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Alves LVGL, Pires CRF, Sousa-Neto MD, Prado HS, Mazzi-Chaves JF, Candemil AP. Metal artifact reduction tool and mA levels impact on the diagnosis of fracture extension in endodontically treated teeth using cone-beam CT. Clin Oral Investig 2024; 28:531. [PMID: 39298025 DOI: 10.1007/s00784-024-05945-3] [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: 04/15/2024] [Accepted: 09/14/2024] [Indexed: 09/21/2024]
Abstract
AIM To evaluate the influence of different levels of metal artifact reduction (MAR) tool and milliamperage (mA) on the diagnosis of fracture extension in endodontically treated teeth using cone beam CT (CBCT). MATERIALS AND METHODS Ten maxillary premolars were endodontically treated and positioned in the empty sockets of a human maxilla covered with wax. CBCT acquisitions were performed using the Eagle Edge device (Dabi Atlante, Brazil) adjusted to 120 kVp, FOV of 4 × 6 cm, exposure time of 24 s and voxel size of 0.2 mm in 8 different conditions with different MAR (1, 2 and 3) and mA (3.2 and 6.3) levels. Crown-root fractures were simulated in the universal testing machine, and CBCT images were acquired again. Five radiologists evaluated the presence and extension of fractures with a 5-point scale. Statistical analysis was performed by analysis of variance, Tukey and Kappa test (α = 0.05). RESULTS Although different mA levels did not significantly (p > 0.05) affect the diagnosis values for fracture presence and extension, when evaluated the different levels of MAR, AUC and sensitivity showed significantly higher values (p < 0.05) for MAR 0 using 6.3 mA and kappa agreement showed significantly higher values (p < 0.05) for MAR 0 and 2 using 6.3 mA. CONCLUSIONS Although mA levels do not have a diagnostic effect when isolating the MAR level; in 6.3 mA, MAR 0 and 2 can positively influence the diagnosis of fracture extension in endodontically treated teeth using CBCT. CLINICAL RELEVANCE The isolate evaluation of dental fracture presence can overlook diagnostics error of its extension.
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Affiliation(s)
- Luísa Valente Gotardo Lara Alves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Cassiano Ricardo Ferreira Pires
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Heitor Silva Prado
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil.
| | - Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
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Ruiz DC, de Oliveira Reis L, Fontenele RC, Miranda-Viana M, Farias-Gomes A, Freitas DQ. Combination of metal artifact reduction and sharpening filter application for horizontal root fracture diagnosis in teeth adjacent to a zirconia implant. Imaging Sci Dent 2024; 54:289-295. [PMID: 39371300 PMCID: PMC11450410 DOI: 10.5624/isd.20240056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/16/2024] [Accepted: 05/10/2024] [Indexed: 10/08/2024] Open
Abstract
Purpose This study examined the influence of metal artifact reduction (MAR), the application of sharpening filters, and their combination on the diagnosis of horizontal root fracture (HRF) in teeth adjacent to a zirconia implant on cone-beam computed tomography (CBCT) examinations. Materials and Methods Nineteen single-rooted teeth (9 with HRF and 10 without) were individually positioned in the right central incisor socket of a dry human maxilla. A zirconia implant was placed adjacent to each tooth. Imaging was performed using an OP300 Maxio CBCT (Instrumentarium, Tuusula, Finland) unit with the following settings: a current of 8 mA, both MAR modes (enabled and disabled), a 5×5 cm field of view, a voxel size of 0.085 mm, and a peak kilovoltage of 90 kVp. Four oral and maxillofacial radiologists independently evaluated the CBCT scans under both MAR conditions and across 3 levels of sharpening filter application (none, Sharpen 1×, and Sharpen 2×). Diagnostic metrics were calculated and compared using 2-way analysis of variance (α=5%). The weighted kappa test was used to assess intra- and inter-examiner reliability in the diagnosis of HRF. Results MAR tool activation, sharpening filter use, and their combination did not significantly impact the area under the receiver operating characteristic curve, sensitivity, or specificity of HRF diagnosis (P>0.05). Intra- and inter-examiner agreement ranged from fair to substantial. Conclusion The diagnosis of HRF in a tooth adjacent to a zirconia implant is not affected by the activation of MAR, the application of a sharpening filter, or the combination of these tools.
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Affiliation(s)
- Débora Costa Ruiz
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Larissa de Oliveira Reis
- Department of Dentistry, Federal University of Juiz de Fora Campus Governador Valadares, Governador Valadares, MG, Brazil
| | | | - Murilo Miranda-Viana
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Amanda Farias-Gomes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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Troca BS, Felizardo HMA, Gaêta-Araujo H. Expression of artefacts from different orthodontic brackets and wires in cone beam computed tomography scans-an in vitro study. Clin Oral Investig 2024; 28:450. [PMID: 39060664 DOI: 10.1007/s00784-024-05840-x] [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: 04/15/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVES To investigate artefacts produced by different orthodontic brackets and wires in cone-beam computed tomography (CBCT) scans. MATERIALS AND METHODS Two dental arches were made using extracted human teeth and plaster. Three pairs of acetate plates containing different brackets - metallic, ceramic, and self-ligating ceramic with NiTi clip - along with a control plate (i.e., without brackets) were prepared. Wire changes (NiTi and steel) were made during CBCT acquisitions, performed with a fixed exposure protocol. Axial slices were selected for mean gray values and standard deviation measurement in three regions of interest (buccal, lingual, and tooth). Noise and contrast-to-noise ratio (CNR) were calculated and compared among the different brackets and wires by ANOVA with a significance level of 5%. RESULTS Overall, the buccal and tooth region were mostly affected by the metallic and self-ligating brackets, showing higher noise, and lower CNR (p < 0.05). On the other hand, less impact of ceramic brackets in the image quality was observed (p ≥ 0.05). The lingual region did not show expressive differences among the brackets and wire combinations (p ≥ 0.05). The presence of wire associated with the brackets did not worsen image quality (p ≥ 0.05). CONCLUSIONS In conclusion, metallic and self-ligating brackets have greater artefact expression than ceramic brackets. The wire did not influence image quality. CLINICAL RELEVANCE One should pay attention to the type of brackets when requesting a CBCT scan during treatment, as metallic and self-ligating brackets may express greater artefacts than ceramic brackets.
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Affiliation(s)
- Bruna Silveira Troca
- School of Dentistry, Federal University of Alfenas (Unifal-MG), Alfenas, Minas Gerais, Brazil
| | | | - Hugo Gaêta-Araujo
- School of Dentistry, Federal University of Alfenas (Unifal-MG), Alfenas, Minas Gerais, Brazil.
