Diagnosis of external root resorption in teeth close and distant to zirconium implants: influence of acquisition parameters and artefacts produced during cone beam computed tomography

Abstract

Aim

To assess the influence of artefacts, the metal artifact reduction (MAR) tool and kilovoltage (kVp) on the diagnosis of simulated external root resorption (ERR) in teeth close and distant to zirconium implants in cone beam computed tomography (CBCT) images.

Methodology

Cavities (0.62 mm in diameter and 0.19 mm deep) were created in the apical thirds of 12 roots on the buccal, lingual, distal or mesial surface; ten roots served as controls. The roots were randomly positioned in the first and second right and left pre‐molar sockets of a dry human mandible and a zirconium implant was placed in the socket of the first right molar. A ProMax 3D unit varying kVp (70, 80, or 90 kVp) and with the MAR tool activated or not was used to obtain CBCT scans. Five examiners evaluated all images to determine the area under the receiver operating characteristic (ROC) curve, sensitivity, and specificity.

Results

The ROC values and sensitivity were not affected by MAR or artefacts regardless of the distance to the implant (p>0.05), while increasing kVp from 70 to 90 led to a significant increase in these values (p=0.0202 and 0.0199, respectively). Specificity was not affected by the factors studied (p>0.05).

Conclusions

Among the factors studied, only kVp influenced the diagnosis of simulated external root resorption in CBCT images. Increasing kVp from 70 to 90 improved the accuracy in diagnosing the simulated lesions.

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