Abstract
THE IMPACT OF METAL ARTIFACTS ON IMAGE QUALITY IN CBCT SECTIONS

Andreea B?lu??, Anca-Oana Dragomirescu, Maria-Angelica Bencze, Adriana Vasilache*, Ioana Suciu and Ecaterina Ionescu

ABSTRACT

For a successful rehabilitation by dental implant, both preoperative surgical planning and postoperative evaluation are important. Cone beam computed tomography (CBCT) is recommended by many oral radiology guidelines as a preoperative examination for dental implant planning, while other guidelines recommend the use of this type of investigation only in situations where there are clinical uncertainties regarding the shape of the bone or the anatomical boundaries. The aim of this study is to quantify the formation of metal artifacts in CBCT sections produced by titanium dental implants inserted in different maxillary or mandibular regions, the influence of implant position at field of view (FOV) and the impact on CBCT image quality. The CBCT images used in this study were selected from the documentation of a private practice in Bucharest and the retrospective study was in accordance with the Helsinki Declaration of 1975. A total of 80 titanium dental implants were evaluated. Comparison of mandibular and maxillary metal artifacts using the Mann-Whitney test showed that there was no significant difference in the number of artifacts. When evaluating the number of artifacts related to implants inserted in the anterior and posterior regions, implants in the frontal region showed significantly more artifacts in all images. Implants placed alone or in the vicinity of other implants did not cause a significant difference in comparison (P > 0.05), nor did the evaluation of implants located centrally or peripherally in FOV. Kruskal-Wallis and Tukey tests revealed a statistically significantly greater difference in artifacts observed in cervical images compared to apical or middle images. Early detection of bone changes around the implant can prevent redundant, unnecessarily extended treatment and can reduce the risk of complications related to implant loss. It is essential to develop research that associates the number of artifacts with diagnostic accuracy until the actual level of interference of these unwanted images with clinical dental practice is found, as the need to improve resolution, including CNR, must be assessed in relation to increasing patient exposure to radiation.

Keywords: dental implant, artifacts, cone beam computed tomography (CBCT), Mann-Whitney test, Tukey test.


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