- Department of Stomatology, Public Health, and Forensic Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Av. do Café, s/n, Campus da USP, Monte Alegre, Ribeirão Preto, São Paulo, 14040-904, Brazil.
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Gonzalez-Passos T, Barros-Costa M, Oliveira ML, Freitas DQ. Influence of tube current and metal artifact reduction on the diagnosis of external cervical resorption in teeth adjacent to a dental implant in CBCT: an ex-vivo study. Clin Oral Investig 2024; 28:356. [PMID: 38834721 DOI: 10.1007/s00784-024-05750-y] [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: 04/03/2024] [Accepted: 05/27/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVES This ex-vivo study aimed to assess the influence of tube current (mA) and metal artifact reduction (MAR) on the diagnosis of early external cervical resorption (EECR) in cone-beam computed tomography (CBCT) in the presence of an adjacent dental implant. MATERIALS AND METHODS Twenty-three single-rooted teeth were sectioned longitudinally and EECR was induced using a spherical drill and 5% nitric acid in 10 teeth. Each tooth was positioned in the socket of the lower right canine of a dry human mandible and CBCT scans were acquired using 90 kVp, voxel of 0.085 mm, field of view of 5 x 5 cm, and varying tube current (4, 8 or 12 mA), MAR (enabled or disabled) and implant conditions (with a zirconia implant in the socket of the lower right first premolar or without). Five oral radiologists evaluated the presence of EECR in a 5-point scale and the diagnostic values (area under the receiver operating characteristic curve - AUC, sensitivity, and specificity) were compared using multi-way Analysis of Variance (α = 0.05). Kappa test assessed intra-/inter-evaluator agreement. RESULTS The tube current only influenced the AUC values in the presence of the implant and when MAR disabled; in this case, 8 mA showed lower values (p<0.007). MAR did not influence the diagnostic values (p>0.05). In general, the presence of an implant reduced the AUC values (p<0.0001); sensitivity values with 8 mA and MAR disabled, and specificity values with 4 mA and MAR enabled and 8 mA regardless MAR were also decreased (p<0.0001). CONCLUSIONS Variations in tube current and MAR were unable to improve EECR detection, which was impaired by the presence of an adjacent implant. CLINICAL RELEVANCE Increasing tube current or activating MAR tool does not improve EECR diagnosis, which is hampered by the artifacts generated by dental implants.
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Affiliation(s)
- Thamiles Gonzalez-Passos
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil. Av. Limeira, 901, Zip Code13414903, Piracicaba, São Paulo, Brazil.
| | - Matheus Barros-Costa
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil. Av. Limeira, 901, Zip Code13414903, Piracicaba, São Paulo, Brazil
| | - Matheus L Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil. Av. Limeira, 901, Zip Code13414903, Piracicaba, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil. Av. Limeira, 901, Zip Code13414903, Piracicaba, São Paulo, Brazil
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Ruiz DC, Rosado LPL, Fontenele RC, Farias-Gomes A, Freitas DQ. Vertical root fracture diagnosis in teeth with metallic posts: Impact of metal artifact reduction and sharpening filters. Imaging Sci Dent 2024; 54:139-145. [PMID: 38948185 PMCID: PMC11211027 DOI: 10.5624/isd.20230233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 07/02/2024] Open
Abstract
Purpose This study examined the influence of a metal artifact reduction (MAR) tool, sharpening filters, and their combination on the diagnosis of vertical root fracture (VRF) in teeth with metallic posts using cone-beam computed tomography (CBCT). Materials and Methods Twenty single-rooted human premolars - 9 with VRF and 11 without - were individually placed in a human mandible. A metallic post composed of a cobalt-chromium alloy was inserted into the root canal of each tooth. CBCT scans were then acquired under the following parameters: 8 mA, a 5×5 cm field of view, a voxel size of 0.085 mm, 90 kVp, and with MAR either enabled or disabled. Five oral and maxillofacial radiologists independently evaluated the CBCT exams under each MAR mode and across 3 sharpening filter conditions: no filter, Sharpen 1×, and Sharpen 2×. The diagnostic performance was quantified by the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. These metrics were compared using 2-way analysis of variance with a significance level of α=5%. Intra- and inter-examiner agreement were assessed using the weighted kappa test. Results Neither MAR nor the application of sharpening filters significantly impacted AUC or specificity (P>0.05). However, sensitivity increased when MAR was combined with Sharpen 1× and Sharpen 2× (P=0.015). The intra-examiner agreement ranged from fair to substantial (0.34-0.66), while the inter-examiner agreement ranged from fair to moderate (0.27-0.41). Conclusion MAR in conjunction with sharpening filters improved VRF detection; therefore, their combined use is recommended in cases of suspected VRF.
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Affiliation(s)
- Débora Costa Ruiz
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | | | | | - Amanda Farias-Gomes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, 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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Coelho-Silva F, Cascante-Sequeira D, Réa MT, Oliveira ML, Freitas DQ, Haiter-Neto F, de-Azevedo-Vaz SL. High-density objects in exomass affect the volume of high-density objects inside the field of view. Dentomaxillofac Radiol 2024; 53:153-160. [PMID: 38224272 DOI: 10.1093/dmfr/twad014] [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: 09/05/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 01/16/2024] Open
Abstract
OBJECTIVES To evaluate the effect of the presence and the number of high-density objects in the exomass on the volume of a high-density object in cone-beam CT (CBCT). METHODS Cylinders of cobalt-chromium (Co-Cr), titanium (Ti), and zirconium (Zi) were inserted into a polymethylmethacrylate phantom in five different combinations of number and position: 1-no cylinder; 2-one cylinder in a posterior region; 3-one cylinder in an anterior region; 4-two cylinders in posterior regions; and 5-three cylinders in anterior and posterior regions. The phantom underwent CBCT scanning using OP300 and X800 systems, with the afore mentioned cylinders of the same composition placed in the exomass and an additional high-density cylinder placed in the centre of the field of view (FOV), corresponding to the left-anterior region. The tomographic volume of the cylinder inside the FOV was measured using semi-automatic segmentation. The volumetric alteration (VA) between the segmented and physical volumes, in percentage, was compared among the experimental groups using repeated measures ANOVA and Tukey post-hoc (α = 5%). RESULTS The factors material, combination, and their interaction affected the volume or both CBCT systems. In OP300, more cylinders in the exomass reduced the VA, mainly for Co-Cr. In X800, more cylinders in the exomass tended to increase the VA inside the FOV, except for Zi. CONCLUSIONS In general, the presence of high-density objects in the exomass influences the VA of the object inside the FOV, although this oscillates according to object composition, number and position in the exomass, and CBCT system.
