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Rosado LPL, Fontenele RC, Farias-Gomes A, Freitas DQ, Neves FS. Influence of the metal post material, tooth location in the dental arch, and metal artifact reduction tool on vertical root fracture diagnosis in cone beam CT. Odontology 2024; 112:959-965. [PMID: 38214844 DOI: 10.1007/s10266-023-00889-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 12/10/2023] [Indexed: 01/13/2024]
Abstract
This study aimed to evaluate the influence of the metal post composition, tooth location in the dental arch, and metal artifact reduction (MAR) on vertical root fracture (VRF) diagnosis in cone beam computed tomography (CBCT). Twenty-two unirradicular premolars (12 sound and 10 fractured) and two alveolar sockets of a mandible (anterior and posterior regions) composed the sample. CBCT scans of each tooth with a metal post placed into the root canal-silver-palladium (Ag-Pd), cobalt-chromium (Co-Cr), or nickel-chromium (Ni-Cr)-were individually acquired for each mandibular region, and two conditions of MAR, using a OP300 device (Instrumentarium, Finland). Images were assessed by five evaluators independently for VRF detection. Diagnostic values were calculated and compared among all groups using multi-way ANOVA with Tukey post hoc test to investigate the effect of post material, anatomical region, and MAR on VRF diagnosis (α = 0.05). Values of area under the receiver operating curve and specificity were not influenced by the studied factors (p > 0.05). Sensitivity was influenced by the MAR in both mandibular regions (p < 0.05). In the anterior region, sensitivity values increased when the MAR was enabled, regardless of the metal post material (p < 0.05). Similar behavior was noticed in the posterior region for Ni-Cr (p < 0.05) but not for Ag-Pd and Co-Cr posts (p > 0.05). The MAR improved the sensitivity in VRF diagnosis for all tested metal posts in the mandibular anterior region and for the Ni-Cr post in the mandibular posterior region. Therefore, for images obtained in the OP300 CBCT device, activation of the MAR is suggested in these cases.
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Affiliation(s)
- Lucas P Lopes Rosado
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil.
- Department of Dentistry, University Center of Espírito Santo (UNESC), Colatina, ES, Brazil.
| | - Rocharles Cavalcante Fontenele
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Amanda Farias-Gomes
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Frederico Sampaio Neves
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
- Department of Propedeutics and Integrated Clinic, Division of Oral Radiology, School of Dentistry, Federal University of Bahia (UFBA), Salvador, BA, Brazil
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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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Zhu T, Zhou G, Chen C, Wang J, Gu P, Zhang J, Wu H, Zhao X, Leng D, Wu D. Quantitative evaluation of artifact expression in conebeam computed tomography of mesoporous calcium silicate nanoparticles as a promising root canal sealer. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:500-507. [PMID: 37453920 DOI: 10.1016/j.oooo.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 05/08/2023] [Accepted: 05/13/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES We aimed to quantitatively compare the area and volume of artifacts in cone beam computed tomography produced by mesoporous calcium silicate nanoparticles (MCSNs), AH Plus sealer, and iRoot SP sealer when used as root canal sealers. METHODS We prepared 40 single-rooted mandibular premolars and divided them into an MCSN sealer group, an AH Plus sealer group, an iRoot SP sealer group, and a no-sealer (control) group. We filled the canals with gutta-percha using the single-cone method and subjected them to conebeam computed tomography before and after the placement of root fillings using the same exposure parameters. We evaluated the images to quantify the areas of hyperdense and hypodense artifacts and non-affected teeth and reconstructed 3-dimensional image models of the materials to study volume distortion artifacts. RESULTS The MCSN sealer group produced a significantly smaller hyperdense and volume distortion artifacts than the AH Plus and iRoot SP groups (P < .01), but the area and volume of hypodense artifacts did not differ significantly among the groups (P > .05). CONCLUSIONS When used as a root canal sealer, MCSNs generate a significantly smaller area and volume of hyperdense artifacts than AH Plus and iRoot SP sealers. By significantly reducing the generation of high-density artifacts, MCSNs may facilitate the evaluation of root canal filling quality and the diagnosis of root canal abnormalities.
