Enhancing image quality: The role of low-radiopacity bioceramic materials in CBCT scans

This study aimed to evaluate artefact expression and volumetric distortion of endodontic obturation materials with varying radiopacity in root canal-treated teeth using cone-beam computed tomography (CBCT).

The radiopacity test was performed according to ANSI/ADA standards for AH Plus sealer, Bio-C Sealer, and conventional and bioceramic cones. Upper incisors were selected and instrumented with WaveOne Gold files (45/05). Teeth were individually positioned into empty sockets of a human jaw, and CBCT scans were initially performed (control group). Each tooth was subsequently filled with different combinations of root filling materials. Mean dentin gray values, image noise, and filling material volumes were measured and segmented. Data comparisons among groups were conducted using analysis of variance and the paired t-test (α=0.05).

The conventional cone and AH Plus demonstrated the highest radiopacity. CBCT images exhibited significantly higher mean gray values, noise, and volumetric distortion for groups with conventional cones and AH Plus sealer (P<0.05).

Bioceramic materials, which had lower radiopacity, generated fewer artefacts and less volumetric distortion compared to conventional gutta-percha cones and AH Plus sealer.