Purpose: This study evaluated the influence of a metal artifact reduction (MAR) tool in a cone-beam computed tomography (CBCT) device on the diagnosis of vertical root fractures (VRFs) in teeth with different root filling materials. Materials and Methods: Forty-five extracted human premolars were classified into three subgroups; 1) no filling; 2) gutta-percha; and 3) metallic post. CBCT images were acquired using an Orthopantomograph 300 unit with and without a MAR tool. Subsequently, the same teeth were fractured, and new CBCT scans were obtained with and without MAR. Two oral radiologists evaluated the images regarding the presence or absence of VRF. Receiver operating characteristic (ROC) curves and diagnostic tests were performed. Results: The overall area under the curve values were 0.695 for CBCT with MAR and 0.789 for CBCT without MAR. The MAR tool negatively influenced the overall diagnosis of VRFs in all tested subgroups, with lower accuracy (0.45-0.72), sensitivity (0.6-0.67), and specificity (0.23-0.8) than were found for the images without MAR. In the latter group, the accuracy, sensitivity, and specificity values were 0.68-0.77, 0.67-083, and 0.53-087, respectively. However, no significant difference was found between images with and without MAR for the no filling and gutta-percha subgroups (P>0.05). In the metallic post subgroup, CBCT showed a significant difference according to MAR use (P<0.05). Conclusion: The OP 300 MAR tool negatively influenced the detection of VRFs in teeth with no root canal filling, gutta-percha, or metallic posts. Teeth with metallic posts suffered the most from the negative impact of MAR.
Purpose: The aim of this study was to assess artifacts generated in cone-beam computed tomography (CBCT) of 3 types of dental implants using 3 metal artifact reduction (MAR) algorithm conditions (pre-acquisition MAR, post-acquisition MAR, and no MAR), and 2 peak kilovoltage (kVp) settings. Materials and Methods: Titanium-zirconium, titanium, and zirconium alloy implants were placed in a dry mandible. CBCT images were acquired using 84 and 90 kVp and at normal resolution for all 3 MAR conditions. The images were analyzed using ImageJ software (National Institutes of Health, Bethesda, MD) to calculate the intensity of artifacts for each combination of material and settings. A 3-factor analysis of variance model with up to 3-way interactions was used to determine whether there was a statistically significant difference in the mean intensity of artifacts associated with each factor. Results: The analysis of all 3 MAR conditions showed that using no MAR resulted in substantially more severe artifacts than either of the 2 MAR algorithms for the 3 implant materials; however, there were no significant differences between pre- and post-acquisition MAR. The 90 kVp setting generated less intense artifacts on average than the 84 kVp setting. The titanium-zirconium alloy generated significantly less intense artifacts than zirconium. Titanium generated artifacts at an intermediate level relative to the other 2 implant materials, but was not statistically significantly different from either. Conclusion: This in vitro study suggests that artifacts can be minimized by using a titanium-zirconium alloy at the 90 kVp setting, with either MAR setting.
Debora Costa Ruiz;Lucas P. Lopes Rosado;Rocharles Cavalcante Fontenele;Amanda Farias-Gomes;Deborah Queiroz Freitas
Imaging Science in Dentistry
/
v.54
no.2
/
pp.139-145
/
2024
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.
Although magnetic resonance imaging without linear hardening of CT is recognized as a method of obtaining high contrast of tissue and excellent resolution image in brain disease and head and neck examination, magnetic susceptibility artifact is generated in case of metal implants in the oral cavity, which is an obstacle to image diagnosis. Therefore, an effort was made in this thesis to find a method to reduce artifacts caused by dental implants and prosthesis in MRI. Implant-induced artifacts in magnetic resonance imaging showed that the signal size increased with shorter TE in GE technique and was inconsistent with water temperature change. In SE technique as well, the signal size of water was generally higher than that of air, but the signal to noise ratio (SNR) was not different by air and temperature. In EPI technique, images with fewer artifacts were obtained quantitatively and qualitatively when there was more water than air, and the signal to noise ratio was measured the highest, especially at water temperatures of 20° and 30°. In conclusion, when examining using the EPI technique rather than the SE or the GE technique, obtaining brain diffusion using a 20° and 30° water bag reduces the magnetic susceptibility artifacts caused by implants and prosthesis, suggesting that it may provide images with high diagnostic value.
