Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
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Effect of cone-beam computed tomography metal artefact reduction on incomplete subtle vertical root fractures

  • Received : 2022.06.13
  • Accepted : 2022.10.18
  • Published : 2023.03.31
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Abstract

Purpose: This study compared the accuracy of detection of incomplete vertical root fractures (VRFs) in filled and unfilled teeth on cone-beam computed tomography images with and without a metal artefact reduction (MAR) algorithm. Materials and Methods: Forty single-rooted maxillary premolars were selected and, after endodontic instrumentation, were categorized as unfilled teeth without fractures, filled teeth without fractures, unfilled teeth with fractures, or filled teeth with fractures. Each VRF was artificially created and confirmed by operative microscopy. The teeth were randomly arranged, and images were acquired with and without the MAR algorithm. The images were evaluated with OnDemand software (Cybermed Inc., Seoul, Korea). After training, 2 blinded observers each assessed the images for the presence and absence of VRFs 2 times separated by a 1-week interval. P-values<0.05 were considered to indicate significance. Results: Of the 4 protocols, unfilled teeth analysed with the MAR algorithm had the highest accuracy of incomplete VRF diagnosis (0.65), while unfilled teeth reviewed without MAR were associated with the least accurate diagnosis (0.55). With MAR, an unfilled tooth with an incomplete VRF was 4 times more likely to be identified as having an incomplete VRF than an unfilled tooth without this condition, while without MAR, an unfilled tooth with an incomplete VRF was 2.28 times more likely to be identified as having an incomplete VRF than an unfilled tooth without this condition. Conclusion: The use of the MAR algorithm increased the diagnostic accuracy in the detection of incomplete VRF on images of unfilled teeth.

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References

  1. Neves FS, Freitas DQ, Campos PS, Ekestubbe A, Lofthag-Hansen 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
  2. Gao A, Cao D, Lin Z. Diagnosis of cracked teeth using cone-beam computed tomography: literature review and clinical experience. Dentomaxillofac Radiol 2021; 50: 20200407.
  3. Ozer SY. Detection of vertical root fractures of different thicknesses in endodontically enlarged teeth by cone beam computed tomography versus digital radiography. J Endod 2010; 36: 1245-9. https://doi.org/10.1016/j.joen.2010.03.021
  4. De Martin E Silva D, Campos CN, Pires Carvalho AC, Devito KL. Diagnosis of mesiodistal vertical root fractures in teeth with metal posts: influence of applying filters in cone-beam computed tomography images at different resolutions. J Endod 2018; 44: 470-74. https://doi.org/10.1016/j.joen.2017.08.030
  5. Dias DR, Iwaki LC, de Oliveira AC, Martinhao FS, Rossi RM, Araujo MG, et al. Accuracy of high-resolution small-volume cone-beam computed tomography in the diagnosis of vertical root fracture: an in vivo analysis. J Endod 2020; 46: 1059-66. https://doi.org/10.1016/j.joen.2020.04.015
  6. Gulibire A, Cao Y, Gao A, Wang C, Wang T, Xie X, et al. Assessment of true vertical root fracture line in endodontically treated teeth using a new subtraction software - a micro-CT and CBCT study. Aust Endod J 2021; 47: 290-7. https://doi.org/10.1111/aej.12476
  7. Aristizabal-Elejalde D, Arriola-Guillen LE, Aliaga-Del Castillo A, Ruiz-Mora GA, Rodriguez-Cardenas YA. Assessment of fractures in endodontically treated teeth restored with and without root canal posts using high-resolution cone beam computed tomography. J Clin Exp Dent 2020; 12: e547-54. https://doi.org/10.4317/jced.56854
  8. Khedmat S, Rouhi N, Drage N, Shokouhinejad N, Nekoofar MH. Evaluation of three imaging techniques for the detection of vertical root fractures in the absence and presence of gutta-percha root fillings. Int Endod J 2012; 45: 1004-9. https://doi.org/10.1111/j.1365-2591.2012.02062.x
  9. Coelho-Silva F, Martins LA, Braga DA, Zandonade E, Haiter-Neto F, de-Azevedo-Vaz SL. Influence of windowing and metal artefact reduction algorithms on the volumetric dimensions of five different high-density materials: a cone-beam CT study. Dentomaxillofac Radiol 2020; 49: 20200039.
