Lagos de Melo Larissa Pereira, Queiroz Polyane Mazucatto, Moreira-Souza Larissa, Nadaes Mariana Rocha, Santaella Gustavo Machado, Oliveira Matheus Lima, Freitas Deborah Queiroz
Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
Dental Clinic Department, Division of Oral Radiology, Dental School, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.
Restor Dent Endod. 2023 Apr 27;48(2):e16. doi: 10.5395/rde.2023.48.e16. eCollection 2023 May.
The aim of this study was to evaluate the influence of peak kilovoltage (kVp) and a metal artifact reduction (MAR) tool on image quality and the diagnosis of vertical root fracture (VRF) in cone-beam computed tomography (CBCT).
Twenty single-rooted human teeth filled with an intracanal metal post were divided into 2 groups: control ( = 10) and VRF ( = 10). Each tooth was placed into the socket of a dry mandible, and CBCT scans were acquired using a Picasso Trio varying the kVp (70, 80, 90, or 99), and the use of MAR (with or without). The examinations were assessed by 5 examiners for the diagnosis of VRF using a 5-point scale. A subjective evaluation of the expression of artifacts was done by comparing random axial images of the studied protocols. The results of the diagnoses were analyzed using 2-way analysis of variance and the Tukey test, the subjective evaluations were compared using the Friedman test, and intra-examiner reproducibility was evaluated using the weighted kappa test (α = 5%).
The kVp and MAR did not influence the diagnosis of VRF ( > 0.05). According to the subjective classification, the 99 kVp protocol with MAR demonstrated the least expression of artifacts, while the 70 kVp protocol without MAR led to the most artifacts.
Protocols with higher kVp combined with MAR improved the image quality of CBCT examinations. However, those factors did not lead to an improvement in the diagnosis of VRF.
本研究旨在评估峰值千伏（kVp）和金属伪影减少（MAR）工具对锥束计算机断层扫描（CBCT）图像质量及垂直根折（VRF）诊断的影响。
将20颗单根人牙根管内填充金属桩，分为2组：对照组（n = 10）和VRF组（n = 10）。将每颗牙齿置于干燥下颌骨牙槽窝内，使用毕加索三重奏CBCT扫描仪，改变kVp（70、80、90或99）并使用或不使用MAR进行扫描。5名检查者使用5分制对VRF诊断进行评估。通过比较各研究方案的随机轴向图像，对伪影表现进行主观评价。诊断结果采用双向方差分析和Tukey检验进行分析，主观评价采用Friedman检验进行比较，检查者内重复性采用加权kappa检验进行评估（α = 5%）。
kVp和MAR对VRF诊断无影响（P > 0.05）。根据主观分类，使用MAR的99 kVp方案伪影表现最少，而不使用MAR的70 kVp方案伪影最多。
较高kVp与MAR相结合的方案可提高CBCT检查的图像质量。然而，这些因素并未改善VRF的诊断。
