuela Lima Barros de Oliveira
- Applied Health Sciences Post-Graduate Program, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Rafael Binato Junqueira
- Applied Health Sciences Post-Graduate Program, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil; Department of Dentistry, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.
| | - Nejlan Eratam
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Esra Ece Çakmak
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Gül Sönmez
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Özlem Küçük
- Department of Nuclear Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Francielle Silvestre Verner
- Applied Health Sciences Post-Graduate Program, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil; Department of Dentistry, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
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ORHAN AI, TUFENKCİ P, ONCU A, SEVGI S, CELİKTEN B, ORHAN K. CBCT Visualization of Furcation Perforation Repair Materials Using Different Voxel Sizes. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.954463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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17
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Fontenele RC, Machado AH, de Oliveira Reis L, Freitas DQ. Influence of metal artefact reduction tool on the detection of vertical root fractures involving teeth with intracanal materials in cone beam computed tomography images: A systematic review and meta-analysis. Int Endod J 2021; 54:1769-1781. [PMID: 34003491 DOI: 10.1111/iej.13569] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND The effectiveness of the metal artefact reduction (MAR) tool for the detection of vertical root fracture (VRF) by cone beam computed tomography (CBCT) images is controversial. OBJECTIVE To evaluate the effectiveness of the MAR tool on VRF detection involving teeth with intracanal materials in CBCT images. METHODOLOGY In September 2019, an electronic search was performed in six databases (PubMed, Scopus, Web of Science, Cochrane, Lilacs and Embase). The electronic search was updated in May 2020 through searches in Google Scholar and references of included studies (embracing the electronic and gray literature searches). No language or year restrictions were applied. Independently, two reviewers examined titles, abstracts and full texts according to the eligibility criteria that were as follows: diagnostic studies that evaluated the effectiveness of the MAR tool on the diagnosis of VRF in human teeth (laboratory or in vivo studies) on CBCT images. The risk of bias was evaluated using the Quality Assessment Tool for Diagnostic of Accuracy Studies-2 (QUADAS-2). For conducting the meta-analysis, the values of sensitivity, specificity, diagnostic odds ratio (DOR) and area under the ROC curve (AUC) were obtained, considering the subgroups with and without MAR active. The Grading of Recommendation, Assessment, Development and Evaluation instrument was applied to assess the level of evidence across the studies using GRADEpro software. RESULTS A total of 8 laboratory studies were included in both systematic review and meta-analysis. The values of sensitivity, specificity, DOR and AUC to VRF diagnosis with and without MAR active were, respectively, 0.586 and 0.603; 0.699 and 0.713, 3.037 and 3.767; 0.67 and 0.71. The quality of the evidence suggested low confidence in estimating the outcomes. DISCUSSION The MAR tool decreased slightly the diagnostic values of VRF involving teeth with intracanal materials in laboratory studies. However, it is important to highlight that most studies had an uncertain risk of bias. CONCLUSIONS Although a low level of evidence and high heterogeneity were observed in the included studies, the meta-analysis revealed better diagnosis values for VRF detection when the MAR was deactivated when analysing extracted teeth in a laboratory setting. REGISTRATION PROSPERO-CRD42020145222. FUNDING This study was financed in party by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (CAPES).
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Affiliation(s)
- Rocharles C Fontenele
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Alessiana H Machado
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Larissa de Oliveira Reis
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Deborah Q Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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Gao A, Cao D, Lin Z. Diagnosis of cracked teeth using cone-beam computed tomography: literature review and clinical experience. Dentomaxillofac Radiol 2021; 50:20200407. [PMID: 33237813 DOI: 10.1259/dmfr.20200407] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Cone-beam computed tomography (CBCT) has been widely used in diagnosis of vertical root fractures (VRFs) in recent years. According to the American Association of Endodontists (AAE) classification, there are five types of cracked teeth and VRF is one of them. Due to the variability and overlapping of the cracks and fractures, some narrow fractures on the roots of VRFs could not be detected by CBCT, and some wide cracks on the crown of cracked teeth could be detected by CBCT. In this review, we firstly discussed the value of CBCT in the diagnosis of the AAE five types of cracked teeth and presented CBCT manifestations of some typical cases. Secondly, we summarized the factors influencing the diagnosis of cracks/fractures using CBCT, namely, CBCT device-related factors, patient-related factors, and evaluator-related factors. The possible strategies to improve the diagnostic accuracy in the clinic practice are also discussed in this part. Finally, we compared the differences of root fractures with lateral canals and external root resorption on CBCT images.