Objective: The aim of this study was to assess artifacts induced by metallic restorations in three-dimensional (3D) dental surface models derived by cone-beam computed tomography (CBCT). Methods: Fifteen specimens, each with four extracted human premolars and molars embedded in a plaster block, were scanned by CBCT before and after the cavitated second premolars were restored with dental amalgam. Five consecutive surface models of each specimen were created according to increasing restoration size: no restoration (control) and small occlusal, large occlusal, disto-occlusal, and mesio-occluso-distal restorations. After registering each restored model with the control model, maximum linear discrepancy, area, and intensity of the artifacts were measured and compared. Results: Artifacts developed mostly on the buccal and lingual surfaces. They occurred not only on the second premolar but also on the first premolar and first molar. The parametric values increased significantly with increasing restoration size. Conclusions: Metallic restorations induce considerable artifacts in 3D dental surface models. Artifact reduction should be taken into consideration for a proper diagnosis and treatment planning when using 3D surface model derived by CBCT in dentofacial deformity patients.
Matheus Barros-Costa;Eduarda Helena Leandro Nascimento;Iago Filipe Correia-Dantas;Matheus L. Oliveira;Deborah Queiroz Freitas
Imaging Science in Dentistry
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v.54
no.1
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pp.49-56
/
2024
Purpose: This study evaluated the impact of artifacts generated by metal crowns on the detection of proximal caries lesions in teeth at various distances using cone-beam computed tomography (CBCT). Additionally, the diagnostic impacts of tube current and metal artifact reduction (MAR) were investigated. Materials and Methods: Thirty teeth were arranged within 10 phantoms, each containing 1 first premolar, 1 second premolar, and 1 second molar. A sound first molar (for the control group) or a tooth with a metal crown was placed. Of the 60 proximal surfaces evaluated, 15 were sound and 45 exhibited enamel caries. CBCT scans were acquired using an OP300 Maxio unit (Instrumentarium, Tuusula, Finland), while varying the tube current (4, 8, or 12.5 mA) and enabling or disabling MAR. Five observers assessed mesial and distal surfaces using a 5-point scale. Multi-way analysis of variance was employed for data comparison, with P<0.05 indicating statistical significance. Results: The area under the curve (AUC) varied from 0.40 to 0.60 (sensitivity: 0.28-0.45, specificity: 0.44-0.80). The diagnostic accuracy was not significantly affected by the presence of a metal crown, milliamperage, or MAR(P>0.05). However, the overall AUC and specificity were significantly lower for surfaces near a crown (P<0.05). Conclusion: CBCT-based caries detection was not influenced by the presence of a metal crown, variations in milliamperage, or MAR activation. However, the diagnostic accuracy was low and was further diminished for surfaces near a crown. Consequently, CBCT is not recommended for the detection of incipient caries lesions.
Fontenele, Rocharles Cavalcante;Nascimento, Eduarda Helena Leandro;Imbelloni-Vasconcelos, Ana Catarina;Martins, Luciano Augusto Cano;Pontual, Andrea dos Anjos;Ramos-Perez, Flavia Maria Moraes;Freitas, Deborah Queiroz
Imaging Science in Dentistry
/
v.52
no.3
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pp.267-273
/
2022
Purpose: The aim of this study was to assess the influence of kilovoltage- peak (kVp) and the metal artifact reduction (MAR) tool on the detection of buccal and lingual peri-implant dehiscence in the presence of titanium-zirconia (Ti-Zr) and zirconia (Zr) implants in cone-beam computed tomography (CBCT) images. Materials and Methods: Twenty implant sites were created in the posterior region of human mandibles, including control sites (without dehiscence) and experimental sites (with dehiscence). Individually, a Ti-Zr or Zr implant was placed in each implant site. CBCT scans were performed using a Picasso Trio device, with variation in the kVp setting (70 or 90 kVp) and whether the MAR tool was used. Three oral radiologists scored the detection of dehiscence using a 5-point scale. The area under the receiver operating characteristic (ROC) curve, sensitivity, and specificity were calculated and compared by multi-way analysis of variance (α=0.05). Results: The kVp, cortical plate involved (buccal or lingual cortices), and MAR did not influence any diagnostic values (P>0.05). The material of the implant did not influence the ROC curve values(P>0.05). In contrast, the sensitivity and specificity were statistically significantly influenced by the implant material (P<0.05) with Zr implants showing higher sensitivity values and lower specificity values than Ti-Zr implants. Conclusion: The detection of peri-implant dehiscence was not influenced by kVp, use of the MAR tool, or the cortical plate. Greater sensitivity and lower specificity were shown for the detection of peri-implant dehiscence in the presence of a Zr implant.