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Affiliation(s)
- Fernanda Coelho-Silva
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba 13414-903, Brazil
| | - Deivi Cascante-Sequeira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba 13414-903, Brazil
| | - Marcela Tarosso Réa
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba 13414-903, Brazil
| | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba 13414-903, Brazil
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba 13414-903, Brazil
| | - Francisco Haiter-Neto
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba 13414-903, Brazil
| | - Sergio Lins de-Azevedo-Vaz
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba 13414-903, Brazil
- Department of Clinical Dentistry, Federal University of Espírito Santo, Espírito Santo 29075-910, Brazil
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Ruiz DC, Reis LDO, Fontenele RC, Miranda-Viana M, Farias-Gomes A, Freitas DQ. Influence of an adjacent zirconium implant, tube current, and metal artifact reduction algorithm on horizontal root fracture diagnosis in cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:190-198. [PMID: 37940483 DOI: 10.1016/j.oooo.2023.10.001] [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: 06/15/2023] [Revised: 09/21/2023] [Accepted: 10/01/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE We evaluated the influence of an adjacent zirconium implant, tube current (mA), and a metal artifact reduction algorithm (MARA) on horizontal root fracture (HRF) diagnosis in cone beam computed tomography (CBCT). STUDY DESIGN Nineteen teeth (9 with HRF, 10 without) were individually placed in a human maxilla. Scan volumes were acquired without and with a zirconium implant adjacent to the tooth at settings of 4, 8, and 10 mA, with MARA disabled and enabled, using a 5×5 cm field of view, 0.085-mm voxel size, and 90 kV. Four maxillofacial radiologists individually assessed the scans. Diagnostic metrics were compared by multiway analysis of variance (α=5%). Inter- and intraexaminer agreements for HRF diagnosis were evaluated with the weighted kappa test. RESULTS Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were significantly lower in the presence of the implant (P≤.005). AUC values were higher in scans obtained with 8 and 10 mA compared with 4 mA (P=0.010), but 10 mA without MARA was better with the implant present. MARA did not significantly influence outcomes (P≥0.240). Inter- and intraexaminer agreements ranged from moderate to almost perfect. CONCLUSIONS The presence of the zirconium implant impairs HRF detection. Settings of 8 or 10 mA improve HRF detection regardless MARA condition without the implant. With an adjacent implant, 10 mA without MARA is recommended to improve diagnostic performance.
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Affiliation(s)
- Débora Costa Ruiz
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
| | - Larissa de Oliveira Reis
- Department of Dentistry, Federal University of Juiz de Fora Campus Governador Valadares, Governador Valadares, MG, Brazil
| | - Rocharles Cavalcante Fontenele
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Murilo Miranda-Viana
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Amanda Farias-Gomes
- School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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Ramage A, Lopez Gutierrez B, Fischer K, Sekula M, Santaella GM, Scarfe W, Brasil DM, de Oliveira-Santos C. Filtered back projection vs. iterative reconstruction for CBCT: effects on image noise and processing time. Dentomaxillofac Radiol 2023; 52:20230109. [PMID: 37665027 DOI: 10.1259/dmfr.20230109] [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: 09/05/2023] Open
Abstract
OBJECTIVES To assess the effect of standard filtered back projection (FBP) and iterative reconstruction (IR) methods on CBCT image noise and processing time (PT), acquired with various acquisition parameters with and without metal artefact reduction (MAR). METHODS CBCT scans using the Midmark EIOS unit of a human mandible embedded in soft tissue equivalent material with and without the presence of an implant at mandibular first molar region were acquired at various acquisition settings (milliamperages [4mA-14mA], FOV [5 × 5, 6 × 8, 9 × 10 cm], and resolutions [low, standard, high] and reconstructed using standard FBP and IR, and with and without MAR. The processing time was recorded for each reconstruction. ImageJ was used to analyze specific axial images. Radial transaxial fiducial lines were created relative to the implant site. Standard deviations of the gray density values (image noise) were calculated at fixed distances on the fiducial lines on the buccal and lingual aspects at specific axial levels, and mean values for FBP and IR were compared using paired t-tests. Significance was defined as p < 0.05. RESULTS The overall mean for image noise (± SD) for FBP was 198.65 ± 55.58 and 99.84 ± 16.28 for IR. IR significantly decreased image noise compared to FBP at all acquisition parameters (p < 0.05). Noise reduction among different scanning protocols ranged between 29.7% (5 × 5 cm FOV) and 58.1% (5mA). IR increased processing time by an average of 35.1 s. CONCLUSIONS IR significantly reduces CBCT image noise compared to standard FBP without substantially increasing processing time.
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Affiliation(s)
- Amanda Ramage
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | | | - Kathleen Fischer
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Michael Sekula
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | | | - William Scarfe
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
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Cascante-Sequeira D, Fontenele RC, Martins LAC, Brasil DM, Oliveira ML, Freitas DQ, Haiter-Neto F. Does the shape of the field-of-view influence the magnitude of artefacts from high-density materials in cone-beam computed tomography? Dentomaxillofac Radiol 2023; 52:20230147. [PMID: 37493606 PMCID: PMC10552126 DOI: 10.1259/dmfr.20230147] [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: 03/29/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 07/27/2023] Open
Abstract
OBJECTIVE To compare cylindrical and convex triangular field-of-views (FOVs) concerning the magnitude of artefacts from high-density materials in cone-beam CT (CBCT). METHODS AND MATERIALS Cylinders of amalgam, chromium-cobalt, titanium, and zirconia were individually placed in the anterior and posterior regions of a polymethylmethacrylate phantom and scanned using cylindrical and convex triangular FOVs of the Veraview X800 CBCT device. Using the Image J software, 15 square regions of interest (ROIs) were placed in the axial reconstruction around the middle level of the cylinder and at distances of 0.5, 1.0, and 1.5 cm from the centre of the cylinder. Mean grey value and standard deviation of each ROI were averaged for each distance and subtracted from the values of a control ROI to calculate the magnitude of the artefacts by the grey value mean difference (GVMD) and grey value standard deviation (GVSD). Multiway analysis of variance with Tukey post-hoc test with a significance level of 5% evaluated the effect of the shape of the FOV, position inside the FOV, high-density material, and the distance of the artefact from the material. RESULTS The convex triangular FOV increased the GVSD for all materials in the anterior and posterior regions at 0.5 cm compared to the cylindrical FOV (p < 0.0001). The convex triangular FOV showed greater GVMD for chromium-cobalt and zirconium in the anterior region and all materials in the posterior region at all distances (p < 0.0001). CONCLUSION The FOV shape influences the magnitude of artefacts from high-density materials. The convex triangular FOV showed greater artefact magnitude with variability among the high-density materials, region in the FOV, and distance from the material.