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Affiliation(s)
- Antian Gao
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Dantong Cao
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zitong Lin
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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Oliveira MR, Sousa TO, Caetano AF, de Paiva RR, Valladares-Neto J, Yamamoto-Silva FP, Silva MAG. Influence of CBCT metal artifact reduction on vertical radicular fracture detection. Imaging Sci Dent 2021; 51:55-62. [PMID: 33828962 PMCID: PMC8007395 DOI: 10.5624/isd.20200191] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/17/2020] [Accepted: 11/24/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose This study evaluated the influence of a metal artifact reduction (MAR) tool in a cone-beam computed tomography (CBCT) device on the diagnosis of vertical root fractures (VRFs) in teeth with different root filling materials. Materials and Methods Forty-five extracted human premolars were classified into three subgroups; 1) no filling; 2) gutta-percha; and 3) metallic post. CBCT images were acquired using an Orthopantomograph 300 unit with and without a MAR tool. Subsequently, the same teeth were fractured, and new CBCT scans were obtained with and without MAR. Two oral radiologists evaluated the images regarding the presence or absence of VRF. Receiver operating characteristic (ROC) curves and diagnostic tests were performed. Results The overall area under the curve values were 0.695 for CBCT with MAR and 0.789 for CBCT without MAR. The MAR tool negatively influenced the overall diagnosis of VRFs in all tested subgroups, with lower accuracy (0.45–0.72), sensitivity (0.6–0.67), and specificity (0.23–0.8) than were found for the images without MAR. In the latter group, the accuracy, sensitivity, and specificity values were 0.68–0.77, 0.67–083, and 0.53–087, respectively. However, no significant difference was found between images with and without MAR for the no filling and gutta-percha subgroups (P>0.05). In the metallic post subgroup, CBCT showed a significant difference according to MAR use (P<0.05). Conclusion The OP 300 MAR tool negatively influenced the detection of VRFs in teeth with no root canal filling, gutta-percha, or metallic posts. Teeth with metallic posts suffered the most from the negative impact of MAR.
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Affiliation(s)
- Mariana Rodrigues Oliveira
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Aline Ferreira Caetano
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Rogério Ribeiro de Paiva
- Department of Oral Radiology, School of Dentistry, Anápolis University Centre, Anápolis, Goiás, Brazil
| | - José Valladares-Neto
- Department of Oral Rehabilitation, Division of Orthodontics, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Maria Alves Garcia Silva
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
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20
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Caetano AP, Sousa TO, Oliveira MR, Evanglista K, Bueno JM, Silva MA. Accuracy of three cone-beam CT devices and two software systems in the detection of vertical root fractures. Dentomaxillofac Radiol 2021; 50:20200334. [PMID: 33259236 DOI: 10.1259/dmfr.20200334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to compare the accuracy of vertical root fracture (VRF) detection using three tomography devices and two software systems in teeth with different endodontic fillings. METHODS The sample consisted of 45 premolars divided into 3 groups: No filling (NF, n=15); Gutta percha (GP, n=15) and Metallic Post (MP, n=15). Cone-beam computed tomography (CBCT) images were acquired in Kodak 9000 3D, Orthopantomography 300 (OP300) and PreXion 3D devices, before and after induced root fractures. Two oral radiologists analyzed all images using InVivoDental and e-Vol DX software systems. The analysis was repeated after 15 days in 30% of the sample. Data analysis compared receiver operating characteristic (ROC) curves, as well the areas under the ROC curves. Accuracy, sensitivity, specificity, positive and negative predictive value were calculated according to each tomographic device and software. Intra- and interexaminer reliability were tested using the Kappa coefficient. RESULTS The highest accuracy was seen in the image set from the PreXion 3D, using InVivo (0.96) or e-Vol DX (0.92) in image analysis. The OP300 device presented a similar performance of the PreXion 3D in teeth with different endodontic fillings. When using e-Vol DX, the accuracy of Kodak 9000 3D improved from 0.62 to 0.74. CONCLUSIONS The PreXion 3D device is the most accurate when detecting VRF, with a performance similar to the OP300 in endodontic filled teeth. Kodak 9000 3D is indicated for teeth without fillings, with better accuracy using e-Vol DX software.
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Affiliation(s)
- Aline Pf Caetano
- Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Mariana R Oliveira
- Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Karine Evanglista
- Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Juliano M Bueno
- São Leopoldo Mandic, Private Practioner, Goiânia, Goiás, Brazil
| | - Maria Ag Silva
- Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
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21
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Rodrigues CT, Jacobs R, Vasconcelos KF, Lambrechts P, Rubira-Bullen IRF, Gaêta-Araujo H, Oliveira-Santos C, Duarte MAH. Influence of CBCT-based volumetric distortion and beam hardening artefacts on the assessment of root canal filling quality in isthmus-containing molars. Dentomaxillofac Radiol 2021; 50:20200503. [PMID: 33400563 DOI: 10.1259/dmfr.20200503] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES To evaluate the influence of artefacts in cone beam CT (CBCT) images of filled root canals in isthmus-containing molars. METHODS 10 teeth presenting canals with an isthmus were instrumented and filled with a thermoplasticised obturation technique. The teeth were scanned using a micro-CT device and two CBCT devices: 3D Accuitomo 170 (ACC) and NewTom VGi evo (NT), with different acquisition protocols: larger and smaller voxel size. Three examiners assessed the CBCT images for: (1) detection of filling voids; (2) assessment of under- or overestimation of the filling material and (3) resemblance of CBCT images to the reference standard. Analyses of Task 1 yielded accuracy, sensitivity and specificity for detection of filling voids. For tasks 2 and 3, statistical analysis was performed using Wilcoxon test. The level of significance was set at p < .05. RESULTS For Task 1, ACC showed higher sensitivity, whereas NT presented higher specificity. No significant difference was found between the protocols in ACC, however, for NT, differences between protocols were significant for all diagnostic values. In Task 2, visualisation of the filling was overestimated for NT, while for ACC, underestimation was observed. For Task 3, images with smaller voxel size were more similar to the reference image, for both CBCT devices. CONCLUSIONS Different artefacts compromise the detection of filling voids on CBCT images of canals in mandibular molars with isthmus. ACC and NT present rather similar diagnostic accuracy, even though artefact expression remains device-specific.
