Cone-beam Computed Tomographic-based Assessment of Filled C-shaped Canals: Artifact Expression of Cone-beam Computed
Jardel Francisco Mazzi-Chaves1, Karla de Faria Vasconcelos2, Ruben Pauwels3
1Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Oral and Maxillofacial Surgery, Imaging and Pathology Research Group, Faculty of Medicine, Department of Imaging and Pathology, University of Leuven, University Hospitals Leuven, Leuven, Belgium.
Introduction:
The present study investigated the assessment of root canal fillings in a series of cone-beam computed tomographic (CBCT) images obtained from endodontically treated mandibular molars with C-shaped canals.
Methods:
Clinically comparable high (HR) and normal (NR) resolution protocols were selected in 3D Accuitomo 170 (J Morita Corporation, Kyoto, Japan), NewTom VGi evo (Cefla QR Verona, Verona, Italy), ProMax 3D Max (Pro; Planmeca, Helsinki, Finland), and Pax-i3D Green Premium (Pax; Vatech, Gyeonggi, South Korea). Micro-computed tomographic and nano-computed tomographic images were considered as the reference standard. The set of images was evaluated according to beam hardening artifact patterns (dark streaks, hypodense areas, and volume distortion).
Results:
Regarding dark streaks, the Fleiss kappa test showed that Pax HR and NR and Pro HR images showed the highest artifact expression. Hypodense areas were detected in 100% and 99.1% of the images obtained using Pax HR and NR, respectively. Kappa tests showed highest distortion for images derived from the Pax and Pro CBCT devices. Root canal filling assessment was considered appropriate in 100% of the 3D Accuitomo 170 HR, NewTom VGi evo NR, micro-computed tomographic, and nano-computed tomographic images.
Conclusions:
The present study confirms the large variability in CBCT-derived artifact expression. Highlighting the increased artifact expression for particular CBCT systems, it may be concluded that for diagnosis of endodontically filled molars with C-shaped canals, the choice of CBCT unit and protocol is essential.
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