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Affiliation(s)
- Deivi Cascante-Sequeira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Luciano Augusto Cano Martins
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Danieli Moura Brasil
- Department of Oral Diagnosis & Oral Health, University of Louisville School of Dentistry, Louisville, United States of America
| | - Matheus L Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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11
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Fontenele RC, Picoli FF, Pinto JC, Coudyzer W, de Faria Vasconcelos K, Farias Gomes A, Binst J, Jacobs R. Feasibility of photon-counting computed tomography as a novel imaging modality for challenging endodontic diagnostic tasks. Sci Rep 2023; 13:6266. [PMID: 37069172 PMCID: PMC10110619 DOI: 10.1038/s41598-023-33322-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 04/11/2023] [Indexed: 04/19/2023] Open
Abstract
Photon-counting computed tomography (PCCT) is an innovative technological advancement in relation to x-ray detectors which offers ultra-high-resolution images. The current study aimed to evaluate the visualization ability of PCCT compared to cone-beam computed tomographic (CBCT) devices for challenging endodontic diagnostic tasks. A reference image of an anthropomorphic phantom was acquired using an industrial micro-CT device. Thereafter, the phantom was scanned with three imaging devices, which included PCCT scanner (NAEOTOM Alpha) and two CBCT devices (3D Accuitomo 170 and NewTom VGi evo) having standard and high-resolution acquisition protocols. The diagnostic tasks involved visualizing fine endodontic structures (apical delta, narrow canal, and isthmus) and root cracks. Three experienced examiners assessed the images and were blinded to the PCCT and CBCT devices. Each image was rated according to a three-grade scale (appropriate, acceptable, or inappropriate) for the diagnostic tasks. In relation to fine endodontic structures grouped together, PCCT showed similar diagnostic performance compared to the reference image (p > 0.05). As for the CBCT devices, an excellent performance was only observed with the 3D Accuitomo 170 device at a high-resolution acquisition mode (p > 0.05). The visualization of root cracks was also better with 3D Accuitomo 170 compared to other devices (p < 0.05). Overall, PCCT and 3D Accuitomo 170 at a high-resolution setting showed similar performance for visualizing fine endodontic structures. In addition, the high-resolution CBCT protocol was superior for visualizing root cracks compared to both PCCT and other standard- and high-resolution CBCT protocols.
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Affiliation(s)
- Rocharles Cavalcante Fontenele
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Fernando Fortes Picoli
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Department of Dentistry, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Jader Camilo Pinto
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | | | - Karla de Faria Vasconcelos
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Amanda Farias Gomes
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Joke Binst
- Department of Radiology, UZ Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
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12
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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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13
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Doriguêtto PVT, de Almeida D, de Lima CO, Lopes RT, Devito KL. Assessment of marginal gaps and image quality of crowns made of two different restorative materials: An in vitro study using CBCT images. J Dent Res Dent Clin Dent Prospects 2022; 16:243-250. [PMID: 37560496 PMCID: PMC10407872 DOI: 10.34172/joddd.2022.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/18/2022] [Indexed: 08/11/2023] Open
Abstract
Background The present study assessed the quality of images and the presence of marginal gaps on cone-beam computed tomography (CBCT) images of teeth restored with all-ceramic and metal-ceramic crowns and compared the gap sizes observed on CBCT images with those obtained on micro-CT images. Methods Thirty teeth restored with metal-ceramic and all-ceramic crowns, properly adapted and with gaps of 0.30 and 0.50 mm, were submitted to micro-CT and CBCT scans. Linear measurements corresponding to the marginal gap (MG) and the absolute marginal discrepancy (AMD) were obtained. The objective assessment of the quality of CBCT images was performed using the contrast-to-noise ratio (CNR), and the subjective assessment was defined by the diagnoses made by five examiners regarding the presence or absence of gaps. Results The measurements were always higher for CBCT, with a significant difference regarding AMD. No significant difference in image quality was observed using CNR between the crowns tested. Low accuracy and sensitivity values could be observed for both crowns. Conclusion Marginal mismatch measures were overestimated in CBCT images. No difference in image quality was observed between the crowns. The correct diagnosis of gaps was considered low, irrespective of crown type and gap size.
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Affiliation(s)
| | - Daniela de Almeida
- School of Dentistry, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | | | - Ricardo Tadeu Lopes
- Nuclear Engineering Department, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Karina Lopes Devito
- Department of Dental Clinic, School of Dentistry, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
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14
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Nomier AS, Gaweesh YSED, Taalab MR, El Sadat SA. Efficacy of low-dose cone beam computed tomography and metal artifact reduction tool for assessment of peri-implant bone defects: an in vitro study. BMC Oral Health 2022; 22:615. [PMID: 36528573 PMCID: PMC9759909 DOI: 10.1186/s12903-022-02663-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Early accurate radiographic assessment of peri-implant bone condition is highly important to avoid excessive loss of supporting bone and implant failure. Cone beam computed tomography (CBCT) is the radiographic technique of choice if peri-implant dehiscence and fenestration defects are suspected. The higher radiation dose and the presence of beam hardening artifacts are the main drawbacks of CBCT imaging techniques. This study aims to evaluate the influence of low-dose cone beam computed tomography (LD-CBCT) and metal artifact reduction (MAR) tool on the assessment of peri-implant dehiscence and fenestration. METHODOLOGY Thirty titanium implants were inserted into bovine rib blocks. Twenty had standardized bone defects (10 with dehiscence and 10 with fenestration), while the remaining 10 were used as control group with no defects. Radiographic examinations held with high-definition CBCT (HD-CBCT) and LD-CBCT with and without application of MAR tool. Images were assessed by four examiners for the presence or absence of peri-implant defects. The area under the area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, and accuracy were calculated for all radiographic protocols. RESULTS In the absence of MAR tool, there was no difference in AUC and diagnostic values between LD-CBCT and HD-CBCT for detection of both defects. When the MAR tool was applied, the AUC values, sensitivity, and accuracy were higher in HD-CBCT than in LD-CBCT for the detection of both defects, especially for the dehiscence, while specificity remained the same. CONCLUSION LD-CBCT can be used in the evaluation of peri-implant dehiscence and fenestration without any decrease in diagnostic accuracy. The application of MAR tool decrease the diagnostic ability of both defects, especially for the detection of dehiscence defects.
