Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
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Potential impact of metal crowns at varying distances from a carious lesion on its detection on cone-beam computed tomography scans with several protocols

  • Matheus Barros-Costa (Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas) ;
  • Eduarda Helena Leandro Nascimento (Radiology Area, Dental School, University of Pernambuco) ;
  • Iago Filipe Correia-Dantas (Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas) ;
  • Matheus L. Oliveira (Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas) ;
  • Deborah Queiroz Freitas (Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas)
  • Received : 2023.09.09
  • Accepted : 2023.12.09
  • Published : 2024.03.31
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Abstract

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.

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References

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