Modifying the head’s spatial orientation reduces cone beam CT artifacts adjacent to dental implants: a laboratory study

Abstract

Abstract Objectives: To evaluate image artifacts in the vicinity of dental implants in cone-beam computed tomography (CBCT) obtained with different spatial orientations, tube current levels, and metal artifact reduction algorithm (MAR) conditions. Materials and Methods: A dental implant and two tubes containing a radiopaque solution were inserted in the posterior region of a mandible. CBCT scans were acquired with the mandible in two spatial orientations in relation to the X-ray projection plane – standard and modified – at three tube current levels: 5, 8, and 11 mA. CBCT scans were repeated without the implant and were reconstructed with and without MAR. Mean voxel and noise values of each tube were obtained and compared using multi-way analysis of variance and Tukey’s test (α=0.05). Results: Mean voxel values were significantly higher and noise values were significantly lower in the modified orientation compared to the standard orientation (p<0.05). MAR activation and mA level did not have significant differences in most cases of the modified spatial orientation and in the absence of the dental implant (p>0.05). Conclusions: The modification of the spatial orientation of the head increases brightness and reduces noise in adjacent regions of a dental implant, with no influence from the tube current level and MAR. Clinical relevance: Considering that artifacts can impair CBCT image quality, studying strategies to reduce them, such as modifying the spatial orientation of the patient head, may be a valuable approach.