To investigate the influence of orthodontic materials, field of view (FOV), and artifact reduction (AR) on the assessment of approximal caries using cone beam computed tomography.
Materials and methods
Forty non-cavitated and restoration-free human premolars and molars ranging from sound to various grades of lesions without cavitations were assigned to 13 groups with different combination of fix appliance equipment. CBCT (cone beam computed tomography) (Planmeca ProMax 3D Mid, Helsinki, Finland) images were obtained using combinations of three orthodontic bracket materials and two orthodontic archwire with small and large FOVs and with and without AR activation. Receiver operating characteristic (ROC) analysis was used to calculate the area under the ROC curve (AUC).
Interobserver agreement ranged from 0.44 to 0.92 and intraobserver agreement ranged from 0.50 to 0.99. Teeth lacking orthodontic materials had the highest Az values at 0.84. FOV and AR activation did not significantly affect AUC values (P > 0.05). The AUC data were significantly reduced by the addition of stainless steel wire, NT wire, or a combination of a stainless steel bracket with stainless steel wire (P < 0.05).
The addition of stainless steel wire, NT wire, or a stainless steel bracket with stainless steel wire combination prevented the diagnosis of non-cavitated interproximal tooth caries by CBCT. With and without AR modes and different FOVs did not influence the diagnosis of interproximal caries lesions with different types of orthodontic equipment.
A wide variety of brackets and wire combinations are used in the clinic; however, the extent to which these combinations impact the diagnosis of caries by CBCT as the effects of FOV and AR algorithms are unknown.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Tsuchida R, Araki K, Okano T (2007) Evaluation of a limited cone-beam volumetric imaging system: comparison with film radiography in detecting incipient proximal caries. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 104:412–416. https://doi.org/10.1016/j.tripleo.2007.02.028
Zhang ZL, Qu XM, Li G, Zhang ZY, Ma XC (2011) The detection accuracies for proximal caries by cone-beam computerized tomography, film, and phosphor plates. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 111:103–108. https://doi.org/10.1016/j.tripleo.2010.06.025
Qu X, Li G, Zhang Z, Ma X (2011) Detection accuracy of in vitro approximal caries by cone beam computed tomography images. Eur J Radiol 79:e24–e27. https://doi.org/10.1016/j.ejrad.2009.05.063
Aglarci OS, Bilgin MS, Erdem A, Ertas ET (2015) Is it possible to diagnose caries under fixed partial dentures with cone beam computed tomography? Oral Surg Oral Med Oral Pathol Oral Radiol 119:579–583. https://doi.org/10.1016/j.oooo.2015.02.004
Sanders MA, Hoyjberg C, Chu CB, Leggitt VL, Kim JS (2007) Common orthodontic appliances cause artifacts that degrade the diagnostic quality of CBCT images. J Calif Dent Assoc 35:850–857
Bechara BB, Moore WS, McMahan CA, Noujeim M (2012) Metal artefact reduction with cone beam CT: an in vitro study. Dentomaxillofac Radiol 41:248–253. https://doi.org/10.1259/dmfr/80899839
Rodrigues AF, Campos MJ, Chaoubah A, Fraga MR, Farinazzo Vitral RW (2015) Use of gray values in CBCT and MSCT images for determination of density: influence of variation of FOV size. Implant Dent 24:155–159. https://doi.org/10.1097/ID.0000000000000179
Pinheiro LR, Scarfe WC, Augusto de Oliveira Sales M, Gaia BF, Cortes AR, Cavalcanti MG (2015) Effect of cone-beam computed tomography field of view and acquisition frame on the detection of chemically simulated peri-implant bone loss in vitro. J Periodontol 86:1159–1165. https://doi.org/10.1902/jop.2015.150223
Kulczyk T, Dyszkiewicz Konwinska M, Owecka M, Krzyzostaniak J, Surdacka A (2014) The influence of amalgam fillings on the detection of approximal caries by cone beam CT: in vitro study. Dentomaxillofac Radiol 43:20130342. https://doi.org/10.1259/dmfr.20130342
Gorelick L, Geiger AM, Gwinnett AJ (1982) Incidence of white spot formation after bonding and banding. Am J Orthod 81:93–98
Mizrahi E (1982) Enamel demineralization following orthodontic treatment. Am J Orthod 82:62–67
