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. 2024 Apr 29;53(4):233-239.
doi: 10.1093/dmfr/twae008.

Effect of metal artefact reduction level on the assessment of dental implant positioning by cone-beam computed tomography

Camila Porto Capel  1 , Raphael Jurca Gonçalves da Motta  1 , Ruben Pauwels  2   3 , Hugo Gaêta-Araujo  4 , Christiano Oliveira-Santos  5 , Camila Tirapelli  1
Affiliations

Effect of metal artefact reduction level on the assessment of dental implant positioning by cone-beam computed tomography

Camila Porto Capel et al. Dentomaxillofac Radiol. .

Abstract

Objectives: This study evaluated the effect of metal artefact reduction (MAR) level and tube current on the assessment of dental implant positioning relative to the mandibular canal (MC) through cone-beam computed tomography (CBCT).

Methods: Titanium dental implants were placed in dried mandibles at 0.5-mm superior to the MC (group 1/n = 8) and 0.5-mm inside the MC with perforation of the cortex (group 2/n = 10). CBCT scans were obtained with different levels of MAR (off, medium, and high) and 2 tube currents (4 and 8 mA). Four examiners analysed the images and scored the contact between the implant and the MC using a 5-point scale. Sensitivity, specificity, area under receiver operating characteristic curve (ROC), and frequency of scores were calculated. Data were compared with analysis of variance 2-way and Tukey's test and scores with Chi-square test.

Results: Specificity and area under ROC curve decreased significantly when MAR level was high compared with MAR-medium and MAR-off. The frequency of score 3 (inconclusive) was the highest, and scores 1 and 5 (definitely no contact and definitely contact, respectively) were the lowest with MAR-high, regardless of the tube current. When MAR was off, there were higher frequencies of scores 1 and 5.

Conclusions: The level of MAR influences the assessment of the relationship between the dental implant and the MC. MAR-high led to lower diagnostic accuracy compared with MAR-medium and off.

Advances in knowledge: This article shows that high level of MAR can interfere in the diagnostic of dental implant positioning relative to the MC, decreasing its accuracy.

Keywords: artefacts; cone-beam computed tomography; dental implant; mandibular canal; metal artefact reduction.

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Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Illustration of the study design.
Figure 2.
Figure 2.
Illustrative images of the sagittal and coronal views of implants in group 1 (no contact of the implant in the mandibular canal) and group 2 (perforation of the mandibular canal with the implant), at different MAR levels (MAR-off, medium and high) and tube currents (4 and 8 mA). MAR = metal artefact reduction.
Figure 3.
Figure 3.
Receiver operating characteristic (ROC) curves for each scan protocol.
Figure 4.
Figure 4.
Absolute and relative frequencies of scores from the professionals' assessments according to a 5-point scale, regarding the contact of the implant with de MC interior (1. Definitely no contact of the implant with MC interior; 2. Probably no contact of the implant with MC interior; 3. Inconclusive; 4. Probably contact of the implant with MC interior; 5. Definitely contact of the implant with MC interior). The Chi-square test indicated statistical differences between the scores (P < .001).
See this image and copyright information in PMC

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