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Affiliation(s)
- Clarissa Teles Rodrigues
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Reinhilde Jacobs
- Department of Imaging and Pathology, Faculty of Medicine, OMFS IMPATH Research Group, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karla Faria Vasconcelos
- Department of Imaging and Pathology, Faculty of Medicine, OMFS IMPATH Research Group, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, Endodontology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium.,Biomaterials-BIOMAT, Leuven, Belgium
| | | | - Hugo Gaêta-Araujo
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Christiano Oliveira-Santos
- Department of Stomatology, Public Oral Health, and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
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22
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Taveras Parra C, Fiori-Chíncaro GA, Agudelo-Botero AM. [Imaginology in the diagnosis and planning of root duct systems: an updated review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2021; 9:e045. [PMID: 38464410 PMCID: PMC10919806 DOI: 10.21142/2523-2754-0901-2021-045] [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: 09/01/2020] [Accepted: 11/18/2020] [Indexed: 03/12/2024] Open
Abstract
Root canal systems present a varied morphological conformation for each group of teeth. Several authors have described the anatomical conformation and its variants in different classifications, including the main, collateral, lateral, secondary, accessory, interduct, recurrent, apical delta and interradicular cavus canals. Currently, radiology still does not allow visualization of all these structures. However, proper use of imaging techniques together with the use of new 3D equipment for adjustments of acquisition parameters with adequate software and algorithms allows greater image precision, facilitating diagnosis and the planning of the most adequate approach for endodontic treatments. The objective of this article was to conduct a review of the literature to identify new concepts and useful imaging tools for better diagnoses.
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Affiliation(s)
- Crismely Taveras Parra
- Universidad Iberoamericana (UNIBE). Santo Domingo, República Dominicana. Universidad Iberoamericana (UNIBE) Santo Domingo República Dominicana
| | - Gustavo Adolfo Fiori-Chíncaro
- División de Radiología Bucal y Maxilofacial, Universidad Científica del Sur. Lima, Perú. Universidad Científica del Sur División de Radiología Bucal y Maxilofacial Universidad Científica del Sur Lima Peru
| | - Ana María Agudelo-Botero
- Universidad Autónoma de Manizales. Manizales, Colombia. Universidad Autónoma de Manizales Universidad Autónoma de Manizales Manizales Colombia
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Comparison of Cone Beam Computed Tomography and Digital Radiography in Detecting Separated Endodontic Files and Strip Perforation. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10238726] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The separation of endodontic files and strip perforation are among procedural intraoperative complications which may ultimately lead to the failure of root canal treatment. The aim of the present study was to compare the diagnostic potential of cone beam computed tomography (CBCT) and digital periapical radiographs in detecting separated rotary files and strip perforation in filled canals. Fifty human mandibular molars were selected for this study. The teeth were randomly divided into two groups based on endodontic errors (i.e., file separation and strip perforation). In each group, 25 of 50 mesial canals were randomly chosen for simulating the errors, while the other 25 canals were considered as the control group. In group one, a simulation of the separation of rotary files was performed using ProTaper F2 files. Strip perforation of the root canals in group two was achieved by number 2 and 3 Gates Glidden drills in the coronal third of the root canals. Digital periapical radiographs in two different horizontal angles and high-resolution CBCT scans were obtained from the teeth mounted on a dry human mandible with simulated soft tissue covering. Three experienced observers who were unaware of the study groups evaluated the digital periapical and CBCT image sets in two separate readings. Intraobserver and interobserver agreements, as well as accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were calculated and compared. Intraobserver and interobserver agreements ranged from poor to excellent and poor to good, respectively. The accuracy, sensitivity, specificity, PPV, and NPV for digital radiography in detecting separated files were 0.950, 0.813, 0.957, 0.929, and 0.880, respectively. The same values for CBCT were 0.747, 0.667, 0.900, 0.833, and 0.783, respectively. For the diagnosis of strip perforation, these values were 0.855, 0.800, 0.909, 0.889, and 0.833 for periapical radiography and 0.955, 1.000, 0.920, 0.926, and 1.000 for CBCT. In conclusion, CBCT was superior for diagnosing strip perforation of the filled root canals, while digital periapical radiographs performed better in the detection of separated rotary files.
