Do the tube current and metal artifact reduction influence the diagnosis of vertical root fracture in a tooth positioned
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ORIGINAL ARTICLE
Do the tube current and metal artifact reduction influence the diagnosis of vertical root fracture in a tooth positioned in the vicinity of a zirconium implant? A CBCT study Rocharles C. Fontenele 1 & Amanda Farias Gomes 1
&
Yuri Nejaim 2 & Deborah Q. Freitas 1
Received: 8 July 2020 / Accepted: 18 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Aim To evaluate the influence of the tube current and metal artifact reduction (MAR) tool on the diagnosis of vertical root fractures (VRF) in a tooth adjacent to a zirconium implant, in cone-beam computed tomography (CBCT) images. Methodology Thirty single-rooted teeth (15 with VRF and 15 control group) were individually positioned in a mandible, and scanned with the OP300 CBCT unit. Images were acquired using a standardized protocol: 5 × 5 cm field of view, 0.08-mm voxel size, and 90 kVp. Each tooth was scanned with and without a zirconium implant in its vicinity, using different tube currents (4 mA, 8 mA, and 10 mA) and conditions of MAR (enabled × disabled). Diagnostic values were calculated for each protocol, and compared by multi-way analysis of variance. Results The ROC curve and sensitivity values did not differ significantly among the tube currents, regardless of the presence of the implant and MAR condition (p > 0.05). There were also no significant differences among the tube currents for the specificity values (p > 0.05); however, the specificity differed significantly between the “with implant” and “without implant” conditions, within the same MAR condition and tube current (p < 0.05). Specificity was significantly lower when the implant was present (p < 0.05). Conclusion The presence of a zirconium implant impairs the diagnosis of VRF in teeth adjacent to the artifact-generator material. Neither the tube current nor the MAR tool is effective in improving this diagnostic task. Therefore, in this clinical scenario, the use of the lowest tube current (4 mA), without MAR activation, is recommended. Clinical relevance Considering that the tube current is one of the main factors that influence the radiation dose and image quality in CBCT, and that metal artifacts negatively influence the diagnosis of VRF in areas adjacent to the artifact-generator material, it is important to evaluate the effect of this energetic parameter in the diagnosis of VRF in teeth adjacent to zirconium implants. Keywords Vertical root fracture . Tube current . Cone-beam computed tomography . Zirconium implant . Artifact
Introduction Vertical root fracture (VRF) is defined as an incomplete or complete fracture, longitudinally oriented, that extends Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00784-020-03538-4) contains supplementary material, which is available to authorized users. * Amanda Farias Gomes [email protected] 1
Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Avenida Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
2
Oral Radiology Ar
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