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Affiliation(s)
- Alaa Shafiek Nomier
- grid.7155.60000 0001 2260 6941Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521 Egypt
| | - Yousria Salah El-Din Gaweesh
- grid.7155.60000 0001 2260 6941Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521 Egypt
| | - Maha R. Taalab
- grid.7155.60000 0001 2260 6941Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521 Egypt
| | - Shaimaa Abu El Sadat
- grid.7269.a0000 0004 0621 1570Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
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15
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Tarce M, de Greef A, Lahoud P, de Faria Vasconcelos K, Jacobs R, Quirynen M. The impact of implant-related characteristics on dental implant blooming: An in vitro study. Clin Oral Implants Res 2022; 33:1199-1211. [PMID: 36189488 DOI: 10.1111/clr.14002] [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: 03/31/2022] [Revised: 08/22/2022] [Accepted: 09/20/2022] [Indexed: 12/13/2022]
Abstract
AIM To assess, in vitro, variables potentially influencing implant blooming using a human-like imaging phantom and 3D-printed mandibles. MATERIAL AND METHODS Sixty implants were inserted in 3D-printed mandibles in 26 different configurations in order to examine the impact of implant diameter, presence of a cover screw, implant design/material, implant position, and the presence of additional implants on implant blooming using two cone-beam computed tomography (CBCT) devices (Accuitomo [ACC] and NewTom [NWT]). Two observers measured the amount of implant blooming in both buccolingual and mesiodistal directions. Inter-rater agreement and descriptive statistics, grouped by implant characteristic and CBCT device, were calculated. RESULTS Both CBCT devices increased implant diameter (a mean increase of 9.2% and 11.8% for titanium, 20.3% and 24.4% for zirconium, for ACC and NWT, respectively). An increase in implant diameter did not increase the amount of blooming, whereas placing a cover screw did (from 8.0% to 10.9% for ACC, and from 10.0% to 15.6% for NWT). Moreover, implant design, anatomical region, and the presence of another implant also affected the extent of the blooming. CONCLUSIONS Dental implants show a clear diameter increase on CBCT, with the effect being more pronounced for zirconium than for titanium implants. Similar effects are likely to occur in the clinical setting, potentially masking nonosseointegration, reducing the dimensions of peri-implant defects, and/or causing underestimation of the buccal bone thickness.
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Affiliation(s)
- Mihai Tarce
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Alexander de Greef
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Pierre Lahoud
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium.,OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Karla de Faria Vasconcelos
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Marc Quirynen
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
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16
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Effect of the Field of View Size on CBCT Artifacts Caused by the Presence of Metal Objects in the Exomass. Int J Dent 2022; 2022:2071108. [PMID: 36117513 PMCID: PMC9481401 DOI: 10.1155/2022/2071108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/08/2022] [Accepted: 08/26/2022] [Indexed: 11/29/2022] Open
Abstract
Materials and Methods In this in vitro experimental study, titanium implants, teeth with cobalt-chromium (Co-Cr) intracanal posts, and teeth with mesio-occluso-distal (MOD) amalgam restorations were placed in an empty socket of the extracted third molar of a human mandible. These metallic materials were differently arranged in the exomass (zone outside of the FOV). A polypropylene tube containing dipotassium phosphate was placed in the empty socket of the right canine tooth in a dry human mandible. CBCT scans were taken with a NewTom VGI (Verona, Italy) scanner using a 6 × 6 cm and an 8 × 8 cm FOV. The histogram tool of OnDemand software (Cybermed, Seoul, Korea) was used to select circles with a 1.5 mm diameter as the (ROI) at the center of the homogenous solution of dipotassium phosphate tube on the axial plane. The mean gray value (GV) and its standard deviation (SD) in the region of interest (ROI) were calculated (P > 0.05). The data were analyzed by SPSS 26. Results The reduction in the size of the FOV significantly decreased the mean GV (P < 0.001). Metal objects in the exomass significantly decreased the mean GV (P < 0.001), and minimum mean GV and maximum SD were recorded for amalgam, followed by Co-Cr intracanal posts, and titanium implants. The unilateral presence of a metal object was associated with a higher mean GV and lower SD (P < 0.001). Conclusion Using a smaller FOV increases the size of the exomass, which may negatively affect the image quality. Metal objects in the exomass decrease the GV of CBCT scans and adversely affect the image quality.
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17
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Moshfeghi M, Safi Y, Różyło-Kalinowska I, Gandomi S. Does the size of an object containing dental implant affect the expression of artifacts in cone beam computed tomography imaging? Head Face Med 2022; 18:20. [PMID: 35765076 PMCID: PMC9241278 DOI: 10.1186/s13005-022-00326-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background Artifacts fault image quality but handling several factors can affect it. This study was conducted to investigate the effect of object size on artifacts in cone-beam computed tomography systems. Methods Five phantoms, each containing a titanium implant in a sheep bone block, were fabricated of various sizes ranging from XS to XL: The M phantom was the same size as the device’s field of view (FOV). The L and XL phantoms were 20 and 40% larger than the FOV while the S and XS phantoms were 20 and 40% smaller than FOV, respectively. Ballistic gelatin was used to fill the phantoms. Phantoms were scanned by NewTom VGI and HDXWill Q-FACE. The mean and standard deviation (SD) of gray values in each 120 ROI was obtained by OnDemand software. The contrast to noise ratio (CNR) was also calculated. Results The gray value in S and M phantoms were more homogenous. The lowest SD value (10.20) was found in S phantom. The highest value for SD (125.16) was observed in XL phantom. The lowest (4.47) and highest (9.92) CNR were obtained in XL and S phantoms, respectively. HDXWill Q-FACE recorded a higher SD and a lower CNR than NewTom VGI (P < 0.05). Conclusion Object dimensions of the FOV size or up to 20% smaller provided better image quality. Since the dimensions of soft tissue in most patients are larger than the selective FOV, it is recommended that in CBCT artifacts studies, an object with dimensions closer to the patient’s dimensions be used to better relate the results with the clinical condition, because the sample dimensions affect the amount of artifacts.
