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de Lima KL, Silva LR, de Paiva Prado TB, Silva MAG, de Freitas Silva BS, Yamamoto-Silva FP. Influence of the technical parameters of CBCT image acquisition on vertical root fracture diagnosis: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:433-474. [PMID: 36700991 DOI: 10.1007/s00784-022-04797-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 11/14/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To evaluate the influence of image acquisition parameters (voxel, FOV, kVp, mA) on the accuracy of cone-beam computed tomography (CBCT) in detecting vertical root fracture (VRF). MATERIAL AND METHODS Searches were performed in 6 main databases and the gray literature, without restrictions of language or date. Observational clinical studies (OCS) and in vitro-extracted teeth (IV) studies were considered eligible for inclusion when investigating the accuracy (sensitivity, specificity) of CBCT in detecting VRF in human teeth. The risk of bias was assessed using QUADAS-2, and a meta-analysis was performed using Review Manager v5.4 software and Jamovi software v1.6. RESULTS A total of 60 out of 132 articles was included after fulfilling the eligibility criteria. Of these, 54 were IV studies while 6 were OCS. In the IV studies, it was seen that smaller FOV sizes tended to present higher accuracy values. The meta-analysis of the 6 OCS showed that the overall sensitivity and specificity values for 0.08 mm and 0.1 mm voxels were greater (0.84 and 0.79, respectively) than the sensitivity and specificity values for 0.125 mm and 0.2 mm voxels (0.70 and 0.55, respectively). CONCLUSIONS Despite the uncertain risk of bias found for the IV and OCS studies, smaller voxel and FOV sizes seem to provide more accurate VRF detection values when using CBCT. CLINICAL RELEVANCE This information is crucial for supporting the clinician when prescribing CBCT in cases of a clinical suspicion of VRF, and contributes to the personalization of the CBCT prescription, thereby ensuring greater accuracy in the VRF diagnosis. Registration This protocol was registered at the PROSPERO database (International Prospective Register of Systematic Review) under registration number CRD42020210118.
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Affiliation(s)
- Kaique Leite de Lima
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Lorena Rosa Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | | | - Maria Alves Garcia Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Brunno Santos de Freitas Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil. .,University of Anápolis, Anápolis, GO, Brazil.
| | - Fernanda Paula Yamamoto-Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil.,University of Anápolis, Anápolis, GO, Brazil
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de Oliveira Pinto MG, Melo SLS, Suassuna FCM, Marinho LE, Leite JBDS, Batista AUD, Bento PM, Melo DP. Influence of size of field of view (FOV), position within the FOV, and scanning mode on the detection of root fracture and observer's perception of artifacts in CBCT images. Dentomaxillofac Radiol 2021; 50:20200563. [PMID: 33565884 DOI: 10.1259/dmfr.20200563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess the influence of field of view (FOV) size, scanning position within the FOV and scanning mode on the detection of root fracture and artifact perception. METHODS Forty single-rooted premolars restored with NiCr and AgPd posts were divided into two groups: fractured and sound. All teeth were scanned using four CBCT scanning protocols varying FOV sizes (80 × 80 mm and 50 × 55 mm) and scanning modes (Standard and High Definition). The sample was positioned within the FOV in two pre-set positions (central and lateral) and in four positions established by the operator (quadrants). Detection of root fracture and artifact perception were assessed by two observers using 5-point and 4-point scales. Sensitivity, specificity, accuracy, and AUC values were calculated and compared by ANOVA two-way and Tukey's test. Chi-square and Fisher's exact test were used to assess artifact perception. The level of significance was set at p < 0.05. RESULTS The central position within the FOV presented higher sensitivity, specificity, accuracy, and AUC values and differed from the lateral position within the FOV for the studied metal posts (p<0.05). Quadrant 2 presented the best sensitivity, accuracy, and AUC values (p<0.05). The lateral position within the FOV, AgPd posts, quadrants 1 and 3 and protocols 1 (SM, 80 × 80) and 2 (HD, 80× 80) presented higher frequency of artifacts classified as "severe". CONCLUSION Positioning the object in the center or closer to the anterior periphery of the FOV while using a small FOV improved the detection of root fracture and decreased artifact perception.
