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. 2024 Jun 4;28(6):356.
doi: 10.1007/s00784-024-05750-y.

Influence of tube current and metal artifact reduction on the diagnosis of external cervical resorption in teeth adjacent to a dental implant in CBCT: an ex-vivo study

Thamiles Gonzalez-Passos  1 , Matheus Barros-Costa  2 , Matheus L Oliveira  2 , Deborah Queiroz Freitas  2
Affiliations

Influence of tube current and metal artifact reduction on the diagnosis of external cervical resorption in teeth adjacent to a dental implant in CBCT: an ex-vivo study

Thamiles Gonzalez-Passos et al. Clin Oral Investig. .

Abstract

Objectives: This ex-vivo study aimed to assess the influence of tube current (mA) and metal artifact reduction (MAR) on the diagnosis of early external cervical resorption (EECR) in cone-beam computed tomography (CBCT) in the presence of an adjacent dental implant.

Materials and methods: Twenty-three single-rooted teeth were sectioned longitudinally and EECR was induced using a spherical drill and 5% nitric acid in 10 teeth. Each tooth was positioned in the socket of the lower right canine of a dry human mandible and CBCT scans were acquired using 90 kVp, voxel of 0.085 mm, field of view of 5 x 5 cm, and varying tube current (4, 8 or 12 mA), MAR (enabled or disabled) and implant conditions (with a zirconia implant in the socket of the lower right first premolar or without). Five oral radiologists evaluated the presence of EECR in a 5-point scale and the diagnostic values (area under the receiver operating characteristic curve - AUC, sensitivity, and specificity) were compared using multi-way Analysis of Variance (α = 0.05). Kappa test assessed intra-/inter-evaluator agreement.

Results: The tube current only influenced the AUC values in the presence of the implant and when MAR disabled; in this case, 8 mA showed lower values (p<0.007). MAR did not influence the diagnostic values (p>0.05). In general, the presence of an implant reduced the AUC values (p<0.0001); sensitivity values with 8 mA and MAR disabled, and specificity values with 4 mA and MAR enabled and 8 mA regardless MAR were also decreased (p<0.0001).

Conclusions: Variations in tube current and MAR were unable to improve EECR detection, which was impaired by the presence of an adjacent implant.

Clinical relevance: Increasing tube current or activating MAR tool does not improve EECR diagnosis, which is hampered by the artifacts generated by dental implants.

Keywords: Artifacts; Cone-beam computed tomography; Endodontics; Root resorption.

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