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BACKGROUND: Dental implants and metal fillings may cause artifacts in cone-beam computed tomography (CBCT) images and reduce image quality and anatomic accuracy. The purposes of this study are a subjective evaluation of anatomic landmarks and linear bone measurements after applying artifact removal (low-medium) option on CBCT images. MATERIALS AND METHODS: In this cross-sectional study, thirty CBCT images from thirty qualified patients were selected in a private radiology center. Low and medium artifact removal was applied to images. Three radiologists assessed the visibility of the mandibular canal, mental foramen, and lamina dura in images. Crestal width and bone length were also measured in three groups of images and was compared by exact McNemar test. ICC test (two-way random model, absolute agreement types) was calculated for comparison of linear bone measurements in three images groups. P ≤ 0.05 was considered statistically significant. RESULTS: Percent agreement of determining mental foramen (outline and location), mandibular canal (outline and location), and lamina dura between three groups of images were 100%, 100%, 83.3%, 96.7%, and 56.6%, respectively. The results of exact McNemar test revealed that medium artifact removal group had a statistical difference in lamina dura observation with none and low artifact removal groups (P < 0.001). Intraclass correlation coefficient showed no statistical differences in crestal width and bone length between groups (P < 0.001). CONCLUSION: Applying artifact removal does not affect the visibility of large anatomical structures and linear bone measurements, but delicate structures such as lamina dura may become less clear after artifact removal.
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OBJECTIVES: This study aimed to compare the diagnostic accuracy of inverted and unprocessed digitized periapical radiographs for detection of peri-implant defects. MATERIALS AND METHODS: A total of 30 osteotomy sites were prepared in three groups of control, study group 1 with 0.425 mm defects and study group 2 with 0.725 mm defects using the SIC and Astra Tech drill systems with 4.25mm and 4.85mm diameters. Small and large defects were randomly created in the coronal 8mm of 20 implant sites; implants (3.4mm diameter, 14.5mm length) were then placed. Thirty periapical (PA) radiographs were obtained using Digora imaging system (Soredex Corporation, Helsinki, Finland), size 2 photostimulable storage phosphor (PSP) plate sensors (40.0mm×30.0mm) and Scanora software. Unprocessed images were inverted using Scanora software by applying image inversion and a total of 60 images were obtained and randomly evaluated by four oral and maxillofacial radiologists. Data were analyzed using the t-test. RESULTS: Significant differences were observed in absolute and complete sensitivity and specificity of the two imaging modalities for detection of small and large defects (P<0.05). Unprocessed digital images had a higher mean in terms of absolute sensitivity for detection of small defects, complete sensitivity for detection of large peri-implant defects and definite rule out of defects compared with inverted images. CONCLUSION: Unprocessed digital images have a higher diagnostic value for detection of small and large peri-implant defects and also for definite rule out of defects compared with inverted images.
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OBJECTIVES: The aim of this study was to compare apical sealing ability of alpha and beta phases of gutta-percha by means of bacterial leakage model. MATERIALS AND METHODS: Fifty single-rooted human premolars were selected. The root canals were prepared with Mtwo rotary instruments up to apical #35.04. Forty teeth were randomly divided into two groups (n= 20). The root canals were obturated by alpha phase (G1) and beta phase (G2) of gutta-percha and AH26 sealer, respectively, with warm vertical compaction technique. Ten teeth served as positive (n=8) and negative (n=2) control groups. Then, the specimens were sterilized with ethylene oxide gas. Bacterial suspension of Enterococcus faecalis (E. faecalis) in 0.5 McFarland concentration was prepared. All teeth were mounted in plastic vial caps containing Muller Hinton broth and then exposed to bacterial suspension of E. faecalis every three days up to 31 days. The number of days required for the contamination of the entire root canals was recorded. The data were analyzed using Mann Whitney U test. RESULTS: There were no significant differences in bacterial leakage between the G1 and G2 groups (P>0.05). Negative controls revealed no microbial leakage; whereas positive controls showed gross microbial leakage. CONCLUSION: Despite better thermal conduction and adaptability of alpha phase of guttapercha, our study revealed no significant difference in bacterial leakage between alpha and beta phases of gutta-percha in warm vertical compaction.