Assessing the Efficacy of Planmeca ProMax® 3D Cone-Beam CT Machine in the Detection of Root Fractures With Varied Metal Artifact Reduction Settings and Three Kilovoltage Peak Levels

Ahmed Almeshari; Ahmed Z Abdelkarim; Hassem Geha; Asma A Khan; Nikita Ruparel

doi:10.7759/cureus.35647

Assessing the Efficacy of Planmeca ProMax® 3D Cone-Beam CT Machine in the Detection of Root Fractures With Varied Metal Artifact Reduction Settings and Three Kilovoltage Peak Levels

Cureus. 2023 Mar 1;15(3):e35647. doi: 10.7759/cureus.35647. eCollection 2023 Mar.

Authors

Ahmed Almeshari¹, Ahmed Z Abdelkarim², Hassem Geha³, Asma A Khan⁴, Nikita Ruparel⁴

Affiliations

¹ Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Najran University, Najran, SAU.
² Division of Oral and Maxillofacial Radiology, The Ohio State University College of Dentistry, Columbus, USA.
³ Department of Comprehensive Dentistry, Oral and Maxillofacial Radiology Program, University of Texas Health Science Center at San Antonio School of Dentistry, San Antonio, USA.
⁴ Department of Endodontics, University of Texas Health Science Center at San Antonio School of Dentistry, San Antonio, USA.

Abstract

Background: This study aims to examine the accuracy of cone-beam computed tomography (CBCT) machines in detecting root fracture when using different metal artifact reduction (MAR) settings at different kilovoltage peak (kVp) levels.

Methodology: Sixty-six tooth roots were treated endodontically using a standardized technique. Of these, 33 roots were randomly selected to be fractured; the other 33 roots were intact and used as controls. The roots were placed randomly in prepared beef ribs to mimic the alveolar bone. Imaging was performed by Planmeca ProMax® 3D (Planmeca, Helsinki, Finland) using different MAR settings (no, low, mid, and high) at three different levels of kVp: 70, 80, and 90. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were calculated.

Results: There was a significant difference in accuracy when using different MAR settings within the group of 70 kVp. Likewise, within the group of 90 kVp. There was no significant difference between different MAR settings at 80 kVp. Using low MAR/90 kVp had significantly higher accuracy relative to other MAR settings at 90 kVp; it also had the highest values of sensitivity, specificity, and AUC in the study. Using mid and high MAR at 70 kVp or 90 kVp decreased accuracy significantly. Mid MAR/90 kVp was the least effective setting in this study.

Conclusions: Using low MAR at 90 kVp significantly increased the accuracy within the group of 90 kVp. In contrast, mid MAR and high MAR in 70 and 90 kVp, respectively, decreased accuracy significantly.

Keywords: accuracy; cbct; kvp; metal artifact; root fracture.