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Baratto-Filho F, Vavassori de Freitas J, Fagundes Tomazinho FS, Leão Gabardo MC, Mazzi-Chaves JF, Damião Sousa-Neto M. Cone-Beam Computed Tomography Detection of Separated Endodontic Instruments. J Endod 2020; 46:1776-1781. [DOI: 10.1016/j.joen.2020.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/28/2020] [Accepted: 08/10/2020] [Indexed: 11/30/2022]
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Mazzi-Chaves JF, de Faria Vasconcelos K, Pauwels R, Jacobs R, Sousa-Neto MD. Cone-beam Computed Tomographic-based Assessment of Filled C-shaped Canals: Artifact Expression of Cone-beam Computed Tomography as Opposed to Micro-computed Tomography and Nano-computed Tomography. J Endod 2020; 46:1702-1711. [PMID: 32682791 DOI: 10.1016/j.joen.2020.07.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/05/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The present study investigated the assessment of root canal fillings in a series of cone-beam computed tomographic (CBCT) images obtained from endodontically treated mandibular molars with C-shaped canals. METHODS Clinically comparable high (HR) and normal (NR) resolution protocols were selected in 3D Accuitomo 170 (J Morita Corporation, Kyoto, Japan), NewTom VGi evo (Cefla QR Verona, Verona, Italy), ProMax 3D Max (Pro; Planmeca, Helsinki, Finland), and Pax-i3D Green Premium (Pax; Vatech, Gyeonggi, South Korea). Micro-computed tomographic and nano-computed tomographic images were considered as the reference standard. The set of images was evaluated according to beam hardening artifact patterns (dark streaks, hypodense areas, and volume distortion). RESULTS Regarding dark streaks, the Fleiss kappa test showed that Pax HR and NR and Pro HR images showed the highest artifact expression. Hypodense areas were detected in 100% and 99.1% of the images obtained using Pax HR and NR, respectively. Kappa tests showed highest distortion for images derived from the Pax and Pro CBCT devices. Root canal filling assessment was considered appropriate in 100% of the 3D Accuitomo 170 HR, NewTom VGi evo NR, micro-computed tomographic, and nano-computed tomographic images. CONCLUSIONS The present study confirms the large variability in CBCT-derived artifact expression. Highlighting the increased artifact expression for particular CBCT systems, it may be concluded that for diagnosis of endodontically filled molars with C-shaped canals, the choice of CBCT unit and protocol is essential.
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Affiliation(s)
- Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Oral and Maxillofacial Surgery, Imaging and Pathology Research Group, Faculty of Medicine, Department of Imaging and Pathology, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Karla de Faria Vasconcelos
- Oral and Maxillofacial Surgery, Imaging and Pathology Research Group, Faculty of Medicine, Department of Imaging and Pathology, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Ruben Pauwels
- Oral and Maxillofacial Surgery, Imaging and Pathology Research Group, Faculty of Medicine, Department of Imaging and Pathology, University of Leuven, University Hospitals Leuven, Leuven, Belgium; Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark; Faculty of Dentistry, Department of Radiology, Chulalongkorn University, Bangkok, Thailand
| | - Reinhilde Jacobs
- Oral and Maxillofacial Surgery, Imaging and Pathology Research Group, Faculty of Medicine, Department of Imaging and Pathology, University of Leuven, University Hospitals Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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de Oliveira Pinto MG, Sousa Melo SL, Cavalcanti YW, de Lima ED, Bento PM, de Melo DP. Influence of tooth position within the field of view on the intensity of cone-beam computed tomographic imaging artifacts when assessing teeth restored with various intracanal materials. Imaging Sci Dent 2020; 50:141-151. [PMID: 32601589 PMCID: PMC7314612 DOI: 10.5624/isd.2020.50.2.141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 02/29/2020] [Accepted: 03/20/2020] [Indexed: 02/06/2023] Open
Abstract
Purpose This study aimed to quantify the influence of tooth position within the field-of-view (FOV) on cone-beam computed tomography (CBCT) imaging artifacts' intensity when assessing teeth restored with various intracanal materials. Materials and Methods Seventy single-rooted teeth were divided into 7 groups (10 teeth per group): NiCr post (NC), AgPd post (AP), metal core fiberglass post (MCFG), fiberglass post (FG), anatomical fiberglass post (AFG), fiberglass post cemented with core build-up cement (FGCo), and anatomical fiberglass post cemented with core build-up cement (AFGCo). All posts were cemented using a regular dual-curing resin cement (Allcem), except FGCo and AFGCo which were cemented with a core build-up dual-curing resin cement (AllcemCore). Each tooth was scanned on a CS9000 in 5 positions within the FOV: a central position, anterior horizontal peripheral, peripheral superior, peripheral inferior, and posterior horizontal peripheral position. Hyperdense, hypodense, remaining teeth areas and ROI areas were quantitatively analyzed using ImageJ software. Results Posterior horizontal peripheral position increased the intensity of artifacts on FGCo and AFGCo post groups (P<0.05), and specifically the hypodense artifact intensity on FG and AFG post groups (P<0.05). NC and AP groups presented greater intensity of artifacts than any other post groups (P<0.05). Conclusion Artifact intensity increases in the presence of high atomic number materials and when the object is not centered within the FOV. The impact of positioning within the FOV on artifact was greater for fiberglass posts cemented with core build-up dual-curing cement than for metal posts and fiberglass posts cemented with regular dual-curing cement.
