Influence of Dental Impression Materials on Metal Artifact in Cone Beam Computed Tomography Examination

Abstract: Aim: To estimate the effect of different dental impression materials on cone beam computed tomography (CBCT) metal artifact at different resolutions and fields of view (FOVs). Material and Methods: A model of the mandible with restored human teeth was created. Six dental materials were molded as teeth overlays to uniform thickness: A-Silicones (Elite HD+, and Vonflex S Putty), Alginate (Tropicalgin), Pink wax (MBwax1), C-Silicon (Zetaplus) and Zinc-oxide (COE-PAK). The model alone (control) and with teeth covered by each of the materials, was scanned using CBCT Unite KAVO dent at two different fields: 5x5 (FOV S) and 6x8cm (FOV M), and three different resolutions: low (0.28-S; 0.32-M), standard (0.20-S; 0.30-M), and high (0.125-S; 0.20-M). Two experienced radiologists analyzed a single representative view of each dataset in Image J: quantitatively- by histogram analysis within the selected regions of interest (ROI), and qualitatively (using a five-point Likert scale). The data were analyzed using standard one-way analysis of variance (ANOVA). Inter-rater reliability was examined. Results: Intraclass Correlation Coefficient for all measurements was between 0.806- 0.996. At low resolution level and FOV S, Zetaplus and Vonflex S Putty showed significantly lower variance and range in grayscale values compared to the control, as well as a higher quality score. With higher resolution levels, image quality improved, but showing no significant differences between the control and tested materials. Conclusion: Covering teeth with dental materials such as Vonflex S Putty and Zetaplus, can reduce the image noise in small field of view and at low resolution level.