Bone quality assessment around dental implants in cone-beam CT images: effect of rotation mode and metal artefact reduction tool.

Abstract

Objectives: The purpose of this study was to evaluate how artefacts caused by titanium and zirconia dental implants affect the bone quality assessment in CBCT images. The effect of scan mode and the use of metal artefact reduction (MAR) algorithm on artefacts suppression were taken in consideration.

Methods: Titanium and zirconia dental implants were installed in porcine bone samples and scanned with two CBCT devices with adjustments on scan mode and with the use of MAR. The control group consisted of bone sample without implant and scanned with full-rotation scan mode without MAR. Artefacts extension and bone quality around implants were measured by deviation of grey values and bone histomorphometry measurements (trabecular volume fraction, bone specific surface, trabecular thickness, and trabecular separation), respectively. Mean difference among groups was assessed by within ANOVA with Bonferroni correction. Correlation between bone quality measurements acquired in the experimental and control groups was assessed by Spearman correlation test (α = .05).

Results: No statistical difference was found for artefacts extension in images acquired by half and full-rotation modes (P = .82). The application of MAR reduced artefacts caused by titanium and zirconia dental implants, showing no statistically significant difference from the control group (titanium: P = .20; zirconia: P = .31). However, there was no correlation between bone quality measurements (P < .05).

Conclusions: Bone quality assessment was affected by the presence of artefacts caused by dental implants. Rotation mode did not affect the appearance of artefacts and bone qualitative measurements. MAR was able to decrease artefacts, however, it did not improve the accuracy of bone quality measurements.