  10. Queiroz PM, Santaella GM, Groppo FC, Freitas DQ. Metal artifact production and reduction in CBCT with different numbers of basis images. Imaging Sci Dent 2018; 48: 41-4. https://doi.org/10.5624/isd.2018.48.1.41
  11. 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
  12. Freitas DQ, Fontenele RC, Nascimento EH, Vasconcelos TV, Noujeim M. Influence of acquisition parameters on the magnitude of cone beam computed tomography artifacts. Dentomaxillofac Radiol 2018; 47: 20180151.
  13. Bechara B, Moore WS, McMahan 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
  14. 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
  15. Oliveira MR, Sousa TO, Caetano AF, de Paiva RR, Valladares-Neto J, Yamamoto-Silva FP, et al. Influence of CBCT metal artifact reduction on vertical radicular fracture detection. Imaging Sci Dent 2021; 51: 55-62. https://doi.org/10.5624/isd.20200191
  16. Yared G. Canal preparation using only one Ni-Ti rotary instrument: preliminary observations. Int Endod J 2008; 41: 339-44. https://doi.org/10.1111/j.1365-2591.2007.01351.x
  17. van der Sluis LW, Vogels MP, Verhaagen B, Macedo R, Wesselink PR. Study on the influence of refreshment/activation cycles and irrigants on mechanical cleaning efficiency during ultrasonic activation of the irrigant. J Endod 2010; 36: 737-40. https://doi.org/10.1016/j.joen.2009.12.004
  18. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-74. https://doi.org/10.2307/2529310
  19. Makins SR. Artifacts interfering with interpretation of cone beam computed tomography images. Dent Clin North Am 2014; 58: 485-95. https://doi.org/10.1016/j.cden.2014.04.007
  20. 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
  21. Hekmatian E, Karbasi Kheir M, Fathollahzade H, Sheikhi M. Detection of vertical root fractures using cone-beam computed tomography in the presence and absence of gutta-percha. ScientificWorldJournal 2018; 2018: 1920946.
  22. Marinho Vieira LE, Diniz de Lima E, Peixoto LR, Oliveira Pinto MG, Sousa Melo SL, Oliveira ML, et al. Assessment of the influence of different intracanal materials on the detection of root fracture in birooted teeth by cone-beam computed tomography. J Endod 2020; 46: 264-70. https://doi.org/10.1016/j.joen.2019.10.028
  23. Dalili Kajan Z, Taramsari M, Khosravi Fard N, Khaksari F, Moghasem Hamidi F. The efficacy of metal artifact reduction mode in cone-beam computed tomography images on diagnostic accuracy of root fractures in teeth with intracanal posts. Iran Endod J 2018; 13: 47-53.
  24. Koc C, Kamburoglu K, Sonmez G, Yilmaz F, Gulen O, Karahan S. Ability to detect endodontic complications using three different cone beam computed tomography units with and without artefact reduction modes: an ex vivo study. Int Endod J 2019; 52: 725-36. https://doi.org/10.1111/iej.13051
  25. Ferreira LM, Visconti MA, Nascimento HA, Dallemolle RR, Ambrosano GM, Freitas DQ. Influence of CBCT enhancement filters on diagnosis of vertical root fractures: a simulation study in endodontically treated teeth with and without intracanal posts. Dentomaxillofac Radiol 2015; 44: 20140352.
