Imaging Sci Dent.  2015 Sep;45(3):147-151. 10.5624/isd.2015.45.3.147.

The effect of metal artifacts on the identification of vertical root fractures using different fields of view in cone-beam computed tomography

• Moudi E
• Haghanifar S
• Madani Z
• Bijani A
• Nabavi ZS

• KMID: 2045021
• DOI: http://doi.org/10.5624/isd.2015.45.3.147

Abstract

PURPOSE
The aim of this study was to investigate the effects of metal artifacts on the accurate diagnosis of root fractures using cone-beam computed tomography (CBCT) images with large and small/limited fields of view (FOVs).
MATERIALS AND METHODS
Forty extracted molar and premolar teeth were collected. Access canals were made in all teeth using a rotary system. In half of the teeth, fractures were created by the application of mild pressure with a hammer. The teeth were then randomly put into a wax rim on an acryl base designed in the shape of a mandible. CBCT scans were obtained using a Newtom 5G system with FOVs of 18 cmx16 cm and 6 cmx6 cm. A metal pin was then placed into each tooth, and CBCT imaging was again performed using the same fields of view. All scans were evaluated by two oral and maxillofacial radiologists. The specificity, sensitivity, positive predictive value, negative predictive value, and likelihood ratios (positive and negative) were calculated.
RESULTS
The maximum levels of sensitivity and specificity (100% and 100%, respectively) were observed in smallvolume CBCT scans of teeth without pins. The highest negative predictive value was found in the small-volume group without pins, whereas the positive predictive value was 100% in all groups except the large-volume group with pins.
CONCLUSION
The specificity of CBCT decreased with the presence of a pin in the large-volume group, but not in the small-volume group.

Keyword

Cone-Beam Computed Tomography; Tooth Fractures; Artifacts; Sensitivity and Specificity

MeSH Terms

Artifacts*
Bicuspid
Cone-Beam Computed Tomography*
Diagnosis
Mandible
Molar
Sensitivity and Specificity
Tooth
Tooth Fractures

Figure

• 

  Fig. 1 Fracture lines in axial and cross-sectional cone-beam computed tomography images. A. Large volume without a pin. B. Small volume without a pin. C. Large volume with a pin. D. Small volume with a pin.

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  Fig. 2 Axial (A) and cross-sectional (B) small-volume cone-beam computed tomography images showing fractures in teeth with a pin. The fracture and the metal atrifact are shown with a straight arrow and a curved arrow, respectively.

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