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Affiliation(s)
| | - Saulo Leonardo Sousa Melo
- Department of Integrative Biomedical and Diagnostic Sciences, School of Dentistry, Oregon Health and Science University, Portland, OR, USA
| | | | - Elisa Diniz de Lima
- Department of Oral Diagnosis, Division of Oral Radiology, State University of Paraíba, Campina Grande, Brazil
| | - Patrícia Meira Bento
- Department of Oral Diagnosis, Division of Oral Radiology, State University of Paraíba, Campina Grande, Brazil
| | - Daniela Pita de Melo
- Department of Oral Diagnosis, Division of Oral Radiology, State University of Paraíba, Campina Grande, Brazil
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de Faria Vasconcelos K, Queiroz PM, Codari M, Pinheiro Nicolielo LF, Freitas DQ, Jacobs R, Haiter-Neto F. A quantitative analysis of metal artifact reduction algorithm performance in volume correction with 3 CBCT devices. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:328-335. [PMID: 32439517 DOI: 10.1016/j.oooo.2020.03.049] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 03/20/2020] [Accepted: 03/31/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this study was to quantitatively assess the performance of metal artifact reduction (MAR) algorithms on the volume of metal cylinders, considering the influence of materials, positions, and fields of view (FOVs), by using 3 cone beam computed tomography (CBCT) devices (NewTom VGi evo, Picasso Trio, and ProMax 3-D Max). STUDY DESIGN Nine phantoms containing cylinders of amalgam, copper-aluminum (CuAl) metal alloy, and titanium, combined in up to 3 positions, were scanned by using 2 different FOVs. MATLAB software was used to evaluate the differences between volumes before and after MAR application, and the possible interference of materials, positions, and FOVs. Wilcoxon's test and the Kruskal-Wallis test were used at a level of significance of 5%. RESULTS In general, images containing amalgam and CuAl showed a significant difference in volume before and after MAR application. However, no significant difference after MAR was observed (P > .05) relative to positions and FOVs. MAR had an impact on the cylinder volumes only in the NewTom VGi evo and ProMax 3-D Max scanners. CONCLUSIONS The performance of MAR algorithms in volume correction of metal objects is dependent on the materials and the CBCT unit.
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Affiliation(s)
- Karla de Faria Vasconcelos
- OMFS IMPATH research group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Division of Oral Radiology, Department of Oral Diagnosis, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, Sao Paulo, Brazil.
| | - Polyane Mazucatto Queiroz
- Division of Oral Radiology, Department of Oral Diagnosis, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Marina Codari
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Laura Ferreira Pinheiro Nicolielo
- OMFS IMPATH research group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Reinhilde Jacobs
- OMFS IMPATH research group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Francisco Haiter-Neto
- Division of Oral Radiology, Department of Oral Diagnosis, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, Sao Paulo, Brazil
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Demirturk Kocasarac H, Ustaoglu G, Bayrak S, Katkar R, Geha H, Deahl ST, Mealey BL, Danaci M, Noujeim M. Evaluation of artifacts generated by titanium, zirconium, and titanium-zirconium alloy dental implants on MRI, CT, and CBCT images: A phantom study. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127:535-544. [PMID: 30879914 DOI: 10.1016/j.oooo.2019.01.074] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 01/16/2019] [Accepted: 01/20/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of this study was to assess artifacts generated by zirconium, titanium, and titanium-zirconium alloy implants on magnetic resonance imaging(MRI), computed tomography(CT), and cone beam computed tomography(CBCT) and to correlate the findings to the dose-area product and exposure factors on CT and CBCT. STUDY DESIGN Three phantoms were built by embedding zirconium, titanium, and titanium-zirconium implants in ultrasound gel. MRI, CT, and CBCT images were acquired by using multiple sequences and settings. For MRI, "artifact" was described as the length of signal void beyond the limits of the implant. For CT and CBCT, "artifact" was calculated by subtracting the gray level of the darkest pixel from the level of the lightest pixel. RESULTS On MRI, zirconium implants had minor distortion artifacts, whereas titanium and titanium-zirconium implants created extensive artifacts (P < .05). On CT and CBCT, artifacts were less prominent with titanium and titanium-zirconium implants compared with zirconium (P < .05). Titanium grade 5 implants with 0.3 and 0.4 mm3 voxels produced the least severe artifacts. CONCLUSIONS MRI images were less affected by artifacts from zirconium implants, whereas CT and CBCT images showed less severe artifacts from titanium and titanium-zirconium alloy implants. CT generated greater artifacts compared with CBCT. Larger CBCT voxel sizes reduced the dose-area product and the severity of artifacts.
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Affiliation(s)
- Husniye Demirturk Kocasarac
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, TX, USA and Department of General Dental Sciences, Marquette University, Milwaukee, WI, USA.
| | - Gulbahar Ustaoglu
- Chair, Department of Periodontology, Abant Izzet Baysal University, Bolu, Turkey
| | - Seval Bayrak
- Chair, Department of Oral and Maxillofacial Radiology, Abant Izzet Baysal University, Bolu, Turkey
| | - Rujuta Katkar
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, TX, USA and Department of General Dental Sciences, Marquette University, Milwaukee, WI, USA
| | - Hassem Geha
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, TX, USA and Department of General Dental Sciences, Marquette University, Milwaukee, WI, USA
| | - S Thomas Deahl
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, TX, USA and Department of General Dental Sciences, Marquette University, Milwaukee, WI, USA
| | - Brian L Mealey
- Graduate Program Director, Department of Periodontology, University of Texas Health San Antonio, TX, USA
| | - Murat Danaci
- Chair, Department of Radiology, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Marcel Noujeim
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, TX, USA and Department of General Dental Sciences, Marquette University, Milwaukee, WI, USA
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Candemil AP, Salmon B, Freitas DQ, Ambrosano GMB, Haiter-Neto F, Oliveira ML. Are metal artefact reduction algorithms effective to correct cone beam CT artefacts arising from the exomass? Dentomaxillofac Radiol 2019; 48:20180290. [PMID: 30540919 DOI: 10.1259/dmfr.20180290] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The aim of this study was to evaluate the effectiveness of metal artefact reduction (MAR) in cone beam CT (CBCT) artefacts arising from metallic objects in the exomass. A radiographic phantom composed of 16 polypropylene tubes filled with a homogeneous radiopaque solution was created. CBCT scans were obtained with two units: Picasso Trio (Vatech, South Korea) and ProMax (Planmeca, Finland). The phantom was centred in a 5 × 5 cm field-of-view (FOV) with titanium and CoCr inserts in the exomass. All scans were repeated after enabling MAR. Mean voxel values were obtained from the 16 tubes and standard deviation was calculated as a way of measuring voxel value variability. Mean values and voxel value variability were compared individually in the presence and absence of MAR by means of analysis of variance, followed by Tukey's test (α = 0.05). In the Picasso Trio, MAR significantly decreased mean voxel values (p ≤ 0.05) and increased voxel value variability (p > 0.05) in the presence of titanium. When CoCr was present, no statistical difference (p > 0.05) was observed. In the ProMax, MAR increased significantly mean voxel values (p ≤ 0.05) in the presence of titanium, and presented no significant difference (p > 0.05) for CoCr. Voxel value variability did not differ significantly (p > 0.05) for both materials. In conclusion, MAR was not effective to correct CBCT artefacts arising from metallic objects in the exomass in the two CBCT units used.
