Influence of adjacent teeth restored with metal posts in the detection of simulated internal root resorption using CBCT

Abstract

AimTo assess the influence of artefacts generated by metal posts on the detection of simulated internal root resorption (IRR) in adjacent teeth using cone‐beam computed tomography (CBCT) and to verify the impact of metal artefact reduction (MAR) on these cases.MethodologyCBCT images of 14 premolar teeth were acquired before and after IRR simulation using chemical and mechanical procedures, in an OP300 Maxio unit, with and without MAR. Each tooth was placed in the socket of a human mandible and scanned under three different conditions: (i) without adjacent teeth – control group; (ii) distal adjacent tooth restored with metal post; and (iii) with both adjacent teeth restored with metal post. Five oral radiologists scored the IRR detection using a 5‐point scale. Diagnostic values were obtained for the tested groups and compared using two‐way analysis of variance (α = 0.05).ResultsThe presence of a single adjacent tooth restored with metal post did not significantly influence the diagnostic values for IRR detection (P > 0.05). The presence of both adjacent teeth with metal posts, without MAR application, was associated with a significantly lower area under the ROC curve (Az) compared to the control (P = 0.0182). In this case, the application of MAR increased Az, leading to nonsignificant differences from the control group and the group with one adjacent restored tooth (P > 0.05). Sensitivity decreased significantly when two adjacent restored teeth were present, regardless of MAR application (P = 0.0379). Specificity was not affected by the conditions tested (P > 0.05).ConclusionCBCT detection of IRR was impaired by artefacts only when both adjacent teeth restored with metal posts were present. In such cases, activation of MAR improved the performance on this diagnostic task.

Modifying the head’s spatial orientation reduces cone beam CT artifacts adjacent to dental implants: a laboratory study

“…However, despite these advantages, image artifacts can occur when high-density materials are present in the scanned area, which is often the case with dental materials [13,18,19]. Strategies to reduce the expression of image artifacts have been well-described in the scienti c literature, with some proving successfully while others have not [6,7,12,[20][21][22][23][24]. In this experimental study, we tested the modi cation of the spatial orientation of the head in an endeavour to avoid image artifacts in the vicinity of a dental implant and, interestingly, observed higher mean voxel values in all cases and, in most cases, lower noise values in the anterior and posterior regions of a dental implant.…”

“…This misdiagnosis can have a signi cant negative impact, potentially resulting in the unnecessary extraction of a tooth. Furthermore, the presence of artifacts generated by teeth restored with a metal post also negatively in uenced the diagnosis of internal root resorption in adjacent teeth [7].…”

“…Dental implants, restorative materials, and endodontic components are commonly present in the oral cavity, causing image artifacts. The resulting image deterioration can extend to the vicinity of the source object and potentially impair the diagnosis [5][6][7][8]. Several attempts to mitigate image artifacts have been described in the literature, including altering acquisition protocols and applying artifact reduction algorithms [5,6,[9][10][11][12].…”

Potential impact of metal crowns at varying distances from a carious lesion on its detection on cone-beam computed tomography scans with several protocols

“…Research regarding the impact of artifacts on diagnostic procedures is widely available in the dental literature. 3 4 5 6 7 8 9 10 11 These studies have primarily focused on the influence of intracanal materials and the presence of dental implants in the oral cavity. 9 10 11 Regarding the assessment of artifacts on the identification of carious lesions, previous studies have typically utilized direct restorations 3 4 or orthodontic materials 8 as the artifact sources or have simulated artificial caries lesions.…”

“… 3 4 5 7 8 Several studies have investigated the impact of artifacts on the diagnosis of various conditions - such as vertical root fractures, internal and external root resorption, and proximal caries lesion - when these conditions are positioned adjacent to high-density materials, including dental implants, endodontic fillings, and restorative materials. 3 4 5 6 9 10 11 …”