Assessment of Cone-beam Computed Tomographic Artifacts from Different Intracanal Materials on Birooted Teeth

Introduction: This study quantitatively evaluated the type and amount of image artifacts generated by different intracanal materials in birooted teeth scanned at different exposure parameters. Methods: The sample consisted of 15 birooted premolars. Seven different intracanal material combinations were used in each tooth one at a time: (1) roots without intracanal materials, (2) roots with gutta-percha, (3) a buccal root with gutta-percha and a lingual root with a fiberglass post, (4) a buccal root with gutta-percha and a lingual root with a metal core fiberglass post, (5) buccal and lingual roots with fiberglass posts, (6) buccal and lingual roots with metal core fiberglass posts, and (7) buccal and lingual roots with NiCr metal posts. Cone-beam computed tomographic scans were acquired using a CS 9000 unit (Carestream Dental, Atlanta, GA). An image of each tooth was captured under 5 exposure parameters: 2.5, 4, 6.3, 8, and 12 mA. The voxel size, field of view, and tube voltage were fixed at 0.076 mm, 5 × 3.75 cm, and 75 kV. We assessed each artifact quantitatively using ImageJ's threshold tool (National Institutes of Health, Bethesda, MD) to determine the hypodense and hyperdense artifact areas within 8-bit images extracted from the scans. All analyses were conducted with a 95% confidence level (α <0.05). Results: The inferential analysis showed that roots filled with metal posts presented the highest amount of hypodense and hyperdense artifacts, whereas fiberglass post in both roots presented fewer artifacts. All materials presented more hypodense than hyperdense artifact formation. Overall, the low-exposure settings presented fewer artifacts and higher values of preserved dental images. Conclusions: Low-exposure protocols and fiberglass posts presented fewer image artifacts in CBCT scans.