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Affiliation(s)
- Amanda Pelegrin Candemil
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Piracicaba , Brazil
| | - Benjamin Salmon
- 2 Orofacial Pathologies, Imaging and Biotherapies Lab and Dental Medicine Department, Bretonneau Hospital, HUPNVS, AP-HP, Paris Descartes University - Sorbonne Paris Cité , Paris , France
| | - Deborah Queiroz Freitas
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Piracicaba , Brazil
| | | | - Francisco Haiter-Neto
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Piracicaba , Brazil
| | - Matheus Lima Oliveira
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Piracicaba , Brazil
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Freitas DQ, Nascimento EHL, Vasconcelos TV, Noujeim M. Diagnosis of external root resorption in teeth close and distant to zirconium implants: influence of acquisition parameters and artefacts produced during cone beam computed tomography. Int Endod J 2019; 52:866-873. [PMID: 30585641 DOI: 10.1111/iej.13065] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 12/15/2018] [Indexed: 12/16/2022]
Abstract
AIM To assess the influence of artefacts, the metal artefact reduction (MAR) tool and kilovoltage (kVp) on the diagnosis of simulated external root resorption (ERR) in teeth close and distant to zirconium implants in cone beam computed tomography (CBCT) images. METHODOLOGY Cavities (0.62 mm in diameter and 0.19 mm deep) were created in the apical thirds of 12 roots on the buccal, lingual, distal or mesial surface; ten roots served as controls. The roots were randomly positioned in the first and second right and left premolar sockets of a dry human mandible, and a zirconium implant was placed in the socket of the first right molar. A ProMax 3D unit varying kVp (70, 80, or 90 kVp) and with the MAR tool activated or not was used to obtain CBCT scans. Five examiners evaluated all images to determine the area under the receiver operating characteristic (ROC) curve, sensitivity and specificity. RESULTS The ROC values and sensitivity were not affected by MAR or artefacts regardless of the distance to the implant (P > 0.05), whilst increasing kVp from 70 to 90 led to a significant increase in these values (P = 0.0202 and 0.0199, respectively). Specificity was not affected by the factors studied (P > 0.05). CONCLUSIONS Amongst the factors studied, only kVp influenced the diagnosis of simulated external root resorption in CBCT images. Increasing kVp from 70 to 90 improved the accuracy in diagnosing the simulated lesions.
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Affiliation(s)
- D Q Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - E H L Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - T V Vasconcelos
- Division of Oral Radiology, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
| | - M Noujeim
- Department of Comprehensive Dentistry, Division of Oral and Maxillofacial Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Koç C, Kamburoğlu K, Sönmez G, Yılmaz F, Gülen O, Karahan S. Ability to detect endodontic complications using three different cone beam computed tomography units with and without artefact reduction modes: an
ex vivo
study. Int Endod J 2018; 52:725-736. [DOI: 10.1111/iej.13051] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 11/27/2018] [Indexed: 11/29/2022]
Affiliation(s)
- C. Koç
- Department of Endodontics Faculty of Dentistry Başkent University Ankara Turkey
| | - K. Kamburoğlu
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Ankara University Ankara Turkey
| | - G. Sönmez
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Ankara University Ankara Turkey
| | - F. Yılmaz
- Department of Endodontics Faculty of Dentistry Ankara University Ankara Turkey
| | - O. Gülen
- DentisTomo Private Imaging Center Ankara Turkey
| | - S. Karahan
- Department of Biostatistics Faculty of Medicine Hacettepe University Ankara Turkey
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Celikten B, Jacobs R, de Faria Vasconcelos K, Huang Y, Shaheen E, Nicolielo LFP, Orhan K. Comparative evaluation of cone beam CT and micro-CT on blooming artifacts in human teeth filled with bioceramic sealers. Clin Oral Investig 2018; 23:3267-3273. [DOI: 10.1007/s00784-018-2748-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 11/19/2018] [Indexed: 12/01/2022]
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Freitas DQ, Vasconcelos TV, Noujeim M. Diagnosis of vertical root fracture in teeth close and distant to implant: an in vitro study to assess the influence of artifacts produced in cone beam computed tomography. Clin Oral Investig 2018; 23:1263-1270. [PMID: 29984377 DOI: 10.1007/s00784-018-2558-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 07/02/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the influence of artifacts produced by zirconium implant on the diagnosis of vertical root fracture (VRF) in teeth close and distant to the implant in cone beam computed tomography (CBCT) images. We also determined if kilovoltage (kVp) and metal artifact reduction (MAR) tool could influence this diagnosis. MATERIALS AND METHODS Twenty single-root teeth were divided in control and fractured groups (n = 10). The teeth were randomly positioned in the first and second and right and left pre-molar alveoli of a dry human mandible. CBCT exams were acquired using a ProMax 3D unit with varying kVp (70, 80, or 90 kVp), with or without MAR, and with and without a zirconium implant placed in the alveolus of first right molar. The images were evaluated by five observers. The area under the receiver operating characteristic curve (ROC), sensitivity, and specificity were calculated and compared by analysis of variance with a significance level of 5%. RESULTS In general, ROC and sensitivity were not affected by the factors studied (p > 0.05). The main effects occurred in specificity; when implant was used without MAR, the values were lower for tooth 45 for all kVps (p = 0.0001). CONCLUSIONS Artifacts produced in the vicinity of teeth with suspected VRF impair the diagnosis by decreasing the specificity, because they can mimic the VRF line generating false positives. However, MAR improves the specificity, being its use recommended when metallic objects are present near teeth with suspected VRF. CLINICAL RELEVANCE Since nowadays, many patients who undergo CBCT show implants and they definitively produce artifacts, it is important to evaluate the influence of such artifacts in the diagnosis of teeth that are close to the generator-artifact object.