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Affiliation(s)
- Tingting Zhu
- Department of Endodontics, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Guangchao Zhou
- Department of Oral and Maxillofacial Imaging, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Cheng Chen
- Department of Endodontics, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Jingyan Wang
- Department of Oral and Maxillofacial Imaging, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Peiyu Gu
- Department of Oral and Maxillofacial Imaging, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Juan Zhang
- Department of Oral and Maxillofacial Imaging, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Huili Wu
- Department of Endodontics, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Xiao Zhao
- Department of Endodontics, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Diya Leng
- Department of Endodontics, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Department of Oral and Maxillofacial Imaging, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Daming Wu
- Department of Endodontics, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Department of Oral and Maxillofacial Imaging, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China.
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Shokri A, Eskandarloo A, Zahedi F, Karkehabadi H, Foroozandeh M, Farhadian M. Effect of different intracanal posts and exposure parameters on detection of vertical root fractures by cone-beam computed tomography. AUST ENDOD J 2023; 49 Suppl 1:132-145. [PMID: 36269003 DOI: 10.1111/aej.12700] [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: 06/20/2022] [Revised: 09/24/2022] [Accepted: 10/05/2022] [Indexed: 11/28/2022]
Abstract
This study evaluated the effect of different amperage values and voxel sizes of two CBCT scanners on VRF detection in the presence of different intracanal posts. After post-space preparation, VRFs were induced in half of the samples of 20 maxillary premolars. Five different intracanal posts were passively placed in each root canal. Samples were scanned using CS 9300 and Cranex3D with two different voxel sizes and amperage setting in each unit. The diagnostic sensitivity, specificity and accuracy were compared using the Mann-Whitney and Kruskal-Wallis tests (α = 0.05). Changes in amperage and voxel size did not affect the detection of VRFs (p ⟩ 0.05). The VRF detection accuracy was the highest in fibreglass and the lowest in nickel-chromium group. Changes in amperage and voxel size within assessed values do not seem to influence the detection of VRF whereas different intracanal post-materials have significant effect on VRF detection.
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Affiliation(s)
- Abbas Shokri
- Dental Implants Research Center, Oral and Maxillofacial Radiology Department, Hamadan University of Medical Science, Hamadan, Iran
| | - Amir Eskandarloo
- Oral and Maxillofacial Radiology Department, Hamadan University of Medical Science, Hamadan, Iran
| | - Foozie Zahedi
- Oral and Maxillofacial Radiology Department, Hamadan University of Medical Science, Hamadan, Iran
| | - Hamed Karkehabadi
- Department of Endodontics, Dental School, Hamadan University of Medical Science, Hamadan, Iran
| | - Maryam Foroozandeh
- Oral and Maxillofacial Radiology Department, Hamadan University of Medical Science, Hamadan, Iran
| | - Maryam Farhadian
- Biostatistics, Modeling of Noncommunicable Diseases Research Center, Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Habibzadeh S, Ghoncheh Z, Kabiri P, Mosaddad SA. Diagnostic efficacy of cone-beam computed tomography for detection of vertical root fractures in endodontically treated teeth: a systematic review. BMC Med Imaging 2023; 23:68. [PMID: 37264339 DOI: 10.1186/s12880-023-01024-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/23/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Vertical root fractures (VRFs) sometimes occur in endodontically treated teeth. They have a difficult diagnosis and a dismal result. The objective of this review was to evaluate the diagnostic performance of cone-beam computed tomography (CBCT) for detecting VRFs in teeth that had undergone endodontic treatment. METHODS Literature was reviewed from Web of Science, PubMed, Cochrane Review, SCOPUS, and Embase databases between 2000 and 2022. The searched keywords included "endodontically treated teeth," "cone-beam computed tomography," "CBCT," "tooth fracture," "vertical root fracture," "VRF," "accuracy," "sensitivity," and "specificity." Only articles in the English language were included. The final analysis included 20 papers that satisfied the eligibility requirements. RESULTS The overall mean ± SD values (%) for the diagnostic sensitivity and specificity of CBCT for detection of VRFs in endodontically treated teeth in the presence of root-filling materials without an intracanal post were 71.50 ± 22.19 and 75.64 ± 19.41, respectively. The overall mean (SD) value (%) for the sensitivity of CBCT for the detection of VRFs in the presence of root-filling materials and intracanal posts was 72.76 (18.73), while the mean (SD) specificity was 75.44 (18.26). The accuracy of CBCT (mean ± SD) was 78.47 ± 17.19% and 74.02 ± 10.64%, respectively, for teeth without intracanal posts and those with posts. CONCLUSIONS Further clinical research is needed to validate the optimum efficiency of CBCT as a diagnostic technique for detecting VRFs in teeth that have had endodontic treatment, given the low sensitivity, significant heterogeneity of studies, and lack of in-vivo studies on the subject.
