Do Artifacts From Dental Implants Impair the Diagnosis of Simulated Internal Root Resorption in Cone‐Beam CT?
Matheus Sampaio‐Oliveira, Fernanda Bulhões Fagundes, Luiz Eduardo Marinho‐Vieira, Rubens Spin‐Neto, Matheus L. OliveiraABSTRACT
Objectives
To evaluate the influence of artifacts generated by dental implants on the diagnosis of simulated internal root resorption (IRR) in cone‐beam computed tomography (CBCT), considering implant number and composition.
Materials and Methods
Thirty‐five single‐rooted teeth were allocated into two groups: with simulated IRR ( n = 15) and without IRR ( n = 20). IRR was simulated using 37% hydrochloric acid for 3 h. Teeth were inserted into a human maxilla and scanned with two CBCT units (Axeos—Dentsply Sirona, Germany and X1—Copenhagen Imaging, Copenhagen) under three conditions: control, one adjacent implant, and two adjacent implants composed of titanium or zirconia. Three blinded observers independently assessed the CBCT volumes for IRR using a 5‐point scale. After 30 days, 15% of volumes were re‐evaluated. Sensitivity, specificity, and area under the curve (AUC) were calculated. Two‐way ANOVA with Tukey post hoc tests analyzed the effects of implant number and composition ( α = 0.05). Weighted Kappa assessed intra‐ and inter‐observer agreement.
Results
Intra‐ and inter‐observer agreements ranged from 0.84 to 0.93 and 0.83–0.84, respectively. For Axeos, two zirconia implants significantly reduced sensitivity and AUC compared with control ( p < 0.05) and titanium implants ( p < 0.05). For X1, two zirconia implants reduced sensitivity and AUC ( p < 0.05), while two titanium implants reduced specificity compared with control, one titanium, and two zirconia conditions ( p < 0.05).
Conclusions
The presence of dental implants, particularly two zirconia implants, reduces the detection of IRR in CBCT.