Objectives: The aim of this study was to evaluate the influence of peak kilovoltage (kVp) and a metal artifact reduction (MAR) tool on image quality and the diagnosis of vertical root fracture (VRF) in cone-beam computed tomography (CBCT). Materials and Methods: Twenty single-rooted human teeth filled with an intracanal metal post were divided into 2 groups: control (n = 10) and VRF (n = 10). Each tooth was placed into the socket of a dry mandible, and CBCT scans were acquired using a Picasso Trio varying the kVp (70, 80, 90, or 99), and the use of MAR (with or without). The examinations were assessed by 5 examiners for the diagnosis of VRF using a 5-point scale. A subjective evaluation of the expression of artifacts was done by comparing random axial images of the studied protocols. The results of the diagnoses were analyzed using 2-way analysis of variance and the Tukey post hoc test, the subjective evaluations were compared using the Friedman test, and intra-examiner reproducibility was evaluated using the weighted kappa test (α = 5%). Results: The kVp and MAR did not influence the diagnosis of VRF (p > 0.05). According to the subjective classification, the 99 kVp protocol with MAR demonstrated the least expression of artifacts, while the 70 kVp protocol without MAR led to the most artifacts. Conclusions Protocols with higher kVp combined with MAR improved the image quality of CBCT examinations. However, those factors did not lead to an improvement in the diagnosis of VRF.

PURPOSE: To evaluate the effect of different numbers of basis images and the use of metal artifact reduction (MAR) on the production and reduction of artifacts in cone-beam computed tomography images. MATERIALS AND METHODS: An acrylic resin phantom with a metal alloy sample was scanned, with 450 or 720 basis images and with or without MAR. Standard deviation values for the test areas (around the metal object) were obtained as a way of measuring artifact production. Two-way analysis of variance was used with a 5% significance level. RESULTS: There was no significant difference in artifact production among the images obtained with different numbers of basis images without MAR (P=.985). MAR significantly reduced artifact production in the test areas only in the protocol using 720 basis images (P=.017). The protocol using 450 basis images with MAR showed no significant difference in artifact production when compared to the protocol using 720 basis images with MAR (P=.579). CONCLUSION: Protocols with a smaller number of basis images and with MAR activated are preferable for minimizing artifact production in tomographic images without exposing the patient to a greater radiation dose.
Alloys ; Artifacts ; Cone-Beam Computed Tomography ; Humans ; Phantoms, Imaging

PURPOSE: This study was conducted to evaluate the effect of different spatial resolutions of a photostimulable phosphor plate (PSP) radiography system on the detection of proximal caries lesions. MATERIALS AND METHODS: Forty-five extracted human permanent teeth were radiographed using a PSP system (VistaScan Perio Plus) and scanned at the 4 resolutions (10 lp/mm, 20 lp/mm, 25 lp/mm, and 40 lp/mm) available in the system. Three independent examiners scored the images for the presence and absence of proximal caries lesions using a 5-point scale. The presence or absence of caries was confirmed by histological sections of the examined teeth (defined as the gold standard). Intra- and inter-observer reproducibility was calculated by the weighted kappa test. One-way analysis of variance with the post hoc Tukey test was used to compare the area under the receiver operating characteristic curve for the classifications made with each resolution. RESULTS: For the detection of enamel lesions, the spatial resolution of 10 lp/mm was significantly superior to the other resolutions. However, the spatial resolution did not affect the detection of caries lesions in dentin (P>0.05). CONCLUSION: Spatial resolution may influence the accuracy of the detection of incipient caries lesions in radiographs with PSP plates. Images with low spatial resolution seem to be more appropriate for this purpose.
Classification ; Dental Caries ; Dental Enamel ; Dentin ; Diagnostic Imaging ; Humans ; Radiography ; ROC Curve ; Tooth

Purpose: The purpose of this study was to evaluate the image quality, diagnostic efficacy, and radiation dose associated with the use of a cadmium telluride (CdTe) detector, compared to charge-coupled device (CCD) and complementary metal oxide semiconductor (CMOS) detectors. Materials and Methods: Lateral cephalographs of a phantom (type 1) composed of synthetic polymer filled with water and another phantom (type 2) composed of human skull macerated with polymer coating were obtained with CdTe, CCD, and CMOS detectors. Dosimeters placed on the type 2 phantom were used to measure radiation. Noise levels from each image were also measured. McNamara cephalometric analysis was conducted, the dentoskeletal configurations were assessed, and a subjective evaluation of image quality was conducted. Parametric data were compared via 1-way analysis of variance with the Tukey post-hoc test, with a significance level of 5%. Subjective image quality and dentoskeletal configuration were described qualitatively. Results: A statistically significant difference was found among the images obtained with the 3 detectors (P<0.05), with the lowest noise level observed among the images obtained with the CdTe detector and a higher subjective preference demonstrated for those images. For the cephalometric analyses, no significant difference (P>0.05) was observed, and perfect agreement was seen with regard to the classifications obtained from the images acquired using the 3 detectors. The radiation dose associated with the CMOS detector was higher than the doses associated with the CCD (P<0.05) and CdTe detectors (P<0.05). Conclusion Considering the evaluated parameters, the CdTe detector is recommended for use in clinical practice.