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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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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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Cao D, Zhang P, Gao A, Gulibire A, Xie X, Liang J, Hu Z, Yin W, Lin Z. Development of a predictive model for identifying previously undetected vertical root fractures. AUST ENDOD J 2023; 49:302-310. [PMID: 35861533 DOI: 10.1111/aej.12667] [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: 01/03/2022] [Revised: 07/04/2022] [Accepted: 07/07/2022] [Indexed: 11/26/2022]
Abstract
This study aimed to develop a predictive model to screen for undetected vertical root fractures (VRFs) in root canal treated teeth. We included 95 root canal treated teeth with suspected VRFs; 77 for training and 18 for validation. Following clinical and cone-beam CT parameters were recorded: sex, tooth type, coronal restoration, time interval from completion of endodontic treatment to definitive diagnosis (TI), type of bone loss (BL), apical extent of root filling (AR) and the ratio of root filling diameter to the actual diameter in the coronal (1/3TA) and middle (2/3TA) root thirds. A predictive model p = 1/(1 - e-x ) was generated, where x = -7.433 + 1.977BL + 1.479 (2/3TA) + 1.102 AR; the sensitivity and specificity were 0.852 and 0.875 for training and 0.917 and 0.833 for validation. VRF teeth were more likely to have vertical bone loss and overfilled root canals. This model had a high diagnostic efficacy for VRFs.
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Affiliation(s)
- Dantong Cao
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Peng Zhang
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Antian Gao
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Aihemaiti Gulibire
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xin Xie
- Department of Stomatology, Third People's Hospital of Danyang City, Danyang, China
| | - Jiahao Liang
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Ziyang Hu
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Weiwei Yin
- Nantong Stomatological Hospital, Nantong, China
| | - Zitong Lin
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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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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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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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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Farias-Gomes A, Fontenele RC, Rosado LPL, Neves FS, Freitas DQ. The metal post material influences the performance of artefact reduction algorithms in CBCT images. Braz Dent J 2022; 33:31-40. [DOI: 10.1590/0103-6440202204222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/08/2021] [Indexed: 11/22/2022] Open
Abstract
Abstract This study aimed to assess the effect of the MAR tool on the expression of artefacts in different regions of a tooth restored with different types of metal posts. Alveolar sockets (anterior, and posterior region) of a mandible and an unirradicular tooth were used. Cone beam computed tomography scans of the tooth without a metal post, and with cobalt-chromium (Co-Cr), nickel-chromium (Ni-Cr), or silver-palladium (Ag-Pd) were individually obtained, with 2 MAR conditions: disabled, and enabled. In an axial reconstruction, lines of interest (LOIs) were set around the canal: 4 in oblique (mesiobuccal, distobuccal, mesiolingual, distolingual) directions, and 4 in orthogonal (mesial, distal, buccal, lingual) directions. Beam-hardening artefacts expression was determined by calculating the difference in the mean of gray values (DMGV) between the experimental and control groups for each LOI. There was no significant difference in the DMGV values between “without MAR” and “with MAR” for any LOI, in neither anterior nor posterior mandible (p>0.05), for the Ni-Cr and Co-Cr groups. For the Ag-Pd, significant differences in the DMGV values were observed between “without MAR” and “with MAR” for most LOIs (p<0.05), mainly in oblique directions in the anterior region, and mesio-distal direction in the posterior region. MAR acted mostly in hypodense artefacts (negative DMGV). The effectiveness of the MAR tool of the OP300 CBCT unit varied according to the post material tested. It was effective in reducing the expression of artefacts raised by the Ag-Pd post, mainly in the tooth regions affected by hypodense artefacts, regardless of the mandibular region.