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Affiliation(s)
- Sareh Habibzadeh
- Associate Professor, Department of Prosthodontics, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
- Associate Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Ghoncheh
- Associate Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Associate Professor, Department of Oral & Maxillofacial Radiology, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Pedram Kabiri
- Dentist, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
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de Lima KL, Silva LR, de Paiva Prado TB, Silva MAG, de Freitas Silva BS, Yamamoto-Silva FP. Influence of the technical parameters of CBCT image acquisition on vertical root fracture diagnosis: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:433-474. [PMID: 36700991 DOI: 10.1007/s00784-022-04797-z] [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: 05/02/2022] [Accepted: 11/14/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To evaluate the influence of image acquisition parameters (voxel, FOV, kVp, mA) on the accuracy of cone-beam computed tomography (CBCT) in detecting vertical root fracture (VRF). MATERIAL AND METHODS Searches were performed in 6 main databases and the gray literature, without restrictions of language or date. Observational clinical studies (OCS) and in vitro-extracted teeth (IV) studies were considered eligible for inclusion when investigating the accuracy (sensitivity, specificity) of CBCT in detecting VRF in human teeth. The risk of bias was assessed using QUADAS-2, and a meta-analysis was performed using Review Manager v5.4 software and Jamovi software v1.6. RESULTS A total of 60 out of 132 articles was included after fulfilling the eligibility criteria. Of these, 54 were IV studies while 6 were OCS. In the IV studies, it was seen that smaller FOV sizes tended to present higher accuracy values. The meta-analysis of the 6 OCS showed that the overall sensitivity and specificity values for 0.08 mm and 0.1 mm voxels were greater (0.84 and 0.79, respectively) than the sensitivity and specificity values for 0.125 mm and 0.2 mm voxels (0.70 and 0.55, respectively). CONCLUSIONS Despite the uncertain risk of bias found for the IV and OCS studies, smaller voxel and FOV sizes seem to provide more accurate VRF detection values when using CBCT. CLINICAL RELEVANCE This information is crucial for supporting the clinician when prescribing CBCT in cases of a clinical suspicion of VRF, and contributes to the personalization of the CBCT prescription, thereby ensuring greater accuracy in the VRF diagnosis. Registration This protocol was registered at the PROSPERO database (International Prospective Register of Systematic Review) under registration number CRD42020210118.
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Affiliation(s)
- Kaique Leite de Lima
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Lorena Rosa Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | | | - Maria Alves Garcia Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Brunno Santos de Freitas Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil. .,University of Anápolis, Anápolis, GO, Brazil.
| | - Fernanda Paula Yamamoto-Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil.,University of Anápolis, Anápolis, GO, Brazil
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Freitas APLDF, Peixoto LR, Mariz Suassuna FC, Bento PM, Maia Amorim AMA, Rovaris Silva K, de Almeida Barros RQ, Pontual de Andrade Lima ADA, de Melo DP. The effects of different metal posts, cements, and exposure parameters on cone-beam computed tomography artifacts. Imaging Sci Dent 2023. [DOI: 10.5624/isd.20220185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Affiliation(s)
| | | | | | - Patrícia Meira Bento
- Department of Oral Diagnosis, State University of Paraíba, Campina Grande, PB, Brazil
| | | | - Karla Rovaris Silva
- Department of Oral Diagnosis, Federal University of Piauí, Teresina, PI, Brazil
| | | | | | - Daniela Pita de Melo
- Department of Oral Diagnosis, State University of Paraíba, Campina Grande, PB, Brazil
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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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Cavalcanti MGP, Salineiro FC, Barros FM, Barros FBA. Influence of endodontic sealers artifacts in the detection of vertical root fractures. Braz Dent J 2022; 33:22-30. [DOI: 10.1590/0103-6440202204392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 11/25/2021] [Indexed: 11/22/2022] Open
Abstract
Abstract The aim of this study was to compare the influence of endodontic sealers artifacts on the detection of vertical root fracture in cone beam computed tomography (CBCT). Premolars and central incisors were assigned into five different groups: Control, Pulp Canal Sealer, AH Plus, Sealer 26, and BC Sealer (n= 10, per group). VRFs were mechanically induced and the teeth were inserted into an image phantom. Subsequently, CBCT (Cranex 3Dx, Soredex, Tuusula, Finland) images were obtained and two observers were asked separately to identify root fracture, by visual analysis. For both premolar and central incisors, kappa coefficients of intraobserver agreement varied from good to excellent (K: 80% - 87%), and the values for interobserver agreement varied from fair to moderate (K: 30% - 35%). As follows, the area under the curve (AUC) of receiver operating characteristic (ROC) values for VRFs highlighted that the use of BC sealer reduced the observers’ ability to discriminate VRFs relative to other sealers. Moreover, sensitivity values for premolars teeth ranged from 20% to 60%, and specificity ranged from 60% to 100%; while sensitivity values for central incisors ranged from 30% to 70%, and specificity ranged from 70% to 100%. In conclusion, the low sensitivity values, mainly for premolars, demonstrated the difficulty in VRF diagnosis. Furthermore, BC Sealer induced significantly more imaging artifacts than other sealers. These results highlighting that endodontic sealers may interfere with the diagnosis of VRFs.
