Ruiz Débora Costa, de Oliveira Reis Larissa, Fontenele Rocharles Cavalcante, Miranda-Viana Murilo, Farias-Gomes Amanda, Freitas Deborah Queiroz
Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
Department of Dentistry, Federal University of Juiz de Fora Campus Governador Valadares, Governador Valadares, MG, Brazil.
Imaging Sci Dent. 2024 Sep;54(3):289-295. doi: 10.5624/isd.20240056. Epub 2024 Jul 2.
This study examined the influence of metal artifact reduction (MAR), the application of sharpening filters, and their combination on the diagnosis of horizontal root fracture (HRF) in teeth adjacent to a zirconia implant on cone-beam computed tomography (CBCT) examinations.
Nineteen single-rooted teeth (9 with HRF and 10 without) were individually positioned in the right central incisor socket of a dry human maxilla. A zirconia implant was placed adjacent to each tooth. Imaging was performed using an OP300 Maxio CBCT (Instrumentarium, Tuusula, Finland) unit with the following settings: a current of 8 mA, both MAR modes (enabled and disabled), a 5×5 cm field of view, a voxel size of 0.085 mm, and a peak kilovoltage of 90 kVp. Four oral and maxillofacial radiologists independently evaluated the CBCT scans under both MAR conditions and across 3 levels of sharpening filter application (none, Sharpen 1×, and Sharpen 2×). Diagnostic metrics were calculated and compared using 2-way analysis of variance (α=5%). The weighted kappa test was used to assess intra- and inter-examiner reliability in the diagnosis of HRF.
MAR tool activation, sharpening filter use, and their combination did not significantly impact the area under the receiver operating characteristic curve, sensitivity, or specificity of HRF diagnosis (>0.05). Intra- and inter-examiner agreement ranged from fair to substantial.
The diagnosis of HRF in a tooth adjacent to a zirconia implant is not affected by the activation of MAR, the application of a sharpening filter, or the combination of these tools.
本研究探讨了金属伪影减少（MAR）、锐化滤波器的应用及其联合使用对锥束计算机断层扫描（CBCT）检查中氧化锆种植体相邻牙齿水平根折（HRF）诊断的影响。
19颗单根牙（9颗有HRF，10颗无HRF）分别置于干燥人上颌骨的右中切牙牙槽窝内。在每颗牙齿旁边植入一颗氧化锆种植体。使用OP300 Maxio CBCT（芬兰图苏拉Instrumentarium公司）设备进行成像，设置如下：电流8 mA，两种MAR模式（启用和禁用），视野5×5 cm²，体素大小0.085 mm，峰值千伏90 kVp。四名口腔颌面放射科医生在两种MAR条件下以及三种锐化滤波器应用水平（无、锐化1倍和锐化2倍）下独立评估CBCT扫描图像。使用双向方差分析（α = 5%）计算并比较诊断指标。采用加权kappa检验评估HRF诊断中检查者内部和检查者之间的可靠性。
MAR工具激活、锐化滤波器使用及其联合使用对HRF诊断的受试者操作特征曲线下面积、敏感性或特异性均无显著影响（P>0.05）。检查者内部和检查者之间的一致性从中度到高度不等。
氧化锆种植体相邻牙齿的HRF诊断不受MAR激活、锐化滤波器应用或这些工具联合使用的影响。