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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: 6] [Impact Index Per Article: 2.0] [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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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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Gulibire A, Cao Y, Gao A, Wang C, Wang T, Xie X, Liang J, Li W, Lin Z. Assessment of true vertical root fracture line in endodontically treated teeth using a new subtraction software - A Micro-CT and CBCT study. AUST ENDOD J 2020; 47:290-297. [PMID: 33314451 DOI: 10.1111/aej.12476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 11/09/2020] [Accepted: 11/21/2020] [Indexed: 11/30/2022]
Abstract
This study aimed to find true facture lines in endodontically treated teeth on CBCT images using digital subtraction and to evaluate the influence of width of facture lines in the diagnosis. Thirty-two endodontically treated teeth with vertical root fractures (VRFs) from 30 patients were included in this study. The CBCT images of the patients and the micro-CT images of extracted teeth were imported into our digital subtraction software to distinguish the true facture lines from the streak artefacts. Of them, 23(71.87%) teeth did not present true fracture lines on the CBCT images (CBCT negative), and 9 (28.13%) teeth presented true fracture lines on the CBCT images (CBCT positive). The width of the facture lines was significantly different between these two groups (P < 0.05). To summarise, for in vivo endodontically treated teeth with subtle VRFs, many true fractures lines could not be demonstrated on CBCT images and wider fractures could be better distinguished.
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Affiliation(s)
- Aihemaiti Gulibire
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Ya Cao
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Antian Gao
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Congyue Wang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Tiemei Wang
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xin Xie
- Department of Stomatology, Third People's Hospital of Danyang City, Danyang, China
| | - Jiahao Liang
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Weifeng Li
- School of Electronic Science and Engineering, Nanjing University, Nanjing, China
| | - Zitong Lin
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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Biao Y, Kim DW, Hwang HS, Lee KM. Effect of artifact area on cone beam computed tomography scans when integrated with intraoral scans. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:468-474. [PMID: 32891574 DOI: 10.1016/j.oooo.2020.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 07/23/2020] [Accepted: 08/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to examine whether integration accuracy increases upon removing artifacts from the registration area when integrating maxillofacial cone beam computed tomography (CBCT) scans and intraoral scans. STUDY DESIGN Three methods were implemented according to the region of interest (ROI): R0, all teeth included as the registration area (artifacts included); R1, anterior teeth included as the registration area (artifacts in premolars and molars not included); and R2, anterior teeth and second molars included as the registration area (artifacts in premolars and first molars not included). Discrepancies between the 2 images were evaluated by using color-mapping methods. The average surface distance was calculated by measuring the shell/shell deviations for overall discrepancies and 3-dimensional distances between the surface points on the 2 images for registration discrepancies. RESULTS The R1 method showed more discrepancies between the CBCT and intraoral scans compared with the other 2 methods. The R2 method showed smaller overall discrepancy values compared with the R1 method. Most CBCT artifacts were located in the posterior area. Registration discrepancies were greatest in the x-dimension. CONCLUSIONS The results suggest that intraoral and CBCT scans might be integrated by using a registration method that involves exclusion of artifacts and inclusion of the second molar on both sides.
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Affiliation(s)
- Yan Biao
- Attending Physician, Department of Stomatology, Yanbian University Hospital, Yanji, Jilin, PR China
| | - Dong-Wook Kim
- Postgraduate Student, Department of Orthodontics, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - Hyeon-Shik Hwang
- Private Practice, Seoul, Korea; Professor Emeritus, Department of Orthodontics, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - Kyung-Min Lee
- Associate Professor, Department of Orthodontics, School of Dentistry, Chonnam National University, Gwangju, Korea.
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Influence of Metal Post in Adjacent Teeth in the Detection of Vertical Root Fracture Using Cone-beam Computed Tomography with Different Acquisition Parameters. J Endod 2020; 46:1655-1661. [PMID: 32835757 DOI: 10.1016/j.joen.2020.08.013] [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] [Received: 04/07/2020] [Revised: 07/12/2020] [Accepted: 08/10/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The aim of the present study was to evaluate the detection of vertical root fracture (VRF) in the presence of adjacent teeth restored with a metal post and the influence of acquisition parameters (tube current and metal artifact reduction [MAR] algorithm) on this diagnostic task. METHODS Cone-beam computed tomographic images of 10 single-rooted teeth were acquired before and after the simulation of VRF. The acquisitions were set up to simulate different conditions regarding the presence of adjacent teeth restored with a metal post (control, 1 adjacent tooth, and both adjacent teeth), different tube currents (4, 8, and 10 mA), and the use of MAR (without MAR and with MAR). Images were assessed by 5 oral and maxillofacial radiologists using a 5-point scale for the presence of VRF. Diagnostic values were calculated and compared by 2-way analysis of variance (significance level of 5%). RESULTS The area under the receiver operating characteristic curve (Az) values for VRF detection were affected by the presence of adjacent teeth and the variation of milliamperes. For 4 mA, when both restored teeth were present, Az values were significantly lower than the control group (P ≤ .05). In the presence of both restored teeth, 8 mA presented significantly higher Az values compared with 4 mA (P ≤ .05). CONCLUSIONS The presence of both adjacent teeth restored with a metal post impairs VRF detection; however, an increase in tube current up to 8 mA may aid in this diagnostic task. Moreover, the MAR tool does not seem to be efficient in those cases.
