Influence of metal artefact reduction on the diagnosis of contact between implant and mandibular canal in cone beam computed tomography: An ex‐vivo study

Abstract

Objective To evaluate the influence of metal artefact reduction (MAR) in the diagnosis of dental implant contact with the mandibular canal (MC) using cone beam computed tomography (CBCT). Methods Dental implants were installed with surgical guides in the posterior hemiarches of 10 dry human mandibles: 0.5 mm above to the MC cortex (G1/n = 8) and 0.5 mm inside the MC (G2/n = 10). The experimental set‐up was scanned with two CBCT equipment using 85 kV and 90 kV, MAR ON or OFF, and different tube currents (4 mA, 8 mA and 10 mA). Two dentomaxillofacial radiologists (DMFRs) and two dentists (DDS) scored the relation between the dental implant and MC. Descriptive statistics were used to observe the absolute frequency of scores. Sensitivity, specificity and accuracy were calculated considering the known relation between the dental implant and the MC interior. McNemar's test (α = .05) was applied to compare the diagnostic efficacy of MAR ON versus MAR OFF. Results Overall specificity was higher than sensitivity for both DDS and DMFR (97% vs. 50% and 92.0% vs. 78.0% respectively). There was a significant effect of MAR (p = .031) for DMFR in the case of contact between the dental implant with the MC interior, in which sensitivity decreased with MAR activation from 90% to 40%. DMFR observers showed a better diagnostic performance compared with the DDS observers (accuracy of 84.0% and 71.0%, respectively). Conclusions Due to the limited efficacy of MAR, it should not be used when conducting CBCT scans for the evaluation of contact between the implant and the mandibular canal.

The current role and future potential of digital diagnostic imaging in implant dentistry: A scoping review

“…In recent years, several efforts have been made to reduce metal artefacts in CBCT images, also those originating from the exomass. Even though these studies did not yet reach the clinical application (i.e., are based on in vitro or ex vivo designs), the overall conclusion is that metal artefact reduction filters and dedicated reconstruction algorithms are effective in decreasing the magnitude of CBCT metal artefacts (de Freitas et al, 2023;Fontenele et al, 2022). For exomass artefacts, however, these metal artefact-reduction approaches were not efficient (Candemil et al, 2019).…”

Performance of different cone-beam computed tomography scan modes with and without metal artifact reduction in detection of recurrent dental caries under various restorative materials

“…restorations, fillings, implants, and endodontic instruments). Different methods have been proposed for artifact reduction in CBCT scans [ 8 , 9 ]. Thus, fewer metal artifacts in the field of view (FOV) will increase the overall quality of the images while providing higher spatial resolution.…”