Detection of different foreign bodies in the maxillofacial region with spiral computed tomography and cone-beam computed tomography: An in vitro study

Purpose: The detection and exact localization of penetrating foreign bodies are crucial for the appropriate management of patients with dentoalveolar trauma. This study compared the efficacy of cone-beam computed tomography (CBCT) and spiral computed tomography (CT) scans for the detection of different foreign bodies composed of 5 frequently encountered materials in 2 sizes. The effect of the location of the foreign bodies on their visibility was also analyzed. Materials and Methods: In this in vitro study, metal, tooth, stone, glass, and plastic particles measuring 1×1×1 mm and 2×2×2 mm were prepared. They were implanted in a sheep's head in the tongue muscle, nasal cavity, and at the interface of the mandibular cortex and soft tissue. CBCT and spiral CT scans were taken and the visibility of foreign bodies was scored by 4 skilled maxillofacial radiologists who were blinded to the location and number of foreign bodies. Results: CT and CBCT were equally accurate in visualizing metal, stone, and tooth particles of both sizes. However, CBCT was better for detecting glass particles in the periosteum. Although both imaging modalities visualized plastic particles poorly, CT was slightly better for detecting plastic particles, especially the smaller ones. Conclusion: Considering the lower patient radiation dose and cost, CBCT can be used with almost equal accuracy as CT for detecting foreign bodies of different compositions and sizes in multiple maxillofacial regions. However, CT performed better for detecting plastic particles.