Artefact expression associated with several cone-beam computed tomographic machines when imaging root filled teeth.

Area of Science:

• Dental Imaging
• Radiology
• Biomedical Engineering

Background:

• Cone-beam computed tomography (CBCT) is essential for endodontic assessment.
• Gutta-percha root fillings can cause imaging artifacts, potentially impacting diagnostic accuracy.
• Understanding these artifacts is crucial for optimizing CBCT protocols.

Purpose of the Study:

• To evaluate and compare artifact patterns generated by Gutta-percha root-filled teeth across four different CBCT devices.
• To identify the prevalence and types of artifacts, including cupping, hypodense halos, and streak artifacts.
• To assess the impact of specific CBCT settings and software on artifact expression.

Main Methods:

• Ten human premolars with Gutta-percha root fillings were scanned using four CBCT devices (3D Accuitomo 170, WhiteFox, Cranex 3D, Scanora 3D) under simulated clinical conditions.
• Images were analyzed by three calibrated dentomaxillofacial radiologists for the presence of specific artifacts.
• Statistical analysis, including Kappa tests and Chi-squared tests, was used to assess observer agreement and artifact prevalence.

Main Results:

• Moderate to perfect intra- and interobserver agreement was achieved for artifact identification.
• Cupping artifact was the most frequent (70%), followed by hypodense halos (35%) and streak artifacts (16%).
• Significant differences in artifact prevalence were observed among CBCT systems, with axial slices showing more streaks. Dedicated artifact reduction modes did not significantly improve results.

Conclusions:

• The type and severity of artifacts associated with Gutta-percha root fillings vary significantly between CBCT devices.
• Further development of CBCT reconstruction algorithms is necessary to mitigate artifacts from dense dental materials.
• Optimizing image quality at low radiation doses remains a key challenge for CBCT in endodontics.