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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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de Oliveira Pinto MG, Melo SLS, Suassuna FCM, Marinho LE, Leite JBDS, Batista AUD, Bento PM, Melo DP. Influence of size of field of view (FOV), position within the FOV, and scanning mode on the detection of root fracture and observer's perception of artifacts in CBCT images. Dentomaxillofac Radiol 2021; 50:20200563. [PMID: 33565884 DOI: 10.1259/dmfr.20200563] [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: 11/05/2022] Open
Abstract
OBJECTIVE To assess the influence of field of view (FOV) size, scanning position within the FOV and scanning mode on the detection of root fracture and artifact perception. METHODS Forty single-rooted premolars restored with NiCr and AgPd posts were divided into two groups: fractured and sound. All teeth were scanned using four CBCT scanning protocols varying FOV sizes (80 × 80 mm and 50 × 55 mm) and scanning modes (Standard and High Definition). The sample was positioned within the FOV in two pre-set positions (central and lateral) and in four positions established by the operator (quadrants). Detection of root fracture and artifact perception were assessed by two observers using 5-point and 4-point scales. Sensitivity, specificity, accuracy, and AUC values were calculated and compared by ANOVA two-way and Tukey's test. Chi-square and Fisher's exact test were used to assess artifact perception. The level of significance was set at p < 0.05. RESULTS The central position within the FOV presented higher sensitivity, specificity, accuracy, and AUC values and differed from the lateral position within the FOV for the studied metal posts (p<0.05). Quadrant 2 presented the best sensitivity, accuracy, and AUC values (p<0.05). The lateral position within the FOV, AgPd posts, quadrants 1 and 3 and protocols 1 (SM, 80 × 80) and 2 (HD, 80× 80) presented higher frequency of artifacts classified as "severe". CONCLUSION Positioning the object in the center or closer to the anterior periphery of the FOV while using a small FOV improved the detection of root fracture and decreased artifact perception.
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Affiliation(s)
| | - Saulo L Sousa Melo
- Department of Integrative Biomedical & Diagnostic Sciences, School of Dentistry, Oregon Health & Science University, Portland, USA
| | | | - Luiz Eduardo Marinho
- 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 Melo
- Department of Oral Diagnosis, State University of Paraíba, Campina Grande, Brazil
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12
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Gregoris Rabelo LE, Bueno MDR, Costa MVCD, de Musis CR, Estrela CRDA, Guedes OA, Gavini G, Estrela C. Blooming artifact reduction using different cone-beam computed tomography software to analyze endodontically treated teeth with intracanal posts. Comput Biol Med 2021; 136:104679. [DOI: 10.1016/j.compbiomed.2021.104679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
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13
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Fontenele RC, Farias Gomes A, Rosado LPL, Neves FS, Freitas DQ. Mapping the expression of beam hardening artefacts produced by metal posts positioned in different regions of the dental arch. Clin Oral Investig 2020; 25:571-579. [PMID: 32772328 DOI: 10.1007/s00784-020-03494-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/03/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To objectively assess the expression and direction of artefacts in the vicinity of metal posts positioned in different mandibular regions. MATERIALS AND METHODS A human mandible had two sockets prepared-anterior and posterior regions-to accommodate a single-rooted tooth. Two CBCT units, Picasso Trio and OP300, were used. CBCT images of the tooth without metal post, and with silver-palladium, nickel-chromium, or cobalt-chromium posts (experimental groups) were individually acquired. Then, 8 lines of interest (LOIs) were determined around the root canal, in an axial reconstruction: 4 in orthogonal (buccal, lingual, mesial, and distal) directions, and 4 in oblique (mesiobuccal, distobuccal, mesiolingual, and distolingual) directions. The mean of gray values was measured for each LOI. RESULTS For the OP300, in general, all experimental groups showed greater expression of hyperdense streaks in orthogonal LOIs and greater expression of hypodense streaks in oblique LOIs. For the Picasso Trio, for both mandibular