Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
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Influence of CBCT metal artifact reduction on vertical radicular fracture detection

  • Received : 2020.07.15
  • Accepted : 2020.11.24
  • Published : 2021.03.31
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Abstract

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.

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References

  1. Khasnis SA, Kidiyoor, KH, Patil AB, Kenganal SB. Vertical root fractures and their management. J Conserv Dent 2014; 17: 103-10. https://doi.org/10.4103/0972-0707.128034
  2. Patel S, Brown J, Pimentel T, Kelly RD, Abella F, Durack C. Cone beam computed tomography in endodontics- a review of the literature. Int Endod J 2019; 52: 1138-52. https://doi.org/10.1111/iej.13115
  3. Patel S, Dawood A, Ford TP, Whaites E. The potential applications of cone beam computed tomography in the management of endodontic problems. Int Endod J 2007; 40: 818-30. https://doi.org/10.1111/j.1365-2591.2007.01299.x
  4. Scarfe WC, Levin MD, Gane D, Farma AG. Use of cone beam computed tomography in endodontics. Int J Dent 2009; 2009: 634567. https://doi.org/10.1155/2009/634567
  5. Edlund M, Nair MK, Nair UP. Detection of vertical root fractures by using cone-beam computed tomography: a clinical study. J Endod 2011; 37: 768-72. https://doi.org/10.1016/j.joen.2011.02.034
  6. Salineiro, FC, Kobayashi-Velasco S, Braga MM, Cavalcanti MG. Radiographic diagnosis of root fractures: a systematic review, meta-analyses and sources of heterogeneity. Dentomaxillofac Radiol 2017; 46: 20170400. https://doi.org/10.1259/dmfr.20170400
  7. Ma RH, Ge ZP, Li G. Detection accuracy of root fractures in cone-beam computed tomography images: a systematic review and meta-analysis. Int Endod J 2016; 49: 646-54. https://doi.org/10.1111/iej.12490
  8. Chang E, Lam E, Shah P, Azarpazhooh A. Cone-beam computed tomography for detecting vertical root fractures in endodontically treated teeth: a systematic review. J Endod 2016; 4: 177-85.
  9. Corbella S, Del Fabbro M, Tamse A, Rosen E, Tsesis I, Taschieri S. Cone beam computed tomography for the diagnosis of vertical root fractures: a systematic review of the literature and metaanalysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118: 593-602. https://doi.org/10.1016/j.oooo.2014.07.014
  10. Hassan B, Metska ME, Ozok AR, van der Stelt P, Wesselink PR. Comparison of five cone beam computed tomography systems for the detection of vertical root fractures. J Endod 2010; 36: 126-9. https://doi.org/10.1016/j.joen.2009.09.013
  11. Rosen E, Taschieri S, Del Fabbro M, Beitlitum I, Tsesis I. The diagnostic efficacy of cone-beam computed tomography in endodontics: a systematic review and analysis by a hierarchical model of efficacy. J Endod 2015; 41: 1008-14. https://doi.org/10.1016/j.joen.2015.02.021
  12. Talwar S, Utneja S, Nawal RR, Kaushik A, Srivastava D, Oberoy SS. Role of cone-beam computed tomography in diagnosis of vertical root fractures: a systematic review and meta-analysis. J Endod 2016; 42: 12-24. https://doi.org/10.1016/j.joen.2015.09.012
  13. Draenert FG, Coppenrath E, Herzog P, Muller S, Mueller-Lisse UG. Beam hardening artefacts occur in dental implant scans with the NewTom cone beam CT but not with the dental 4-row multidetector CT. Dentomaxillofac Radiol 2007; 36: 198-203. https://doi.org/10.1259/dmfr/32579161
  14. Vasconcelos KF, Nicolielo LF, Nascimento MC, Haiter-Neto F, Boscolo FN, Van Dessel J, et al. Artefact expression associated with several cone-beam computed tomographic machines when imaging root filled teeth. Int Endod J 2015; 48: 994-1000. https://doi.org/10.1111/iej.12395
  15. Queiroz PM, Santaella GM, da Paz TD, Freitas DQ. Evaluation of a metal artefact reduction tool on different positions of a metal object in the FOV. Dentomaxillofac Radiol 2017; 46: 20160366. https://doi.org/10.1259/dmfr.20160366
  16. Schulze R, Heil U, Gross D, Bruellmann DD, Dranischnikow E, Schwanecke U, et al. Artefacts in CBCT: a review. Dentomaxillofac Radiol 2011; 40: 265-73. https://doi.org/10.1259/dmfr/30642039
  17. Neves FS, Freitas DQ, Campos PS, Ekestubbe A, LofthangHansen S. Evaluation of cone-beam computed tomography in the diagnosis of vertical root fractures: the influence of imaging modes and root canal materials. J Endod 2014; 40: 1530-6. https://doi.org/10.1016/j.joen.2014.06.012
  18. Wanderley VA, Neves FS, Nascimento MC, Monteiro GQ, Lobo NS, Oliveira ML, et al. Detection of incomplete root fractures in endodontically treated teeth using different high-resolution cone-beam computed tomographic imaging protocols. J Endod 2017; 43: 1720-4. https://doi.org/10.1016/j.joen.2017.05.017
