Effect of different cone beam computed tomography settings on artifact production in titanium and zirconia dental implants: An in vitro study.

Background: The use of dental implants in the treatment of edentulous patients is increasing. Zirconia implants are an alternative to titanium implants, offering advantages in terms of aesthetics and biological compatibility. However, the number of artifacts observed on radiographic images with zirconia implants compared to titanium implants is yet to be determined.

Objectives: The purpose of this study was to evaluate the impact of different cone-beam computed tomography (CBCT) parameters on the production of artifacts in zirconia and titanium implants.

Material and methods: A dry human mandible was coated with wax to simulate human soft tissues and examined. Subsequently, titanium and zirconia implants were placed at the same points in the posterior region of the mandible. The production of artifacts on CBCT scans was evaluated using 2 parameters. The first parameter, the standard deviation within the region of interest (SDROI), is based on a comparison of the gray levels at implant and control areas. The second parameter was the contrast-to-noise ratio (CNR), which was evaluated for different protocols created by various combinations of the field of view (FOV) area, milliampere [mA] intensity and metal artifact reduction (MAR) programs.

Results: The study found that zirconia implants produced more artifacts than titanium implants. However, the production of artifacts in zirconia implants could be significantly reduced by increasing the mA values, performing CBCT scans with smaller FOV areas, and enabling MAR programs.

Conclusions: The production of artifacts is a disadvantage of zirconia implants, but this drawback can be mitigated by selecting appropriate protocols for the CBCT device.