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Affiliation(s)
- Mahkameh Moshfeghi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ingrid Różyło-Kalinowska
- Department of Dental and Maxillofacial Radiodiagnostics, Medical University of Lublin, Lublin, Poland
| | - Shiva Gandomi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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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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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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Vadiati Saberi B, Khosravifard N, Nooshmand K, Dalili Kajan Z, Ghaffari ME. Fractal analysis of the trabecular bone pattern in the presence/absence of metal artifact-producing objects: Comparison of cone-beam computed tomography with panoramic and periapical radiography. Dentomaxillofac Radiol 2021; 50:20200559. [PMID: 33705225 DOI: 10.1259/dmfr.20200559] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The effect of metallic objects on the fractal dimension (FD), bone area fraction (BAF) and gray scale values (GSVs) of cone-beam CT (CBCT) images was assessed. Also, FD, BAF and GSV were compared among CBCT, digital periapical and panoramic radiographies. METHODS Digital periapical and panoramic radiographs were acquired from six blocks of bovine rib. Additionally, different arrangements of titanium implants and intracanal metallic posts were created in the bone blocks and CBCT scans were taken from the different implant-root arrangements. The three radiographical modalities were compared by analysis of variance. Pairwise comparisons between the modalities were performed by the Tukey test (significance level set at 0.05). RESULTS Different root-implant arrangements in the CBCT images revealed no significant differences in the FD (p = 0.920), BAF and GSV values (p = 0.623). FD differed significantly among the three modalities (p < 0.001). Significant differences were found between CBCT and each of the periapical and panoramic techniques (p < 0.001), while no remarkable differences were observed in the FD of the periapical and panoramic images (p = 0.294). BAF and GSV showed significantly different results among the three radiographical techniques (p < 0.001). The difference was remarkable between CBCT and periapical (p < 0.001), CBCT and panoramic (p < 0.001) and periapical and panoramic (p = 0.008). CONCLUSION Presence of titanium implants and intracanal posts does not produce different results in the fractal analysis (FA) of the CBCT images. The trabecular bone pattern is best assessed by FA of the periapical radiographs followed by the panoramic and CBCT techniques, respectively.
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Affiliation(s)
- Bardia Vadiati Saberi
- Department of Periodontics, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Negar Khosravifard
- Department of Maxillofacial Radiology, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Kowsar Nooshmand
- Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Dalili Kajan
- Department of Maxillofacial Radiology, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Ebrahim Ghaffari
- Department of Biostatistics, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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Barros de Oliveira ML, Junqueira RB, Kamburoğlu K, Eratam N, Çakmak EE, Sönmez G, Küçük Ö, Verner FS. Assessment of the Metal Artifact Reduction Tool for the Detection of Root Isthmus in Mandibular Molars with Intraradicular Posts in Cone-beam Computed Tomographic Scans. J Endod 2021; 47:1583-1591. [PMID: 34265325 DOI: 10.1016/j.joen.2021.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/21/2021] [Accepted: 07/03/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION This study evaluated the performance of the metal artifact reduction (MAR) tool in cone-beam computed tomographic scans using different fields of view (FOVs) in the detection of a root isthmus in mandibular molars with intraradicular posts. METHODS Twenty-eight teeth were scanned by micro-computed tomographic imaging (gold standard images). Thereafter, specimens were allocated into the following groups: gutta-percha (teeth without posts, n = 10), a prefabricated metal post (n = 9), and a fiberglass post (n = 9). Cone-beam computed tomographic scans were taken using 8 acquisition protocols, varying the size of the FOV (10 × 5.5 cm and 5 × 5.5 cm) and the MAR tool (disabled, low, normal, and high modes). A root isthmus was evaluated considering a 5-point scale. Data were analyzed considering a 5% significance level. RESULTS Intra- and interexaminer agreement varied from moderate to substantial. The frequency of correct diagnosis varied significantly in all groups regardless of the image acquisition protocol selected (P < .05). In the gutta-percha group, there was no difference in the accuracy, sensitivity, and specificity values between the tested protocols. In the metal and fiberglass post groups, the accuracy values were higher with the "disabled" and "low" modes of the MAR tool regardless of the FOV size. This was also observed for the sensitivity values in the metal post group (P < .05). CONCLUSIONS The size of the FOV did not affect the performance of the MAR tool in the diagnosis of a root isthmus in molars with intraradicular posts. Our findings suggest that the use of the tool in the "normal" and "high" modes is contraindicated for this purpose.
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Affiliation(s)
- Manuela Lima Barros de Oliveira
- Applied Health Sciences Post-Graduate Program, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Rafael Binato Junqueira
- Applied Health Sciences Post-Graduate Program, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil; Department of Dentistry, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.
| | - Nejlan Eratam
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Esra Ece Çakmak
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Gül Sönmez
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Özlem Küçük
- Department of Nuclear Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Francielle Silvestre Verner
- Applied Health Sciences Post-Graduate Program, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil; Department of Dentistry, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
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22
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Coelho-Silva F, Gaêta-Araujo H, Rosado LPL, Freitas DQ, Haiter-Neto F, de-Azevedo-Vaz SL. Distortion or magnification? An in vitro cone-beam CT study of dimensional changes of objects with different compositions. Dentomaxillofac Radiol 2021; 50:20210063. [PMID: 34111368 DOI: 10.1259/dmfr.20210063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To assess whether dimensional changes occur as shape distortion (unevenly), contraction or magnification (evenly) in cone beam computed tomography (CBCT) considering materials, anatomical regions and metal artefact reduction algorithms. METHODS Four cylinders of amalgam (Am), cobalt-chromium (Co-Cr), gutta-percha (Gu), titanium (Ti) and zirconium (Zi) were inserted inside a polymethylmethacrylate phantom in anterior and posterior regions for acquisitions in Picasso Trio and OP300 with MAR enabled and disabled. Two observers measured the dimensions of each cylinder in three axes: Y (height), Z (antero posterior diameter) and X (latero-lateral diameter). Repeated measures ANOVA with Tukey post-hoc test compared the data (α = 5%). RESULTS Shape distortion occurred for all materials in anterior region of Picasso Trio without MAR (p < 0.05). With MAR enabled, Gu and Ti contracted (p ≥ 0.05), while the others showed distortion (p < 0.05). In posterior region, all materials distorted in both MAR conditions (p < 0.05), except Gu, which magnified without MAR (p ≥ 0.05) and contracted unevenly with MAR (p < 0.05). In anterior region of OP300, all materials magnified without MAR, (p ≥ 0.05) and had shape distortion with MAR (p < 0.05). In posterior region, only Am showed magnification without MAR (p ≥ 0.05), while all materials presented shape distortion with MAR (p < 0.05). CONCLUSION Dimensional changes of high-density materials in CBCT can be either a magnification, a contraction or a distortion; the last condition is the most prevalent. Furthermore, changes differ considering material, anatomical region and MAR condition.
