Ex vivo evaluation of artifacts mimicking fracture lines on cone-beam computed tomography produced by different root canal sealers.

ABSTRACT

AIM: To evaluate streaking artifacts produced by several root canal sealers on CBCT images with variations in voxel resolution. METHODOLOGY: Single-rooted premolars were selected and root filled using gutta-percha cones and one of the following sealers Endofill, Sealer 26, Fillapex or AH Plus. Root canals filled only with gutta-percha were used as control. Scans of teeth using a small-volume CBCT were performed, and the images acquired were evaluated by two calibrated observers (k > 0.75). Artifacts were identified as streaks and dark bands on root dentine in axial slices with 2 voxel sizes (0.076 and 0.2 mm). Fisher's exact test (P < 0.05) was used to compare the presence/absence ratio of artifacts considering the factors 'sealer' and 'voxel size'. RESULTS: For the 0.20 mm voxel size, Sealer 26 had significantly more artifacts than Fillapex (P = 0.006) or AH Plus (P = 0.017). No differences existed between the sealers when the 0.07 mm voxel size was used. Sealer 26 (P = 0.042) and Endofill (P = 0.035) had significantly more artifacts in the 0.20 mm voxel size than with the 0.076 mm voxel size, whilst no difference was noted for other filling conditions. CONCLUSIONS: The material used for root filling and the voxel resolution can influence the presence of streaking artifacts observed in CBCT images.