Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil.
Department of Dentistry, University Center of Espírito Santo (UNESC), Colatina, ES, Brazil.
Odontology. 2024 Jul;112(3):959-965. doi: 10.1007/s10266-023-00889-8. Epub 2024 Jan 12.
This study aimed to evaluate the influence of the metal post composition, tooth location in the dental arch, and metal artifact reduction (MAR) on vertical root fracture (VRF) diagnosis in cone beam computed tomography (CBCT). Twenty-two unirradicular premolars (12 sound and 10 fractured) and two alveolar sockets of a mandible (anterior and posterior regions) composed the sample. CBCT scans of each tooth with a metal post placed into the root canal-silver-palladium (Ag-Pd), cobalt-chromium (Co-Cr), or nickel-chromium (Ni-Cr)-were individually acquired for each mandibular region, and two conditions of MAR, using a OP300 device (Instrumentarium, Finland). Images were assessed by five evaluators independently for VRF detection. Diagnostic values were calculated and compared among all groups using multi-way ANOVA with Tukey post hoc test to investigate the effect of post material, anatomical region, and MAR on VRF diagnosis (α = 0.05). Values of area under the receiver operating curve and specificity were not influenced by the studied factors (p > 0.05). Sensitivity was influenced by the MAR in both mandibular regions (p < 0.05). In the anterior region, sensitivity values increased when the MAR was enabled, regardless of the metal post material (p < 0.05). Similar behavior was noticed in the posterior region for Ni-Cr (p < 0.05) but not for Ag-Pd and Co-Cr posts (p > 0.05). The MAR improved the sensitivity in VRF diagnosis for all tested metal posts in the mandibular anterior region and for the Ni-Cr post in the mandibular posterior region. Therefore, for images obtained in the OP300 CBCT device, activation of the MAR is suggested in these cases.
本研究旨在评估金属桩成分、牙在牙弓中的位置和金属伪影减少（MAR）对锥形束计算机断层扫描（CBCT）中垂直根折（VRF）诊断的影响。样本由 22 颗无根管的前磨牙（12 颗完好和 10 颗折断）和下颌骨的两个牙槽（前区和后区）组成。对每个带有金属桩置于根管内的牙齿（银钯（Ag-Pd）、钴铬（Co-Cr）或镍铬（Ni-Cr））进行单独的 CBCT 扫描，并使用 OP300 设备（Instrumentarium，芬兰）对每个下颌区域进行两种 MAR 条件的扫描。由五名评估员独立评估图像以检测 VRF。使用多因素方差分析和 Tukey 事后检验比较所有组的诊断值，以研究桩材料、解剖区域和 MAR 对 VRF 诊断的影响（α=0.05）。受研究因素影响，曲线下面积和特异性的值没有变化（p>0.05）。敏感性受两种下颌区域的 MAR 影响（p<0.05）。在前区，启用 MAR 时，敏感性值增加，而与金属桩材料无关（p<0.05）。在 Ni-Cr 后区也观察到类似的行为（p<0.05），但在 Ag-Pd 和 Co-Cr 桩中则没有（p>0.05）。MAR 提高了下颌骨前区所有测试金属桩和下颌骨后区 Ni-Cr 桩的 VRF 诊断的敏感性。因此，建议在 OP300 CBCT 设备获取的图像中启用 MAR。