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Affiliation(s)
- Fernanda Coelho-Silva
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Hugo Gaêta-Araujo
- Oral Radiology Section, School of Dentistry, Federal University of Alfenas, Minas Gerais, Brazil
| | - Lucas P Lopes Rosado
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Sergio Lins de-Azevedo-Vaz
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.,Department of Clinical Dentistry, Federal University of Espírito Santo, Espírito Santo, Brazil
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23
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Khosravifard A, Saberi BV, Khosravifard N, Motallebi S, Kajan ZD, Ghaffari ME. Application of an auto-edge counting method for quantification of metal artifacts in CBCT images: a multivariate analysis of object position, field of view size, tube voltage, and metal artifact reduction algorithm. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:735-743. [PMID: 33975812 DOI: 10.1016/j.oooo.2021.03.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 03/03/2021] [Accepted: 03/23/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The objective was to assess the effects of object position, field of view (FOV) size, peak kilovoltage (kVp), and a metal artifact reduction (MAR) algorithm on metal artifacts in cone beam computed tomography (CBCT) as measured with an auto-edge counting method. STUDY DESIGN A titanium implant and a stainless steel intracanal post in a root were inserted in bovine rib blocks. CBCT scans were acquired with changes in object position (incisor, canine, and premolar-molar areas), FOV, kVp, and MAR (on or off) mode. Images were quantitatively analyzed in MATLAB by using the Canny edge detection algorithm. Four-way analysis of variance and Tukey tests were applied for data analysis. RESULTS The implant produced no significant differences in number of artifacts among the object positions through changing the kVp and MAR mode for all FOV sizes (P > .05). The intracanal post scanned with the medium-sized FOV, high kVp, and MAR off mode generated significant differences among object positions (P = .033). Among the variables assessed, FOV size and MAR mode had a significant influence on the number of artifacts (P ≤ .039). CONCLUSION Reduction of FOV size and application of the MAR tool significantly decreased the number of streak artifacts. The Canny edge detection algorithm could be an efficient method of metal artifact quantification.
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Affiliation(s)
- Amir Khosravifard
- Department of Mechanical Engineering, Shiraz University, Shiraz, Iran
| | - Bardia Vadiati Saberi
- Dental Sciences Research Center, Department of Periodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Negar Khosravifard
- Dental Sciences Research Center, Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran.
| | - Samaneh Motallebi
- Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Dalili Kajan
- Dental Sciences Research Center, Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Ebrahim Ghaffari
- Dental Sciences Research Center, Department of Biostatistics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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24
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Do the number of basis images and metal artifact reduction affect the production of artifacts near and far from zirconium dental implants in CBCT? Clin Oral Investig 2021; 25:5281-5291. [PMID: 33625608 DOI: 10.1007/s00784-021-03836-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study aimed to evaluate the influence of the number of basis images and the metal artifact reduction (MAR) tool on the production of artifacts near and far from a zirconium implant in cone-beam computed tomography (CBCT). MATERIALS AND METHODS CBCT scans of a mandible were acquired before and after insertion of an implant, using 450 and 720 basis images, with and without MAR activation. The mean and standard deviation (SD) of the gray values of the regions of interest (ROIs) located on the cortices adjacent to the implant and at different distances from it (in the soft tissue) were calculated. The mean of the gray values was used to calculate the absolute contrast difference (ACD) between the control and implant scans. RESULTS In general, the number of basis images did not affect the SD and the ACD values of the buccal and lingual ROIs (p > 0.05). The implant increased the SD in the lingual cortical plate (p < 0.05). In this case, MAR activation decreased SD (p < 0.05). All ROIs located at different distances from the implant showed higher SD on scans acquired with 450 basis images (p < 0.05), regardless of MAR condition. CONCLUSIONS A higher number of basis images reduces the magnitude of artifacts but does not influence the image quality in bone cortical plates. MAR improves the image in the areas most affected by artifacts. CLINICAL RELEVANCE The number of basis images is known as a factor capable of influencing the image quality and radiation dose for the patient. Therefore, it is important to investigate its effect on the expression of artifacts in the CBCT images.
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25
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Mancini AXM, Santos MUC, Gaêta-Araujo H, Tirapelli C, Pauwels R, Oliveira-Santos C. Artefacts at different distances from titanium and zirconia implants in cone-beam computed tomography: effect of tube current and metal artefact reduction. Clin Oral Investig 2021; 25:5087-5094. [PMID: 33544197 DOI: 10.1007/s00784-021-03821-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/29/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the effect of cone-beam computed tomography (CBCT) tube current (mA) on the magnitude of artefacts at different distances from titanium or zirconia implants, with and without activation of a proprietary metal artefact reduction (MAR). MATERIAL AND METHODS Human mandibles were scanned on an OP300 Maxio CBCT unit (Instrumentarium, Tuusula, Finland) before and after the installation of dental implants, with four different tube currents (4 mA, 6.3 mA, 8 mA and 10 mA), with and without activation of proprietary MAR. The effect of mA on the standard deviation (SD) of gray values and contrast to noise ratio (CNR) were assessed in regions of interest located 1.5 cm, 2.5 cm, and 3.5 cm from implants. RESULTS In the presence of titanium implants, a significant decrease in SD was found by increasing tube current from 4 mA to 6.3 mA or 8 mA. For zirconia implants, 8 mA yielded better results for all distances. MAR improved CNR in the presence of zirconia implants at all distances, whereas no differences were observed with the use of MAR for titanium implants. CONCLUSION Increased tube current can improve overall image quality in the presence of implants, at all the distances tested. When a zirconia implant is present, such increase in mA should be higher in comparison to that for examinations with titanium implants. Activation of OP300 Maxio proprietary MAR improved image quality only among examinations with zirconia implants. CLINICAL RELEVANCE Artefact-generating implants are common in the field of view of CBCT examinations. Optimal exposure parameters, such as tube current, ensure high image quality with lowest possible radiation exposure.
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Affiliation(s)
- Arthur Xavier Maseti Mancini
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Av. Do Café, s/n, Ribeirao Preto, Sao Paulo, 14040-904, Brazil.
