Influence of metal post in adjacent teeth in the detection of vertical root fracture using CBCT with different acquisition parameters.

Abstract Introduction The aim of the present study was to evaluate the detection of vertical root fracture (VRF) in the presence of adjacent teeth restored with metal post, and the influence of acquisition parameters (tube current and metal artifact reduction algorithm – MAR) on this diagnostic task. Methods Cone beam computed tomography images of ten single-rooted teeth were acquired before and after the simulation of VRF. The acquisitions were set up to simulate different conditions regarding the presence of adjacent teeth restored with metal post (control, one adjacent tooth, and both adjacent teeth), different tube currents (4ma, 8mA, and 10mA), and the use of MAR (without MAR and with MAR). Images were assessed by 5 Oral and Maxillofacial radiologists using a 5-point scale for the presence of VRF. Diagnostic values were calculated and compared by two-way analysis of variance (significance level of 5%). Results The area under the ROC curve (Az) values for VRF detection were affected by the presence of adjacent teeth and variation of mA. For 4mA, when both restored teeth were present, Az and accuracy values were significantly lower than the control group (p≤0.05). In the presence of both restored teeth, 8mA presented significantly higher Az values compared to 4mA (p≤0.05). Conclusion The presence of both adjacent teeth restored with metal post impairs VRF detection, however, an increase in tube current up to 8mA may aid in this diagnostic task. Moreover, MAR tool does not seem to be efficient in those cases.