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Affiliation(s)
- Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil.
| | - Taruska Ventorini Vasconcelos
- Division of Oral Radiology, School of Dentistry, Federal University of Bahia, Rua Araújo Pinho, 62, Salvador, Bahia, 40110-040, Brazil
| | - Marcel Noujeim
- Department of Comprehensive Dentistry, Division of Oral and Maxillofacial Radiology, University of Texas Health Science Center at San Antonio, 7707, Floyd Curl Drive, San Antonio, TX, 78229, USA
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Rajasekharan S, Martens LC, Cauwels RGEC, Anthonappa RP. Biodentine™ material characteristics and clinical applications: a 3 year literature review and update. Eur Arch Paediatr Dent 2018; 19:1-22. [PMID: 29372451 DOI: 10.1007/s40368-018-0328-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 01/11/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Biodentine™ has frequently been acknowledged in the literature as a promising material and serves as an important representative of tricalcium silicate based cements used in dentistry. AIM To provide an update on the physical and biological properties of Biodentine™ and to compare these properties with those of other tricalcium silicate cements namely, different variants of mineral trioxide aggregate (MTA) such as ProRoot MTA, MTA Angelus, Micro Mega MTA (MM-MTA), Retro MTA, Ortho MTA, MTA Plus, GCMTA, MTA HP and calcium enriched mixture (CEM), Endosequence and Bioaggregate™. STUDY DESIGN A comprehensive literature search for publications from November 20, 2013 to November 20, 2016 was performed by two independent reviewers on Medline (PubMed), Embase, Web of Science, CENTRAL (Cochrane), SIGLE, SciELO, Scopus, Lilacs and clinicaltrials.gov. Electronic and hand search was carried out to identify randomised control trials (RCTs), case control studies, case series, case reports, as well as in vitro and animal studies published in the English language. CONCLUSIONS The enhanced physical and biologic properties of Biodentine™ could be attributed to the presence of finer particle size, use of zirconium oxide as radiopacifier, purity of tricalcium silicate, absence of dicalcium silicate, and the addition of calcium chloride and hydrosoluble polymer. Furthermore, as Biodentine™ overcomes the major drawbacks of MTA it has great potential to revolutionise the different treatment modalities in paediatric dentistry and endodontics especially after traumatic injuries. Nevertheless, high quality long-term clinical studies are required to facilitate definitive conclusions.
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Affiliation(s)
- S Rajasekharan
- Department of Paediatric Dentistry and special care, PAECOMEDIS Research Cluster, Ghent University, 9000, Ghent, Belgium.
| | - L C Martens
- Department of Paediatric Dentistry and special care, PAECOMEDIS Research Cluster, Ghent University, 9000, Ghent, Belgium
| | - R G E C Cauwels
- Department of Paediatric Dentistry and special care, PAECOMEDIS Research Cluster, Ghent University, 9000, Ghent, Belgium
| | - R P Anthonappa
- Paediatric Oral Health Research Group, School of Dentistry, The University of Western Australia, Perth, Australia
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Rabelo KA, Cavalcanti YW, de Oliveira Pinto MG, Sousa Melo SL, Campos PSF, de Andrade Freitas Oliveira LS, de Melo DP. Quantitative assessment of image artifacts from root filling materials on CBCT scans made using several exposure parameters. Imaging Sci Dent 2017; 47:189-197. [PMID: 28989902 PMCID: PMC5620464 DOI: 10.5624/isd.2017.47.3.189] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 06/03/2017] [Accepted: 06/07/2017] [Indexed: 02/01/2023] Open
Abstract
Purpose To quantify artifacts from different root filling materials in cone-beam computed tomography (CBCT) images acquired using different exposure parameters. Materials and Methods Fifteen single-rooted teeth were scanned using 8 different exposure protocols with 3 different filling materials and once without filling material as a control group. Artifact quantification was performed by a trained observer who made measurements in the central axial slice of all acquired images in a fixed region of interest using ImageJ. Hyperdense artifacts, hypodense artifacts, and the remaining tooth area were identified, and the percentages of hyperdense and hypodense artifacts, remaining tooth area, and tooth area affected by the artifacts were calculated. Artifacts were analyzed qualitatively by 2 observers using the following scores: absence (0), moderate presence (1), and high presence (2) for hypodense halos, hypodense lines, and hyperdense lines. Two-way ANOVA and the post-hoc Tukey test were used for quantitative and qualitative artifact analysis. The Dunnet test was also used for qualitative analysis. The significance level was set at P<.05. Results There were no significant interactions among the exposure parameters in the quantitative or qualitative analysis. Significant differences were observed among the studied filling materials in all quantitative analyses. In the qualitative analyses, all materials differed from the control group in terms of hypodense and hyperdense lines (P<.05). Fiberglass posts did not differ statistically from the control group in terms of hypodense halos (P>.05). Conclusion Different exposure parameters did not affect the objective or subjective observations of artifacts in CBCT images; however, the filling materials used in endodontic restorations did affect both types of assessments.