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Affiliation(s)
| | - Saulo L Sousa Melo
- Department of Integrative Biomedical & Diagnostic Sciences, School of Dentistry, Oregon Health & Science University, Portland, USA
| | | | - Luiz Eduardo Marinho
- Department of Oral Diagnosis, Division of Oral Radiology, State University of Paraíba, Campina Grande, Brazil
| | | | | | - Patrícia Meira Bento
- Department of Oral Diagnosis, Division of Oral Radiology, State University of Paraíba, Campina Grande, Brazil
| | - Daniela Pita Melo
- Department of Oral Diagnosis, State University of Paraíba, Campina Grande, Brazil
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Afkhami F, Ghoncheh Z, Khadiv F, Kaviani H, Shamshiri AR. How Does Voxel Size of Cone-beam Computed Tomography Effect Accurate Detection of Root Strip Perforations. IRANIAN ENDODONTIC JOURNAL 2021; 16:43-48. [PMID: 36704411 PMCID: PMC9709875 DOI: 10.22037/iej.v16i1.25145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 11/14/2020] [Accepted: 12/06/2020] [Indexed: 01/28/2023]
Abstract
Introduction Our study aimed to assess the diagnostic accuracy of different voxel sizes for cone-beam computed tomography (CBCT) when detecting strip perforations of variable sizes. We used 0.2 and 0.3 mm3 voxel for detecting root strip perforations. Methods and Materials This was an in vitro study conducted on 155 extracted humans' mandibular first molars. The teeth were randomly divided into five groups (n=31). Perforation were not induced in the control group. In the remaining four groups, strip perforations of 0.5, 1, 1.5, and 2 mm diameters were created in the mesiolingual canal using #3 Gates Glidden drills. The CBCT scans were taken first with a 12×9 cm field of view (FOV), 90 kVp, 4 mA, and 0.2 mm3 voxel size for 24 sec and then with a 12×9 cm FOV, 90 kVp, 2 mA, and 0.3 mm3 voxel size for another 24 sec. Two observers evaluated the images and reported the largest diameter of perforations. The results were compared with the gold standard values (determined by an electronic digital caliper) using statistical methods, including the kappa coefficient and generalized estimating equation (P<0.05). Results Based on the findings of our study, the inter-observer agreement ranged from 58-100%, while the intra-observer agreement was reported to be around 100%. The difference in accuracy between 0.2 and 0.3 mm3 voxel sizes was not statistically significant (P>0.05). In addition, the accuracy of detecting different perforation sizes in the CBCT did not follow a specific pattern. Conclusion This in vitro study showed that CBCT is a reliable diagnostic tool, and even in lower dosages of 0.3 mm3 voxel size, image resolution and diagnostic accuracy was not affected. Moreover, smaller root perforations could be detected as accurately as larger ones with CBCT.
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Affiliation(s)
- Farzaneh Afkhami
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran;
| | - Zahra Ghoncheh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran; ,Corresponding author: Zahra Ghoncheh, Department of Oral and Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran
| | | | - Hanieh Kaviani
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran;
| | - Ahmad Reza Shamshiri
- Research Center for Caries Prevention, Dentistry Research Institute, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Icen M, Orhan K, Şeker Ç, Geduk G, Cakmak Özlü F, Cengiz Mİ. Comparison of CBCT with different voxel sizes and intraoral scanner for detection of periodontal defects: an in vitro study. Dentomaxillofac Radiol 2020; 49:20190197. [PMID: 32134338 DOI: 10.1259/dmfr.20190197] [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: 11/05/2022] Open
Abstract
OBJECTIVES This study aimed to compare the diagnostic accuracy of cone beam CT (CBCT) units with different voxel sizes with the digital intraoral scanning technique in terms of the detection of periodontal defects. METHODS AND MATERIALS The study material comprised of 12 dry skulls with maxilla and mandible. Artificial defects were created on teeth separately using burs randomly on dry skulls. In total 46 dehiscences, 10 fenestrations, 17 furcations, 12 wall defects and 13 without periodontal defect were used in the study. Each tooth with and without defects was imaged at various vertical angles using each of the following modalities: a Veraviewepocs 3D R100 CBCT device and a 3D Shape TRIOSㄾ Color P13 Shade Intraoral Scanner. RESULTS The κ values for interobserver agreement between observers ranged between 0.29 and 0.86 for the CBCT 10 × 8 cm field of view (FOV) with 0,160 mm3 voxel size; 0.35 and 1 for the CBCT 8 × 8 cm FOV with 0,125 mm3 voxel size; and 0.30 and 1 of intraoral scans. The κ values for detecting defects on anterior teeth were the least, following premolar and molar teeth both CBCT and intraoral scanning. CONCLUSIONS Smaller voxel sizes and smaller CBCT FOV has the highest sensitivity and diagnostic accuracy for detecting various periodontal defects among the scanner modalities examined. ADVANCES IN KNOWLEDGE Adequate evaluation of the condition of the alveolar bone and periodontal tissues is important for the diagnosis, treatment, and prognosis of periodontal disease. Limited examination methods, such as palpation, inspection, and periodontal probe examination, may provide insufficient information for the diagnosis of periodontal diseases.