Schwendicke F, Tzschoppe M, Paris S (2015) Radiographic caries detection: a systematic review and meta-analysis. J Dent 43:924–933. https://doi.org/10.1016/j.jdent.2015.02.009
Haiter-Neto F, Wenzel A, Gotfredsen E (2008) Diagnostic accuracy of cone beam computed tomography scans compared with intraoral image modalities for detection of caries lesions. Dentomaxillofac Radiol 37:18–22. https://doi.org/10.1259/dmfr/87103878
Prell D, Kyriakou Y, Struffert T, Dörfler A, Kalender W (2010) Metal artifact reduction for clipping and coiling in interventional C-arm CT. Am J Neuroradiol 31:634–639
Obuchowski NA (2003) Receiver operating characteristic curves and their use in radiology 1. Radiology 229:3–8
Valizadeh S, Tavakkoli MA, Karimi Vasigh H, Azizi Z, Zarrabian T (2012) Evaluation of cone beam computed tomography (CBCT) system: comparison with intraoral periapical radiography in proximal caries detection. J Dent Res Dent Clin Dent Prospects 6:1–5. https://doi.org/10.5681/joddd.2012.001
Kalathingal SM, Mol A, Tyndall DA, Caplan DJ (2007) In vitro assessment of cone beam local computed tomography for proximal caries detection. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 104:699–704. https://doi.org/10.1016/j.tripleo.2006.08.032
Hintze H, Frydenberg M, Wenzel A (2003) Influence of number of surfaces and observers on statistical power in a multiobserver ROC radiographic caries detection study. Caries Res 37:200–205. https://doi.org/10.1159/000070445
Rino Neto J, Silva FP, Chilvarquer I, Paiva JB, Hernandez AM (2012) Hausdorff distance evaluation of orthodontic accessories’ streaking artifacts in 3D model superimposition. Braz Oral Res 26:450–456
Bechara B, Alex McMahan C, Moore WS, Noujeim M, Teixeira FB, Geha H (2013) Cone beam CT scans with and without artefact reduction in root fracture detection of endodontically treated teeth. Dentomaxillofac Radiol 42:20120245. https://doi.org/10.1259/dmfr.20120245
Candemil AP, Salmon B, Freitas DQ, Ambrosano GMB, Haiter-Neto F, Oliveira ML (2019) Are metal artefact reduction algorithms effective to correct cone beam CT artefacts arising from the exomass? Dentomaxillofac Radiol 48:20180290. https://doi.org/10.1259/dmfr.20180290
Kamburoglu K, Kolsuz E, Murat S, Eren H, Yuksel S, Paksoy CS (2013) Assessment of buccal marginal alveolar peri-implant and periodontal defects using a cone beam CT system with and without the application of metal artefact reduction mode. Dentomaxillofac Radiol 42:20130176. https://doi.org/10.1259/dmfr.20130176
de Rezende Barbosa GL, Sousa Melo SL, Alencar PN, Nascimento MC, Almeida SM (2016) Performance of an artefact reduction algorithm in the diagnosis of in vitro vertical root fracture in four different root filling conditions on CBCT images. Int Endod J 49:500–508. https://doi.org/10.1111/iej.12477
Queiroz PM, Groppo FC, Oliveira ML, Haiter-Neto F, Freitas DQ (2017) Evaluation of the efficacy of a metal artifact reduction algorithm in different cone beam computed tomography scanning parameters. Oral Surg Oral Med Oral Pathol Oral Radiol 123:729–734. https://doi.org/10.1016/j.oooo.2017.02.015
Da Silveira PF, Fontana MP, Oliveira HW, Vizzotto MB, Montagner F, Silveira HL et al (2015) CBCT-based volume of simulated root resorption - influence of FOV and voxel size. Int Endod J 48:959–965. https://doi.org/10.1111/iej.12390
Shokri A, Jamalpour MR, Khavid A, Mohseni Z, Sadeghi M (2019) Effect of exposure parameters of cone beam computed tomography on metal artifact reduction around the dental implants in various bone densities. BMC Med Imaging 19:34. https://doi.org/10.1186/s12880-019-0334-4
The authors would like to thank Prof. Dr. Hasan Hüseyin Yılmaz for his contributions as a scientific advisor.
Conflict of interest
The authors declare that they have no conflicts of interest.
This study was approved by the Gaziantep University Faculty of Medicine Ethic Committee Presidency (Protocol code: 407).
For this type of study, formal consent is not required.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Isman, O., Aktan, A.M. & Ertas, E.T. Evaluating the effects of orthodontic materials, field of view, and artifact reduction mode on accuracy of CBCT-based caries detection. Clin Oral Invest 24, 2487–2496 (2020). https://doi.org/10.1007/s00784-019-03112-7
- Orthodontic brackets
- Field of view
- Artifact reduction