EVALUATION OF CBCT SCANS WITH METALLIC ARTIFACTS FOR ASSESSMENT OF DIAGNOSTIC QUALITY

Abstract

<h3>Background</h3> Cone beam computed tomography (CBCT) is increasingly being used in dentistry for diagnosis and treatment planning. However, the presence of metals in the form of coronal restorations, implants, and endodontic post and cores results in the generation of artifacts. Beam hardening artifacts, streaks, and scatter are the main types of metallic artifacts and, when present, cause image degradation that may compromise the accuracy of diagnosis. Depending on the severity of the artifact and the diagnostic task, images may be unusable. <h3>Objective(s)</h3> The objective of this study was to retrospectively evaluate CBCT scans with metallic artifacts and assess whether or not the presence of metal affects diagnosis of a specific entity. <h3>Study Design</h3> A total of 105 scans from the archives of the Department of Oral and Maxillofacial Radiology at University of Connecticut, School of Dental Medicine, were evaluated for this study. The scans were divided into 3 groups comprising referrals for implant site evaluation, for endodontic evaluation for root canal morphologies/anatomy, and for crown/root fractures, respectively. Inclusion criteria were scans that had metallic artifacts. The scans were analyzed to determine if these artifacts positively or negatively influenced diagnosis. All images were evaluated by a radiology resident in training (K.B.) and a board certified Oral and Maxillofacial Radiologist (A.T.). <h3>Results</h3> Of the scans analyzed for implant treatment planning, 100% were deemed to be of diagnostic quality. For root canal morphology and anatomy, 94% were adequate for diagnosis, whereas 6% were not. For evaluation of fractures, 63% were adequate for diagnosis, and 37% were not adequate for diagnosis. <h3>Discussion/Conclusions</h3> In this study, a large percentage of the scans were adequate for diagnosis despite the presence of metallic artifacts except for root fractures.