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Affiliation(s)
- Murat Icen
- Department of Dentomaxillofacial Radiology, Nevşehir Hacı Bektaş Veli University, Faculty of Dentistry, Nevşehir, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Ankara University, Faculty of Dentistry, Ankara, Turkey
| | - Çiğdem Şeker
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Gediz Geduk
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Fethiye Cakmak Özlü
- Department of Orthodontics, Ondokuz Mayıs University, Faculty of Dentistry, Samsun, Turkey
| | - Murat İnanç Cengiz
- Department of Periodontology, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
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Safi Y, Fazlyab M, Asgary S, Fazlalipour M. A Novel Technique for Minimizing the Metal Artifacts on Anterior Teeth in Cone-Beam Computed Tomography. IRANIAN ENDODONTIC JOURNAL 2019; 14:79-83. [PMID: 36879592 PMCID: PMC9984812 DOI: 10.22037/iej.v14i1.21636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 11/04/2018] [Accepted: 11/19/2018] [Indexed: 03/08/2023]
Abstract
In endodontics, metal artifacts are the major weak points of employing cone-beam computed tomography (CBCT) in teeth with metallic posts and restorations. The aim of this article is to introduce a novel technique for preparation of beneficial CBCT images of anterior teeth with metal posts and/or crowns. In this novel technique, the patient who was instructed to take CBCT images for reason of implant surgery, was asked to puff out his cheeks/lips during the rotation of x-ray tube. By comparing the image taken with this technique to normal image it was obvious that after applying the cheek puffing technique, the metal artifacts around restored anterior teeth significantly reduced. Then it seems that this novel technique removes the metal artifacts from the crowned teeth to distances far from the tooth structure and enables more accurate diagnosis.
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Affiliation(s)
- Yaser Safi
- Department of Radiology, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahta Fazlyab
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Endodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Fazlalipour
- Department of Radiology, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Yamamoto-Silva FP, de Oliveira Siqueira CF, Silva MAGS, Fonseca RB, Santos AA, Estrela C, de Freitas Silva BS. Influence of voxel size on cone-beam computed tomography-based detection of vertical root fractures in the presence of intracanal metallic posts. Imaging Sci Dent 2018; 48:177-184. [PMID: 30276154 PMCID: PMC6148034 DOI: 10.5624/isd.2018.48.3.177] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/17/2018] [Accepted: 07/31/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose This study was performed to evaluate the influence of voxel size and the accuracy of 2 cone-beam computed tomography (CBCT) systems in the detection of vertical root fracture (VRF) in the presence of intracanal metallic posts. Materials and Methods Thirty uniradicular extracted human teeth were selected and randomly divided into 2 groups (VRF group, n=15; and control group, n=15). The VRFs were induced by an Instron machine, and metallic posts were placed in both groups. The scans were acquired by CBCT with 4 different voxel sizes: 0.1 mm and 0.16 mm (for the Eagle 3D V-Beam system) and 0.125 mm and 0.2 mm (for the i-CAT system) (protocols 1, 2, 3, and 4, respectively). Interobserver and intraobserver agreement was assessed using the Cohen kappa test. Sensitivity and specificity were evaluated and receiver operating characteristic analysis was performed. Results The intraobserver coefficients indicated good (0.71) to very good (0.83) agreement, and the interobserver coefficients indicated moderate (0.57) to very good (0.80) agreement. In respect to the relationship between sensitivity and specificity, a statistically significant difference was found between protocols 1 (positive predictive value: 0.710, negative predictive value: 0.724) and 3 (positive predictive value: 0.727, negative predictive value: 0.632) (P<.05). The least interference due to artifact formation was observed using protocol 2. Conclusion Protocols with a smaller voxel size and field of view seemed to favor the detection of VRF in teeth with intracanal metallic posts.