  26. Nikbin A, Dalili Kajan Z, Taramsari M, Khosravifard N. Effect of object position in the field of view and application of a metal artifact reduction algorithm on the detection of vertical root fractures on cone-beam computed tomography scans: an in vitro study. Imaging Sci Dent 2018; 48: 245-54. https://doi.org/10.5624/isd.2018.48.4.245
  27. Guo XL, Li G, Zheng JQ, Ma RH, Liu FC, Yuan FS, et al. Accuracy of detecting vertical root fractures in non-root filled teeth using cone beam computed tomography: effect of voxel size and fracture width. Int Endod J 2019; 52: 887-98. https://doi.org/10.1111/iej.13076
  28. 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
  29. Zhang L, Wang T, Cao Y, Wang C, Tan B, Tang X, et al. In vivo detection of subtle vertical root fracture in endodontically treated teeth by cone-beam computed tomography. J Endod 2019; 45: 856-62. https://doi.org/10.1016/j.joen.2019.03.006
  30. Rivera EM, Walton RE. Longitudinal tooth fractures: findings that contribute to complex endodontic diagnoses. Endod Topics 2007; 16: 82-111. https://doi.org/10.1111/j.1601-1546.2009.00243.x
  31. Tsesis I, Rosen E, Tamse A, Taschieri S, Kfir A. Diagnosis of vertical root fractures in endodontically treated teeth based on clinical and radiographic indices: a systematic review. J Endod 2010; 36: 1455-8. https://doi.org/10.1016/j.joen.2010.05.003
  32. Hassan B, Metska ME, Ozok AR, van der Stelt P, Wesselink PR. Detection of vertical root fractures in endodontically treated teeth by a cone beam computed tomography scan. J Endod 2009; 35: 719-22. https://doi.org/10.1016/j.joen.2009.01.022
  33. Yuan M, Gao AT, Wang TM, Liang JH, Aihemati GB, Cao Y, et al. Using meglumine diatrizoate to improve the accuracy of diagnosis of cracked teeth on cone-beam CT images. Int Endod J 2020; 53: 709-14. https://doi.org/10.1111/iej.13270
  34. Kapralos V, Koutroulis A, Irinakis E, Kouros P, Lyroudia K, Pitas I, et al. Digital subtraction radiography in detection of vertical root fractures: accuracy evaluation for root canal filling, fracture orientation and width variables. An ex-vivo study. Clin Oral Investig 2020; 24: 3671-81.
  35. 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
  36. Byakova SF, Novozhilova NE, Makeeva IM, Grachev VI, Kasatkina IV. The detection of vertical root fractures in post-core restored teeth with cone-beam CT: in vivo and ex vivo. Dentomaxillofac Radiol 2019; 48: 20180327.
  37. Freitas-E-Silva A, Marmora B, Barriviera M, Panzarella FK, Raitz R. CBCT performance and endodontic sealer influence in the diagnosis of vertical root fractures. J Contemp Dent Pract 2019; 20: 552-6. https://doi.org/10.5005/jp-journals-10024-2556
  38. Chavda R, Mannocci F, Andiappan M, Patel S. Comparing the in vivo diagnostic accuracy of digital periapical radiography with cone-beam computed tomography for the detection of vertical root fracture. J Endod 2014; 40: 1524-9. https://doi.org/10.1016/j.joen.2014.05.011
  39. 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
  40. 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
  41. Caetano AP, Sousa TO, Oliveira MR, Evanglista K, Bueno JM, Silva MA. Accuracy of three cone-beam CT devices and two software systems in the detection of vertical root fractures. Dentomaxillofac Radiol 2021; 50: 20200334.
  42. Fox A, Basrani B, Lam EW. The performance of a zirconium-based root filling material with artifact reduction properties in the detection of artificially induced root fractures using cone-beam computed tomographic imaging. J Endod 2018; 44: 828-33. https://doi.org/10.1016/j.joen.2018.02.007
  43. Diniz de Lima E, Lira de Farias Freitas AP, Mariz Suassuna FC, Sousa Melo SL, Bento PM, Pita de Melo D. Assessment of cone-beam computed tomographic artifacts from different intracanal materials on birooted teeth. J Endod 2019; 45: 209-13.e2. https://doi.org/10.1016/j.joen.2018.11.007