Abstract
ObjectivesThe current study aimed to evaluate different CBCT exposure protocols and influencing factors affecting the subjective image quality of scans taken for endodontic indications.Materials and methodsTwelve extracted teeth, comprising of two sets of maxillary molars, premolars, canines and incisors, mandibular premolars, and molars, were endodontically treated, and either received a fiber or metal post. The teeth were scanned by CBCT imaging before and after root canal treatment, and after post insertion. Each scan was performed thrice, using an ultra low dose (ULD), standard (SM), and high-resolution mode (HR), respectively. Twelve observers—4 endodontists, 4 periodontists, and 4 radiologists—assessed the subjective image quality using visual analogue scales (VAS). Potential influencing factors were evaluated including acquisition mode, observer specialty, stage of treatment, type of post, and type of tooth, using one-way ANOVA and T test.ResultsTeeth scanned with the ULD had the highest average VAS score (72.5), followed by HR (70.2), and SM (69.0) for values pooled from all teeth and observers. CBCT acquisition mode was not a significant influencing factor on the VAS scores. Observer specialty, stage of treatment, type of post, and type of tooth were significant influencing factors.ConclusionsBased on the present in vitro data, a low-dose CBCT mode seems not to negatively affect the perception of image quality.Clinical relevanceThe findings from this in vitro study demonstrate that a low-dose CBCT mode might have potential for diagnostics prior to or following endodontic treatment.
Highlights
The pitfalls of two-dimensional (2D) radiographic imaging in endodontics are well known [1]
cone beam computed tomography (CBCT) is recommended as an efficient method of studying root canal systems [14], and high-resolution settings have been recommended by the literature and manufacturers for assessment of root canal anatomy [15]
Teeth scanned with ultra low dose (ULD) had the highest average visual analogue scales (VAS) score (72.5), followed by high-resolution mode (HR) (70.2), and SM mode (69.0) for values pooled from all teeth and all observers (Table 1)
Summary
The pitfalls of two-dimensional (2D) radiographic imaging in endodontics are well known [1]. Clinicians should consider using low-dose protocols for CBCT scans when possible [12]. An established low-dose protocol for pediatric CBCT may reduce as much as 50% of radiation dose compared to the standard exposure as recommended by the manufacturer [13]. CBCT is recommended as an efficient method of studying root canal systems [14], and high-resolution settings have been recommended by the literature and manufacturers for assessment of root canal anatomy [15]. There is a need to investigate standard and lowdose protocols, based on the fact that the three imaging protocols—high resolution, standard, and low dose—have not yet been assessed and compared for their impact on subjective image quality to evaluate root canal systems prior to or after root canal treatment
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