Effect of Dental Implant Metal Artifacts on Accuracy of Linear Measurements by Two Cone-beam Computed Tomography Systems Before and After Crown Restoration

  • Hoorieh Bashizadeh Fakhar Assistant Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
  • Roxana Rashtchian Postgraduate Student, Department of Oral and Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
  • Milad Parvin Postgraduate student, Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
Keywords: Artifacts, Cone-Beam Computed Tomography, Dental Implants

Abstract

Objectives: The aim of this study was to determine the impact of fixture location and crown restoration on the accuracy of linear measurements by two cone-beam computed tomography (CBCT) systems.

Materials and Methods: Six dental implants were inserted in a dry human mandible in two stages. CBCT images were obtained in each stage by Alphard VEGA 3030 and Promax 3D Max systems. Imaging procedures were repeated after metallic crown placement. Two observers measured the alveolar height and width using five radiopaque markers. Values were compared to the same measurements made on initial images (prior to implant insertion) using t-test. The linear regression test was used to evaluate the effect of implant location on the accuracy of linear measurements.

Results: The impact of fixture and fixture-crown combination on the accuracy of linear measurements of height (t = -5.2, P=0.0001 and t=-5.98, P<0.0001, respectively) and width (t=-3.42, P=0.004 and t= -2.7, P=0.015, respectively) was significantly underestimated. Metal crowns had no significant effect on measurements of bone height and width (t=-1.38, P=0.19 and t=0, P=1.00, respectively). Although both systems showed some underestimations, Promax 3D Max underestimated bone width significantly more than the other system (Alphard VEGA 3030=- 0.51mm and Promax 3D Max=-0.80). Regarding implant location, the measurements in the canine sites were found to be more accurate than the region between adjacent implants.

Conclusions: CBCT is an accurate and reproducible system for dental implant follow-up examinations. Metal artifacts can lead to underestimation of measurements. However, this was not statistically significant in our study.

References

- Parsa A, Ibrahim N, Hassan B, Syriopoulos K, van der Stelt P. Assessment of metal artefact reduction around dental titanium implants in cone beam CT. Dentomaxillofac Radiol 2014,43(7):20140019.

- Bornstein MM, Horner K, Jacobs R. Use of cone beam computed tomography in implant dentistry: current concepts, indications and limitations for clinical practice and research. Periodontol 2000. 2017 Feb;73(1):51-72.

- Jaju PP, Jain M, Singh A, Gupta A. Artefacts in cone beam CT. Open J Stomatol 2013 Jul 24;3(05):292.

- Schulze R, Heil U, Gross D, Bruellmann DD, Dranischnikow E, Schwanecke U, et al. Artefacts in CBCT: a review. Dentomaxillofac Radiol 2011 Jul,40(5):265-73.

- Esmaeili F, Johari M, Haddadi P, Vatankhah M. Beam hardening artifacts: comparison between two cone beam computed tomography scanners. J Dent Res Dent Clin Dent Prospects 2012,6(2):49-53.

- Panjnoush M, Kheirandish Y, Kashani PM, Fakhar HB, Younesi F, Mallahi M. Effect of Exposure Parameters on Metal Artifacts in Cone Beam Computed Tomography. J Dent (Tehran) 2016 Jun,13(3):143.

- Chindasombatjaroen J, Kakimoto N, Murakami S, Maeda Y, Furukawa S. Quantitative analysis of metallic artifacts caused by dental metals: comparison of cone-beam and multi-detector row CT scanners. Oral Radiol 2011 Dec,27(2):114-120.

- Sullivan P, Smith J, Rozzelle A. Cranio-orbital Reconstruction: Safety and image quality of metallic implants on CT and MRI scanning. J Ophthalmic Plast Reconstr Surg 1994 Oct;94(5):589-96.

- Dalal T, Kalra MK, Rizzo SM, Schmidt B, Suess C, Flohr T, et al. Metallic prosthesis: Technique to avoid increase in CT radiation dose with automatic tube current modulation in a phantom and patients. Radiology. 2005 Aug;236(2):671-5.

- Barrett JF, Keat N. Artifacts in CT: recognition and avoidance. Radiographics. 2004 Nov-Dec;24(6):1679-91.

- Schulze R, Heil U, Groβ D, Bruellmann D, Dranischnikow E, Schwanecke U, et al. Artefacts in CBCT: a review. Dentomaxillofac Radiol 2014,40(5):265-273.

- Schulze RKW, Berndt D, d'Hoedt B. On cone‐beam computed tomography artifacts induced by titanium implants. Clin Oral Implants Res. 2010 Jan;21(1):100-7.

- Bechara BB, Moore WS, McMahan CA, Noujeim M. Metal artefact reduction with cone beam CT: an in vitro study. Dentomaxillofac Radiol. 2012 Mar;41(3):248-53.

- Gong X, Meyer E, Yu X, Sun J, Sheng L, Huang K, et al. Clinical evaluation of the normalized metal artefact reduction algorithm caused by dental fillings in CT. Dentomaxillofac Radiol. 2013;42(4): 20120105.

