الفهرس 
Introduction and Review of LiteratureOnly 14 pages are availabe for public view
 |  | from | 122 |  |  |
| | | from | 122 | | |
Abstract
This study aimed to evaluate the accuracy of CBCT in detecting simulated root perforation in the presence of a titanium implant and the influence of a metal artifact reduction algorithm on CBCT accuracy of root perforation detection. The impact of this study in the dental field is that it enhances the decision-making rationale on the need for applying the MAR algorithm in cases with suspected root perforation adjacent to a titanium implant.
Fifty-six human single-rooted teeth, a dry human mandible, and two titanium implants were used. Teeth were endodontically cleaned, shaped, and decoronated at the level of their CEJ. Simulated lateral root perforations were then performed. Titanium implants were inserted in the dry mandible. Teeth were inserted adjacent to these implants. CBCT scans were obtained without and with a metal artifact reduction filter and assessed by two dental radiologists and one general dentist. Results were statistically analyzed in terms of accuracy, specificity, and sensitivity in addition to Kendall’s coefficient of concordance and receiver operator characteristic curve analysis.
The results showed that CBCT images without the MAR application had high accuracy, sensitivity, and specificity and substantial agreement with the gold standard. Moreover, the comparison between the accuracy without and with MAR showed a significant difference. Acquisitions without MAR had higher accuracy and sensitivity values than with MAR, while the specificity was almost the same for both modes for all observers.
In conclusion, CBCT is a valuable and accurate tool for detecting lateral root perforations in the presence of adjacent titanium implants. In addition, the metal artifact reduction algorithm decreases CBCT-detection accuracy in this condition; therefore, in the clinical situation, it is not recommended to be used.