Abstract
Cone-beam computed tomography (CBCT) imaging artifacts can hinder accurate diagnosis of several conditions. The aim of this study was to quantify CBCT artifacts created by nonmetallic root canal filling materials using two fields of view (FOV). Root canals of twenty extracted maxillary central incisors (n = 20) were instrumented and randomly divided into four equal groups: canals in Group 1 were filled with gutta-percha, canals in Group 2 with mineral trioxide aggregate (MTA) and gutta-percha, canals in Group 3 with gutta-percha and glass-fiber posts, and canals in Group 4 with MTA and glass-fiber posts. Each tooth was mounted on a silicon block and scanned three times using a CBCT machine, first with a prefilling scan (control) and then with postfilling scans, using two different FOV (40∗50 mm and 80∗50 mm). Imaging software was used to measure grayscale pixel values of canal cross sections. Data were analyzed using t-test and paired t-test statistical tests, with statistical significance set at p ≤ 0.05. Dentin at the apical and middle third of the teeth showed a significant decrease in minimum grayscale values in association with gutta-percha (p = 0.027, p = 0.034). However, a wide 80∗50 FOV showed a significant increase in maximum grayscale values of coronal (p = 0.048) and apical dentin (p = 0.049). Glass-fiber posts in middle third cross sections also corresponded to an increase in maximum grayscale values (p = 0.018). Gutta-percha produced dark band artifacts in the root's middle and apical thirds, whereas white streak artifacts were produced by gutta-percha in the coronal third and glass-fiber posts in the coronal and middle thirds when imaged with a wider FOV. A smaller FOV is therefore recommended for CBCT imaging, as it produces fewer artifacts.
Highlights
Accurate radiographic examination is necessary for successful endodontic diagnosis and treatment preparation, as well as for determining the treatment outcome
Glass-fiber posts resulted in lower maximum values when compared with gutta-percha, but a significant difference was found only for values in the middle third cross sections taken at 80 ∗ 50 fields of view (FOV) (p = 0:027)
The novelty of the present study is that it addresses the quantification of cone-beam computed tomography (CBCT) artifacts by measuring the pixel values of different nonmetallic root canal filling materials using two different FOV
Summary
Accurate radiographic examination is necessary for successful endodontic diagnosis and treatment preparation, as well as for determining the treatment outcome. Radiographic analysis in endodontics was primarily performed using conventional periapical radiography, which provides a two-dimensional (2D) depiction of three-dimensional (3D) anatomical structures. This imaging is plagued with errors due to overlapping structures and the likelihood of distortion [1]. Treated teeth are filled with a number of materials that, due to their composition, create artifacts on CBCT imaging that reduce image quality [5]. Most research has focused on assessing the effect of artifacts from metallic materials (metal posts placed in the root canal) [6,7,8]. The most common root canal filling materials are nonmetallic, most notably gutta-percha, mineral trioxide aggregate (MTA), and, more recently, glass-fiber posts, which have
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