  19. Fuss Z, Lustig J, Tamse A. Prevalence of vertical root fractures in extracted endodontically treated teeth. Int Endod J 1999; 32: 283-6. https://doi.org/10.1046/j.1365-2591.1999.00208.x
  20. Queiroz PM, Groppo FC, Oliveira ML, Haiter-Neto F, Freitas DQ. Evaluation of the efficacy of a metal artifact reduction algorithm in different cone beam computed tomography scanning parameters. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123: 729-34. https://doi.org/10.1016/j.oooo.2017.02.015
  21. Helvacioglu-Yigit D, Demirturk Kocasarac H, Bechara B, Noujeim M. Evaluation and reduction of artifacts generated by 4 different root-end filling materials by using multiple cone-beam computed tomography imaging settings. J Endod 2016; 42: 307-14. https://doi.org/10.1016/j.joen.2015.11.002
  22. Bechara B, Alex McMahan C, Moore WS, Noujeim M, Teixeira FB, Geha H. Cone beam CT scans with and without artefact reduction in root fracture detection of endodontically treated teeth. Dentomaxillofac Radiol 2013; 42: 20120245. https://doi.org/10.1259/dmfr.20120245
  23. Bezerra IS, Neves FS, Vasconcelos TV, Ambrosano GM, Freitas DQ. Influence of the artefact reduction algorithm of Picasso Trio CBCT system on the diagnosis of vertical root fractures in teeth with metal posts. Dentomaxillofac Radiol 2015; 44: 20140428. https://doi.org/10.1259/dmfr.20140428
  24. Junqueira RB, Verner FS, Campos CN, Devito KL, do Carmo AM. Detection of vertical root fractures in the presence of intracanal metallic post: a comparison between periapical radiography and cone-beam computed tomography. J Endod 2013; 39: 1620-4. https://doi.org/10.1016/j.joen.2013.08.031
  25. Soares CJ, Pizi EC, Fonseca RB, Martins LR. Influence of root embedment material and periodontal ligament simulation on fracture resistance tests. Braz Oral Res 2005; 19: 11-6. https://doi.org/10.1590/S1806-83242005000100003
  26. DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 1988; 44: 837-45. https://doi.org/10.2307/2531595
  27. Bechara B, McMahan CA, Geha H, Noujeim M. Evaluation of a cone beam CT artefact reduction algorithm. Dentomaxillofac Radiol 2012; 41: 422-8. https://doi.org/10.1259/dmfr/43691321
  28. Bechara BB, Moore WS, MacMahan CA, Noujeim M. Metal artefact reduction with cone beam CT: an in vitro study. Dentomaxillofac Radiol 2012; 41: 248-53. https://doi.org/10.1259/dmfr/80899839
  29. de Rezende Barbosa GL, Sousa Melo SL, Alencar PN, Nascimento MC, Almeida SM. Performance of an artefact reduction algorithm in the diagnosis of in vitro vertical root fracture in four different root filling conditions on CBCT images. Int Endod J 2016; 49: 500-8. https://doi.org/10.1111/iej.12477
  30. Bueno MR, Estrela C, Azevedo BC, Diogenes A. Development of a new cone-beam computed tomography software for endodontic diagnosis. Braz Dent J 2018; 29: 517-29. https://doi.org/10.1590/0103-6440201802455
  31. Fontenele RC, Nascimento EH, Santaella GM, Freitas DQ. Does the metal artifact reduction algorithm activation mode influence the magnitude of artifacts in CBCT images? Imaging Sci Dent 2020; 50: 23-30. https://doi.org/10.5624/isd.2020.50.1.23
  32. Yamamoto-Silva FP, de Oliveira Siqueira CF, Silva MA, Fonseca RB, Santos AA, Estrela C, et al. Influence of voxel size on conebeam computed tomography-based detection of vertical root fractures in the presence of intracanal metallic posts. Imaging Sci Dent 2018; 48: 177-84. https://doi.org/10.5624/isd.2018.48.3.177
  33. Ozer SY. Detection of vertical root fractures by using cone beam computed tomography with variable voxel sizes in an in vitro model. J Endod 2011; 37: 75-9. https://doi.org/10.1016/j.joen.2010.04.021
  34. Bechara B, McMahan CA, Moore WS, Noujeim M, Geha H, Teixeira FB. Contrast-to-noise ratio difference in small field of view cone beam computed tomography machines. J Oral Sci 2012; 54: 227-32. https://doi.org/10.2334/josnusd.54.227
  35. Patel S, Brady E, Wilson R, Brown J, Mannocci F. The detection of vertical root fractures in root filled teeth with periapical radiographs and CBCT scans. Int Endod J 2013; 46: 1140-52. https://doi.org/10.1111/iej.12109
  36. Brady E, Mannocci F, Brown J, Wilson R, Patel S. A comparison of cone beam computed tomography and periapical radiography for the detection of vertical root fractures in nonendodontically treated teeth. Int Endod J 2014; 47: 735-46. https://doi.org/10.1111/iej.12209
  37. da Silveira PF, Vizzotto MB, Liedke GS, da Silveira HL, Montagner F, da Silveira HE. Detection of vertical root fractures by conventional radiographic examination and cone beam computed tomography - an in vitro analysis. Dent Traumatol 2013; 29: 41-6. https://doi.org/10.1111/j.1600-9657.2012.01126.x