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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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Gaêta‐Araujo H, Nascimento EHL, Oliveira‐Santos N, Pinheiro MCR, Coelho‐Silva F, Oliveira‐Santos C. Influence of adjacent teeth restored with metal posts in the detection of simulated internal root resorption using CBCT. Int Endod J 2020; 53:1299-1306. [DOI: 10.1111/iej.13348] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/09/2020] [Indexed: 02/01/2023]
Affiliation(s)
- H. Gaêta‐Araujo
- Division of Oral Radiology Department of Oral Diagnosis Piracicaba Dental School University of Campinas (UNICAMP) PiracicabaBrazil
| | - E. H. L. Nascimento
- Division of Oral Radiology Department of Oral Diagnosis Piracicaba Dental School University of Campinas (UNICAMP) PiracicabaBrazil
| | - N. Oliveira‐Santos
- Division of Oral Radiology Department of Oral Diagnosis Piracicaba Dental School University of Campinas (UNICAMP) PiracicabaBrazil
| | - M. C. R. Pinheiro
- Division of Oral Radiology Department of Oral Diagnosis Piracicaba Dental School University of Campinas (UNICAMP) PiracicabaBrazil
| | - F. Coelho‐Silva
- Division of Oral Radiology Department of Oral Diagnosis Piracicaba Dental School University of Campinas (UNICAMP) PiracicabaBrazil
| | - C. Oliveira‐Santos
- Division of Oral Radiology Department of Stomatology, Public Oral Health, Forensic Dentistry School of Dentistry of Ribeirao Preto University of Sao Paulo (USP) Ribeirao Preto 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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Gaêta-Araujo H, Nascimento EHL, Fontenele RC, Mancini AXM, Freitas DQ, Oliveira-Santos C. Magnitude of beam-hardening artifacts produced by gutta-percha and metal posts on cone-beam computed tomography with varying tube current. Imaging Sci Dent 2020; 50:1-7. [PMID: 32206614 PMCID: PMC7078413 DOI: 10.5624/isd.2020.50.1.1] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/26/2019] [Accepted: 10/10/2019] [Indexed: 02/01/2023] Open
Abstract
Purpose This study was performed to evaluate the magnitude of artifacts produced by gutta-percha and metal posts on cone-beam computed tomography (CBCT) scans obtained with different tube currents and with or without metal artifact reduction (MAR). Materials and Methods A tooth was inserted in a dry human mandible socket, and CBCT scans were acquired after root canal instrumentation, root canal filling, and metal post placement with various tube currents with and without MAR activation. The artifact magnitude was assessed by the standard deviation (SD) of gray values and the contrast-to-noise ratio (CNR) at the various distances from the tooth. Data were compared using multi-way analysis of variance. Results At all distances, a current of 4 mA was associated with a higher SD and a lower CNR than 8 mA or 10 mA (P<0.05). For the metal posts without MAR, the artifact magnitude as assessed by SD was greatest at 1.5 cm or less (P<0.05). When MAR was applied, SD values for distances 1.5 cm or closer to the tooth were reduced (P<0.05). MAR usage did not influence the magnitude of artifacts in the control and gutta-percha groups (P>0.05). Conclusion Increasing the tube current from 4 mA to 8 mA may reduce the magnitude of artifacts from metal posts. The magnitude of artifacts arising from metal posts was significantly higher at distances of 1.5 cm or less than at greater distances. MAR usage improved image quality near the metal post, but had no significant influence farther than 1.5 cm from the tooth.
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Affiliation(s)
- Hugo Gaêta-Araujo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Rocharles Cavalcante Fontenele
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Arthur Xavier Maseti Mancini
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Christiano Oliveira-Santos
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Radiology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, 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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