Dental implants and the mandibular canal: influence of metal artifact reduction in the diagnostic with cone-beam computed tomography

• Autor(a) principal: Motta, Raphael Jurca Gonçalves da
• Data de Publicação: 2023
• Tipo de documento: Tese
• Idioma: eng
• Título da fonte: Biblioteca Digital de Teses e Dissertações da USP
• Texto Completo: https://www.teses.usp.br/teses/disponiveis/58/58131/tde-23102023-165255/
• topic: Canal mandibular; Cone-beam computed tomography; Dental implants; Diagnostic imaging; Diagnóstico por imagem; Implantes dentais; Mandibular canal; Tomografia computadorizada de feixe cônico

The aim of this study was to evaluate the influence of Metal Artefact Reduction (MAR) in the diagnosis of dental implants regarding the mandibular canal (MC) using Cone Beam Computed Tomography (CBCT). Guided dental implants were installed in each hemiarch of ten dried human mandibles in the region of lower first molar: 0.5mm superior to the MC cortical (upMC/n=8) and 0,5mm inside the MC (inMC/n=10). Mandibles were included in ballistic gelatin and scanned with two CBCT devices under defined setups: fixed 90 kVp, MAR ON and OFF, and different tube currents (4mA, 8mA and 10mA). Two Dentomaxillofacial Radiologists (DMFR) and two Doctor of Dental Surgery (DDS) examined the images and scored (1-5 scale) the relation between the dental implant and MC. Data were analyzed for sensitivity, specificity and accuracy. Fisher test was used to consider MAR, examiners, mA and CBCT devices as factors of variation. DDS and DMFR examiners were observed through Kappa considering the interexaminer and intraexaminer agreement with the real contact between the implant and MC (confidence level of 95%). Specificity was overall higher than sensitivity for both DDS and DMFR. MAR activation did not affect the sensitivity and decreased it depending on CBCT device and examiner; intraexaminer agreement was higher for DMFR compared to the DDS. Interexaminer agreement was overall poor. Due to the limited efficacy of MAR, it should not be used when conducting CBCT scans for the evaluation of contact between the implant and the mandibular canal.