- Ibraheem I. Reduction of artifacts in dental cone beam CT images to improve the three dimensional image reconstruction. J Biomed Sci Eng 2012 Jul,5(08):409.

- Bechara B, McMahan CA, Geha H, Noujeim M. Evaluation of a cone beam CT artefact reduction algorithm. Dentomaxillofac Radiol 2012 Jul,41(5):422-8.

- Mangione F, Meleo D, Talocco M, Pecci R, Pacifici L, Bedini R. Comparative evaluation of the accuracy of linear measurements between cone beam computed tomography and 3D microtomography. Ann Ist Super Sanita. 2013;49(3):261-5.

- Patcas R, Markic G, Muller L, Ullrich O, Peltomaki T, Kellenberger CJ, et al. Accuracy of linear intraoral measurements using cone beam CT and multidetector CT: a tale of two CTs. Dentomaxillofac Radiol. 2012 Dec;41(8):637-44.

- Winter AA, Pollack AS, Frommer HH, Koenig L. Cone beam volumetric tomography vs. medical CT scanners. N Y State Dent J. 2005 Jun-Jul;71(4):28-33.

- White SC, Pharoah MJ. Oral radiology: principles and interpretation. 7th Ed., St. Louis, Missouri, Elsevier-Mosby, 2014:194.

- Safi Y, Kadkhodazadeh M, Nejad AE, Vasegh Z, Amid R, Reza H. Reliability and reproducibility of linear measurements of alveolar ridges using cone-beam CT made by radiologists and periodontists. J Periodontol 2015,7(2):35-8.

- Moshfeghi M, Tavakoli MA, Hosseini ET, Hosseini AT, Hosseini IT. Analysis of linear measurement accuracy obtained by cone beam computed tomography (CBCT-NewTom VG). Dent Res J (Isfahan) 2012 Dec,9(Suppl 1):S57.

- Berco M, Rigali PH, Miner RM, DeLuca S, Anderson NK, Will LA. Accuracy and reliability of linear cephalometric measurements from cone-beam computed tomography scans of a dry human skull. Am J Orthod Dentofacial Orthop 2009 Jul;136(1):17-e1.

- Lascala C, Panella J, Marques M. Analysis of the accuracy of linear measurements obtained by cone beam computed tomography (CBCT-NewTom). Dentomaxillofac Radiol 2004 Sep;33(5):291-4.

- Creed B, Kau CH, English JD, Xia JJ, Lee RP. A comparison of the accuracy of linear measurements obtained from cone beam computerized tomography images and digital models. Semin Orthod.

Mar;17(1):49-56.

- Loubele M, Van Assche N, Carpentier K, Maes F, Jacobs R, van Steenberghe D, et al. Comparative localized linear accuracy of small-field cone-beam CT and multislice CT for alveolar bone measurements. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008 Apr,105(4):512-8.

- Baumgaertel S, Palomo JM, Palomo L, Hans MG. Reliability and accuracy of cone-beam computed tomography dental measurements. Am J Orthod Dentofacial Orthop 2009 Jul,136(1):19-25.

- Kuusisto N, Vallittu P, Lassila L, Huumonen S. Evaluation of intensity of artefacts in CBCT by radio-opacity of composite simulation models of implants in vitro. Dentomaxillofac Radiol 2014 Nov,44(2):20140157.

- Liedke GS, Spin‐Neto R, Silveira HE, Schropp L, Stavropoulos A, Wenzel A. Factors affecting the possibility to detect buccal bone condition around dental implants using cone beam computed tomography.

Clin Oral Implant Res 2017 Sep,28(9):1082-8.

- Brown AA, Scarfe WC, Scheetz JP, Silveira AM, Farman AG. Linear accuracy of cone beam CT derived 3D images. Angle orthod 2009 Jan,79(1):150-7.

- Neves FS, Vasconcelos TV, Campos PS, Haiter‐Neto F, Freitas DQ. Influence of scan mode (180/360) of the cone beam computed tomography for preoperative dental implant measurements. Clin Oral Implant Res 2014 Feb,25(2):155-8.

- Leung CK, Pow EH, Li TK, Lo E, Chow TW. Accuracy of radiographic measurements for implant planning using cone‐beam and helical computer tomography. J Investig Clin Dent 2017 Aug,8(3).

- Razavi T, Palmer RM, Davies J, Wilson R, Palmer PJ. Accuracy of measuring the cortical bone thickness adjacent to dental implants using cone beam computed tomography. Clin Oral Implants Res. 2010 Jul;21(7):718-25.

Published
2017-12-16
How to Cite
1.
Bashizadeh Fakhar H, Rashtchian R, Parvin M. Effect of Dental Implant Metal Artifacts on Accuracy of Linear Measurements by Two Cone-beam Computed Tomography Systems Before and After Crown Restoration. Front Dent. 14(6):329-336.
Section
Original Article