Influence of orthodontic brackets and permanent retainers on the diagnostic image quality of MRI scans: A preliminary study.

Praveen Kumar Neela,Mohammed Wahajuddin Syed,Pavan Kumar Mamillapalli,Sreekanth Keesara,Venkat Kishan,Vasu Murthy Sesham

doi:10.17219/dmp/132390

Praveen Kumar Neela, Mohammed Wahajuddin Syed + Show 4 more

Open Access

https://doi.org/10.17219/dmp/132390

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Abstract

Orthodontic treatment with fixed mechanotherapy using appliances and permanent retainers bonded after treatment is a routine procedure performed in clinical dentistry. Patients with braces or retainers sometimes need to undergo magnetic resonance imaging (MRI) for various reasons. Radiologists do not know the exact impact of the materials used in orthodontics on the diagnostic image quality of MRI scans. The aim of the study was to evaluate the influence of different types of orthodontic brackets and permanent retainers on the diagnostic image quality of MRI scans. Twenty patients with bonded brackets (stainless steel buccal/labial, stainless steel lingual, ceramic self-ligating with metal slots, ceramic, and polycarbonate) and 18 patients with bonded fixed retainers (titanium, fiber-reinforced composite, multi-stranded stainless steel, and different combinations of permanent retainers) participated in the study. The same adhesive was used for bonding. Cranial MRI scans of 6 regions were acquired for each subject, using a 1.5T MAGNETOM machine. Six radiologists evaluated the images and provided scores based on the modified receiver operating characteristic (ROC) analysis of distortion. The paired Wilcoxon signed-rank test was used to assess differences between the materials and the anatomic sites with regard to the distortion rating scale. Cohen's kappa coefficient (κ) was applied to establish the interrater reliability. A statistically significant difference was found between stainless steel brackets (both buccal/ labial and lingual) and all other experimental materials in terms of mean distortion scores (p = 0.020 or p = 0.024). The interrater reliability proved to be high. Stainless steel buccal/labial and lingual brackets caused maximum distortion of the images, which became non-diagnostic; hence, such brackets should be removed before MRI. Ceramic and polycarbonate brackets as well as fiber-reinforced composite retainers did not distort the images; thus, they need not be removed. Ceramic self-ligating brackets with metal slots, titanium retainers, multi-stranded stainless steel retainers, and combinations of fixed retainers caused minimal distortion; however, the images were still diagnostic. Hence, patients using these materials may not need to have them removed before MRI.

Highlights

Magnetic resonance imaging (MRI) is one of the most powerful diagnostic tools in radiology
Orthodontic treatment with fixed mechanotherapy using appliances and permanent retain ers bonded after treatment is a routine procedure performed in clinical dentistry
Radiologists do not know the exact impact of the materials used in orthodontics on the diagnostic image quality of magnetic resonance imaging (MRI) scans

Summary

Introduction

Magnetic resonance imaging (MRI) is one of the most powerful diagnostic tools in radiology It is characterized by high sensitivity and specificity. The system does not use ionizing radiation, and for the majority of people there is little risk associated with the application of the magnetic field. This radiological modality is indispensable when investigating soft tissue tumors, including those of the head and neck,[1] temporomandibular joint (TMJ) pathology,[2] cardiovascular pathology,[3] seizures,[4] and cerebral palsy.[5] The number of MRI scans performed per year is steadily increasing. Radiologists do not know the exact impact of the materials used in orthodontics on the diagnostic image quality of MRI scans

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