| | - Matheus Urias Cruz Santos
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Radiology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Av. Do Café, s/n, Ribeirao Preto, Sao Paulo, 14040-904, Brazil
| | - Hugo Gaêta-Araujo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Camila Tirapelli
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Av. Do Café, s/n, Ribeirao Preto, Sao Paulo, 14040-904, Brazil
| | - Ruben Pauwels
- Medical Physics & Quality Assessment, Department of Imaging & Pathology, Catholic University of Leuven, Leuven, Belgium and Aarhus Institute of Advanced Studies, Aarhus University, Høegh-Guldbergs Gade 6B, 8000, Aarhus, Denmark
| | - 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, Av. Do Café, s/n, Ribeirao Preto, Sao Paulo, 14040-904, Brazil
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26
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Nascimento EHL, Fontenele RC, Lopes PDA, Santaella GM, Vasconcelos KF, de Freitas DQ, Oenning AC, Groppo FC. Development of a model of soft tissue simulation using ballistic gelatin for CBCT acquisitions related to dentomaxillofacial radiology research. Dentomaxillofac Radiol 2020; 50:20200191. [PMID: 32941781 DOI: 10.1259/dmfr.20200191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To present the ballistic gelatin as a new material capable of simulating the soft tissues in cone-beam CT (CBCT) images. METHODS CBCT images of three piglet heads were acquired with their soft tissues intact (standard group). Subsequently, the piglet heads were fixed in a container using metallic pins and moulded with acrylic resin; the soft tissues were then removed and replaced by ballistic gelatin, with the same thickness of the original soft tissues. The images were evaluated by two oral radiologists, to check the adaptation on bone surfaces, thickness and density, penetration into large bone cavities and cancellous bone, and the presence of air bubbles using a 5-score scale. Additionally, an objective analysis was carried out by one oral radiologist. For each CBCT scan, three axial reconstructions were selected to represent the mandibular, occlusal, and maxillary levels. The mean and standard deviation (SD) of the grey values were calculated in four regions of interest determined on soft tissue areas and compared by two-way ANOVA. RESULTS The ballistic gelatin showed subjective scores ranging from good to excellent for all parameters evaluated. There was no significant difference in the mean and SD values of the grey values between ballistic gelatin and the gold standard groups for all levels (p > 0.05). Higher SD values were observed in the occlusal level for both groups (p < 0.05). CONCLUSIONS Ballistic gelatin has visual and objective similarity with the gold standard. Thus, the ballistic gelatin is a promising material capable of simulating soft tissues in CBCT images.
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Affiliation(s)
- Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil.,Department of Clinical and Preventive Dentistry, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | | | - Priscila de Azeredo Lopes
- Odontoclínica Central da Marinha, Serviço de radiologia e Imaginologia Odontológica, Brazilian Navy, Rio de Janeiro, RJ, Brazil
| | - Gustavo Machado Santaella
- Radiology and Imaging Sciences, Department of Diagnosis and Oral Health, University of Louisville, Lousville, KY, USA
| | - Karla Faria Vasconcelos
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Deborah Queiroz de Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Anne Caroline Oenning
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, Sao Paulo, Brazil
| | - Francisco Carlos Groppo
- Department of Physiological Sciences, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
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27
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Moratin J, Berger M, Rückschloss T, Metzger K, Berger H, Gottsauner M, Engel M, Hoffmann J, Freudlsperger C, Ristow O. Head motion during cone-beam computed tomography: Analysis of frequency and influence on image quality. Imaging Sci Dent 2020; 50:227-236. [PMID: 33005580 PMCID: PMC7506095 DOI: 10.5624/isd.2020.50.3.227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/30/2020] [Accepted: 06/25/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose Image artifacts caused by patient motion cause problems in cone-beam computed tomography (CBCT) because they lead to distortion of the 3-dimensional reconstruction. This prospective study was performed to quantify patient movement during CBCT acquisition and its influence on image quality. Materials and Methods In total, 412 patients receiving CBCT imaging were equipped with a wireless head sensor system that detected inertial, gyroscopic, and magnetometric movements with 6 dimensions of freedom. The type and amplitude of movements during CBCT acquisition were evaluated and image quality was rated in 7 different anatomical regions of interest. For continuous variables, significance was calculated using the Student t-test. A linear regression model was applied to identify associations of the type and extent of motion with image quality scores. Kappa statistics were used to assess intra- and inter-rater agreement. Chi-square testing was used to analyze the impact of age and sex on head movement. Results All CBCT images were acquired in a 10-month period. In 24% of the investigations, movement was recorded (acceleration: >0.10 [m/s2]; angular velocity: >0.018 [°/s]). In all examined regions of interest, head motion during CBCT acquisition resulted in significant impairment of image quality (P<0.001). Movement in the horizontal and vertical axes was most relevant for image quality (R2>0.7). Conclusion Relevant head motions during CBCT imaging were frequently detected, leading to image quality loss and potentially impairing diagnosis and therapy planning. The presented data illustrate the need for digital correction algorithms and hardware to minimize motion artefacts in CBCT imaging.
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Affiliation(s)
- Julius Moratin
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | - Moritz Berger
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | - Thomas Rückschloss
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | - Karl Metzger
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | - Hannah Berger
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | - Maximilian Gottsauner
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Germany
| | - Michael Engel
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | - Jürgen Hoffmann
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | | | - Oliver Ristow
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
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28
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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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29
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Fontenele RC, Farias Gomes A, Nejaim Y, Freitas DQ. Do the tube current and metal artifact reduction influence the diagnosis of vertical root fracture in a tooth positioned in the vicinity of a zirconium implant? A CBCT study. Clin Oral Investig 2020; 25:2229-2235. [PMID: 32827079 DOI: 10.1007/s00784-020-03538-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
AIM To evaluate the influence of the tube current and metal artifact reduction (MAR) tool on the diagnosis of vertical root fractures (VRF) in a tooth adjacent to a zirconium implant, in cone-beam computed tomography (CBCT) images. METHODOLOGY Thirty single-rooted teeth (15 with VRF and 15 control group) were individually positioned in a mandible, and scanned with the OP300 CBCT unit. Images were acquired using a standardized protocol: 5 × 5 cm field of view, 0.08-mm voxel size, and 90 kVp. Each tooth was scanned with and without a zirconium implant in its vicinity, using different tube currents (4 mA, 8 mA, and 10 mA) and conditions of MAR (enabled × disabled). Diagnostic values were calculated for each protocol, and compared by multi-way analysis of variance. RESULTS The ROC curve and sensitivity values did not differ significantly among the tube currents, regardless of the presence of the implant and MAR condition (p > 0.05). There were also no significant differences among the tube currents for the specificity values (p > 0.05); however, the specificity differed significantly between the "with implant" and "without implant" conditions, within the same MAR condition and tube current (p < 0.05). Specificity was significantly lower when the implant was present (p < 0.05). CONCLUSION The presence of a zirconium implant impairs the diagnosis of VRF in teeth adjacent to the artifact-generator material. Neither the tube current nor the MAR tool is effective in improving this diagnostic task. Therefore, in this clinical scenario, the use of the lowest tube current (4 mA), without MAR activation, is recommended. CLINICAL RELEVANCE Considering that the tube current is one of the main factors that influence the radiation dose and image quality in CBCT, and that metal artifacts negatively influence the diagnosis of VRF in areas adjacent to the artifact-generator material, it is important to evaluate the effect of this energetic parameter in the diagnosis of VRF in teeth adjacent to zirconium implants.
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Affiliation(s)
- Rocharles C Fontenele
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Avenida Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Amanda Farias Gomes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Avenida Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil.
| | - Yuri Nejaim
- Oral Radiology Area, Dental School, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Deborah Q Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Avenida Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
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30
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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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