regions, the buccal LOI showed greater expression of hypodense streaks; conversely, greater expression of hyperdense streaks was observed in the distal and distobuccal LOIs in the anterior region and in the mesiolingual LOI in the posterior region. The silver-palladium group showed significantly greater expression of beam hardening artefacts in the posterior region of the mandible, regardless of the CBCT unit (p < 0.05). The mandibular posterior region showed significantly lower gray values than the anterior region (p < 0.05). CONCLUSION The expression and direction of artefacts produced in the vicinity of metal posts vary according to the mandibular region, composition of the post, and CBCT unit. CLINICAL RELEVANCE The mapping of artefacts produced by metal posts reveals the root regions with greater expression of hypodense and hyperdense artefacts, which may contribute to recognizing regions more likely to mimic or hide root fracture lines.
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Affiliation(s)
- Rocharles C Fontenele
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, SP, 13414-903, Brazil.
| | - Amanda Farias Gomes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, SP, 13414-903, Brazil
| | - Lucas P Lopes Rosado
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, SP, 13414-903, Brazil
| | - Frederico S Neves
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, SP, 13414-903, Brazil.,Department of Propedeutics and Integrated Clinic, Division of Oral Radiology, School of Dentistry, Federal University of Bahia, Salvador, BA, Brazil
| | - Deborah Q Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, SP, 13414-903, Brazil
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Influence of the Intracanal Material and Metal Artifact Reduction Tool in the Detection of the Second Mesiobuccal Canal in Cone-beam Computed Tomographic Examinations. J Endod 2020; 46:1067-1073. [DOI: 10.1016/j.joen.2020.04.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/23/2020] [Accepted: 04/11/2020] [Indexed: 11/22/2022]
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15
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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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Assessment of the Influence of Different Intracanal Materials on the Detection of Root Fracture in Birooted Teeth by Cone-beam Computed Tomography. J Endod 2019; 46:264-270. [PMID: 31812360 DOI: 10.1016/j.joen.2019.10.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 10/07/2019] [Accepted: 10/27/2019] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The aim of this study was to assess 2 cone-beam computed tomographic systems on the detection of artificially induced vertical root fractures (VRFs) and artifact intensity using birooted teeth restored with different intracanal materials. METHODS The sample consisted of 20 extracted birooted premolars. Root fracture was induced in half of the sample. Seven intracanal material combinations were used in each tooth, 1 at a time: unrestored, gutta-percha, a buccal root with gutta-percha and a lingual root with a fiberglass post, a buccal root with gutta-percha and a lingual root with a metal core fiberglass post, fiberglass posts, metal core fiberglass posts, and NiCr posts. Cone-beam computed tomographic scans were acquired using CS 9000 3D (Carestream Dental Rochester, NY) and OP300 (Instrumentarium Dental Inc, Tuusula, Finland) units. Exposure parameters were fixed at 90 kV and 8 mA. The voxel size and field of view were set at 0.085 mm and 5 × 5 cm for OP300 and 0.076 mm and 5 × 3.75 cm for CS 9000, respectively. Two observers assessed all images using a 5-point confidence scale for VRF detection and a 4-point score for artifact interference. The sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve were compared using 2-way analysis of variance and the Tukey test (α = 0.05). Artifact interference was evaluated by descriptive statistics and the chi-square test. RESULTS There were significant differences between scanners (P > .05) and among the different intracanal material groups (OP300) (P < .05) for specificity. When a metal post was present in both roots, severe artifact interference was observed in all images. CONCLUSIONS CS 9000 3D presented better performance than OP300 on VRF detection of endodontically treated teeth. Unrestored teeth and teeth filled with fiberglass posts were considered the groups with the lowest artifact interference and the highest VRF detection results.
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