Larissa Pereira Lagos de Melo;Polyane Mazucatto Queiroz;Larissa Moreira-Souza;Mariana Rocha Nadaes;Gustavo Machado Santaella;Matheus Lima Oliveira;Deborah Queiroz Freitas
Restorative Dentistry and Endodontics
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v.48
no.2
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pp.16.1-16.11
/
2023
Objectives: The aim of this study was to evaluate the influence of peak kilovoltage (kVp) and a metal artifact reduction (MAR) tool on image quality and the diagnosis of vertical root fracture (VRF) in cone-beam computed tomography (CBCT). Materials and Methods: Twenty single-rooted human teeth filled with an intracanal metal post were divided into 2 groups: control (n = 10) and VRF (n = 10). Each tooth was placed into the socket of a dry mandible, and CBCT scans were acquired using a Picasso Trio varying the kVp (70, 80, 90, or 99), and the use of MAR (with or without). The examinations were assessed by 5 examiners for the diagnosis of VRF using a 5-point scale. A subjective evaluation of the expression of artifacts was done by comparing random axial images of the studied protocols. The results of the diagnoses were analyzed using 2-way analysis of variance and the Tukey post hoc test, the subjective evaluations were compared using the Friedman test, and intra-examiner reproducibility was evaluated using the weighted kappa test (α = 5%). Results: The kVp and MAR did not influence the diagnosis of VRF (p > 0.05). According to the subjective classification, the 99 kVp protocol with MAR demonstrated the least expression of artifacts, while the 70 kVp protocol without MAR led to the most artifacts. Conclusions: Protocols with higher kVp combined with MAR improved the image quality of CBCT examinations. However, those factors did not lead to an improvement in the diagnosis of VRF.
This study evaluates the change of computer tomography (CT) number in the case of the metal artifact reduction (MAR) algorithm, using the phantom. The images were obtained from dual CT using a gammex 467 tissue characterization phantom, which is similar to human tissues. The test method was performed by dividing pre and post MAR algorithm and measured CT values of nonmagnetic materials within the phantom. In addition, the changes of CT values for each material were compared and analyzed after measuring CT values up to 140 keV, using the spectral HU curve followed by CT scan. As a result, in the cases of N rod (trabecular bone) and E rod (trabecular bone), the CT numbers decreased as keV increasing but were constant above 90 keV. In the cases of I rod (dense bone) and K rod (dense bone), the CT numbers also decreased as keV increased but were uniform above 90 keV. The CT numbers from 40 keV to 140 keV were consistent in the cases of J rod (liver), D rod (liver), L rod (muscle), and F rod (muscle). For A rod (adipose), G rod (adipose), B rod (breast) and O rod (breast), the CT numbers increased as keV increased but were constant after 90 keV. The CT numbers from 40 keV to 140 keV were consistent in the cases of C rod (lung (exhale)), P rod (lung (exhale)), M rod (lung (inhale)) and H rod (lung (exhale)). Conclusively, because dual CT exhibits no changes in image quality and is able to analyze nonmagnetic materials by measuring the CT values of various materials, it will be used in the future as a useful tool for the diagnosis of lesions.
Desalination is the main focus of the stabilization of iron artifacts. However, drawbacks such as re-corrosion are noted due to the uncertainty in the elimination of the corrosive factors and artifacts. Several studies have been carried out on the effects of corrosion inhibitors to overcome these shortcomings. In this study, the effects of type 3 water treatment on corrosion inhibitors were investigated. Surfaces of samples that contained film corrosion inhibitors on their surfaces were analyzed. The results revealed that the surface rust was removed from the sample of type 1 No. 2 that was mainly composed of phosphate. The average weight reduction rates of re-corrosion samples were 0.58, 0.03, and 0.07% for type 1 No. 2, type 2 No. 2, and type 3 No. 2 respectively. The changes in the $Cl^-$ ion, a corrosive agent were found to be 28.60, -4.08, and -1.94 ppm for type 1 No. 2, type 2 No. 2, and type 3 No. 2 respectively. The water-treated films were analyzed by X-ray photoelectron spectroscopy (XPS). It was found that type 2 No. 2 had less Fe the basis metal, than that in type 3 No. 2 indicating much better film. Moreover, Si content was higher in type 2 No. 2, based on the silicate content, than in type 3 No. 2. They are speculated to be the reason or the formation of a better film. Type 1 No. 2, which is mainly composed of phosphate, would be inappropriate as a metal artifact conservation treatment. It was determined that type 2 No. 2 and type 3 No. 2 water treatments, which are mainly composed of silicate, provided excellent corrosion inhibiting effects. Corrosion inhibitors could be used as emergency treatment agents during the excavation of iron artifacts.
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