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Affiliation(s)
| | | | | | | | | | | | - Daniela Pita de Melo
- Department of Oral Diagnosis, State University of Paraíba, Campina Grande, Brazil
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Assessment of Volumetric Distortion Artifact in Filled Root Canals Using Different Cone-beam Computed Tomographic Devices. J Endod 2017; 43:1517-1521. [DOI: 10.1016/j.joen.2017.03.035] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 03/13/2017] [Accepted: 03/19/2017] [Indexed: 11/21/2022]
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Codari M, de Faria Vasconcelos K, Ferreira Pinheiro Nicolielo L, Haiter Neto F, Jacobs R. Quantitative evaluation of metal artifacts using different CBCT devices, high-density materials and field of views. Clin Oral Implants Res 2017; 28:1509-1514. [DOI: 10.1111/clr.13019] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Marina Codari
- OIC; OMFS IMPATH Research Group; Department Imaging & Pathology; Faculty of Medicine; KU Leuven and Oral and Maxillofacial Surgery; University Hospitals Leuven; Leuven Belgium
- Department of Biomedical Sciences for Health; Faculty of Medicine and Surgery; Università degli Studi di Milano; Milano Italy
| | - Karla de Faria Vasconcelos
- OIC; OMFS IMPATH Research Group; Department Imaging & Pathology; Faculty of Medicine; KU Leuven and Oral and Maxillofacial Surgery; University Hospitals Leuven; Leuven Belgium
- Division of Oral Radiology; Department of Oral Diagnosis; Piracicaba Dental School; State University of Campinas; Piracicaba São Paulo Brazil
| | - Laura Ferreira Pinheiro Nicolielo
- OIC; OMFS IMPATH Research Group; Department Imaging & Pathology; Faculty of Medicine; KU Leuven and Oral and Maxillofacial Surgery; University Hospitals Leuven; Leuven Belgium
| | - Francisco Haiter Neto
- Division of Oral Radiology; Department of Oral Diagnosis; Piracicaba Dental School; State University of Campinas; Piracicaba São Paulo Brazil
| | - Reinhilde Jacobs
- OIC; OMFS IMPATH Research Group; Department Imaging & Pathology; Faculty of Medicine; KU Leuven and Oral and Maxillofacial Surgery; University Hospitals Leuven; Leuven Belgium
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Sousa TO, Hassan B, Mirmohammadi H, Shemesh H, Haiter-Neto F. Feasibility of Cone-beam Computed Tomography in Detecting Lateral Canals before and after Root Canal Treatment: An Ex Vivo Study. J Endod 2017; 43:1014-1017. [PMID: 28416319 DOI: 10.1016/j.joen.2017.01.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/04/2017] [Accepted: 01/15/2017] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The study objective was to evaluate the effectiveness of cone-beam computed tomographic (CBCT) imaging for the detection of lateral canals (LCs) in endodontically treated premolars. METHODS Two evaluators classified 80 extracted premolars into 2 groups based on the absence (n = 40) or presence (n = 40) of LCs according to micro-computed tomographic analysis. The extracted teeth were fixated in a human mandible and scanned with CBCT imaging. Subsequently, each tooth was endodontically treated, and CBCT scans were repeated. Three experienced examiners evaluated all images randomly. Receiver operating characteristic curves were compared using the McNemar test, and sensitivity, specificity, positive predictive value, and negative predictive value (NPV) were obtained. RESULTS The area under the receiver operating characteristic curve values were 0.58 and 0.49 before and after root canal treatment, respectively. These values were statistically significantly different (P < .001). Before root canal treatment sensitivity, specificity, positive predictive value, and negative predictive value were 55%, 52%, 55%, and 56%, whereas after root canal treatment the values were 33%, 61%, 46%, and 48%, respectively. CONCLUSIONS LC detection in nontreated teeth presented low accuracy, whereas among treated teeth CBCT imaging showed no efficacy. The results suggest that CBCT imaging is not an effective diagnostic tool for LC detection.
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Affiliation(s)
- Thiago Oliveira Sousa
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Campinas, São Paulo, Brazil.
| | - Bassam Hassan
- Department of Oral Implantology and Prosthetic Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Hesam Mirmohammadi
- Department of Endodontology, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Hagay Shemesh
- Department of Endodontology, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Campinas, São Paulo, Brazil
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