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Affiliation(s)
| | | | | | - Rodrigo Borges Fonseca
- Department of Oral Rehabilitation, Dental School, Federal University of Goiás, Goiânia, Brazil
| | - Ananda Amaral Santos
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Brazil
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Kamburoğlu K, Sönmez G, Berktaş ZS, Kurt H, Özen D. Effects of various cone-beam computed tomography settings on the detection of recurrent caries under restorations in extracted primary teeth. Imaging Sci Dent 2017; 47:109-115. [PMID: 28680847 PMCID: PMC5489666 DOI: 10.5624/isd.2017.47.2.109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/09/2017] [Accepted: 05/13/2017] [Indexed: 11/26/2022] Open
Abstract
Purpose The aim of this study was to assess the ex vivo diagnostic ability of 9 different cone-beam computed tomography (CBCT) settings in the detection of recurrent caries under amalgam restorations in primary teeth. Materials and Methods Fifty-two primary teeth were used. Twenty-six teeth had dentine caries and 26 teeth did not have dentine caries. Black class II cavities were prepared and restored with amalgam. In the 26 carious teeth, recurrent caries were left under restorations. The other 26 intact teeth that did not have caries served as controls. Teeth were imaged using a 100×90-mm field of view and a 0.2-mm voxel size with 9 different CBCT settings. Four observers assessed the images using a 5-point scale. Kappa values were calculated to assess observer agreement. CBCT settings were compared with the gold standard using a receiver operating characteristic analysis. The area under the curve (AUC) values for each setting were compared using the chi-square test, with a significance level of α=.05. Results Intraobserver kappa values ranged from 0.366 to 0.664 for observer 1, from 0.311 to 0.447 for observer 2, from 0.597 to 1.000 for observer 3, and from 0.869 to 1 for observer 4. Furthermore, interobserver kappa values among the observers ranged from 0.133 to 0.814 for the first reading and from 0.197 to 0.805 for the second reading. The highest AUC values were found for setting 5 (0.5916) and setting 3 (0.5886), and were not found to be statistically significant (P>.05). Conclusion Variations in tube voltage and tube current did not affect the detection of recurrent caries under amalgam restorations in primary teeth.
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Affiliation(s)
- Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Gül Sönmez
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Zeynep Serap Berktaş
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Hakan Kurt
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Doĝukan Özen
- Department of Biostatistics, Faculty of Veterinary Medicine, Ankara University, Ankara, Turkey
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Safi Y, Ghaedsharaf S, Aziz A, Hosseinpour S, Mortazavi H. Effect of Field Of View on Detection of External Root Resorption in Cone-Beam Computed Tomography. IRANIAN ENDODONTIC JOURNAL 2017; 12:179-184. [PMID: 28512482 PMCID: PMC5431714 DOI: 10.22037/iej.2017.35] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Conventional methods for diagnosis of external root resorption (ERR) are based on clinical findings and x-ray observations which are not appropriate for early diagnosis. The present study assessed the effect of different sizes and field of views (FOVs) in the diagnosis of simulated external root resorption by cone-beam computed tomography (CBCT). METHODS AND MATERIALS In this diagnostic in vitro trial, 100 human extracted mandibular central incisors were collected and marked in 3 apical, middle and coronal areas. Cavities with different sizes were created in buccal and lingual surfaces of each area. Following this procedure, CBCT images were taken in 2 different 6 × 6 cm and 12 × 8 cm FOVs with the same voxel size of 0.2 mm. Absence or presence of cavities in CBCT images were assigned by 3 radiologists and compared with gold standard results which were obtained by measurement of the size of cavities using a digital caliper. Sensitivity and specificity values, positive predictive value (PPV) and negative predictive value (NPV), AZ value and Kappa values were calculated and reported. RESULTS Amounts of sensitivity in 6 × 6 cm FOV with voxel size of 0.2 mm for small, medium and large cavities were 95.93%, 96.03% and 97.1%, respectively. Amounts of sensitivity in 12 × 8cm FOV with the same voxel size for small, medium and large cavities were noted as 94.4%, 96.03% and 98.5%, respectively. However, specificity in FOV of 6 × 6 cm and FOV of 12 × 8 cm was calculated as 93.03% and 90.83%, respectively. CONCLUSION Both used FOVs show nearly same performances in the case of detection of ERR; therefore, smaller FOV should be preferably used for detection of ERR in order to decrease the amount of imposed radiation dose given to patients.
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Affiliation(s)
- Yaser Safi
- Department of Radiology, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | | | | | - Sepanta Hosseinpour
- Research Fellow, Dental Research Center, Research Institute of Dental Sciences, Dental School, Students' Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran; ,Corresponding author: Sepanta Hosseinpour, Gifted and Talented Dental Students' Office, dental school, Shahid Beheshti University of Medical Sciences, Daneshjou Blvd., Evin, Tehran, Iran.Tel: +98-935 2282511, E-mail:
| | - Hamed Mortazavi
- Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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