الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
A separated instrument in the root canal may compromise adequate treatment of the entire root canal system. Radiographic detection of retained instruments is a very important step for proper treatment planning. Cone Beam Computed Tomography (CBCT) scans provide three-dimensional (3D) imaging of maxillofacial anatomy. Yet, the presence of root canal filling in close proximity to a fractured instrument may cause beam hardening artifacts in CBCT images that may reduce the diagnostic accuracy. So that, the need for Metal artifact reduction (MAR) tool is mandatory to improve image quality.
Objective of the study: The purpose of this study is to assess the accuracy of CBCT with MAR tool in the detection of separated instruments in filled and unfilled canals.
Materials and Methods: Mandibular molar teeth were selected with a total of 144 root canals and divided into four groups: The control group with empty canals, the fracture group having a separated instrument, the fill group with gutta-percha points, and the fill/fracture group that was filled with a separated instrument present. The teeth were radiographed by periapical X-ray using complementary metal oxide semiconductor (CMOS) sensor and CBCT with and without the MAR tool application to evaluate the diagnostic efficacy of the three radiographic techniques in the detection of separated instruments.
Results: In the absence of filling, there was no statistically significant difference among the three radiographic techniques. In the presence of filling, periapical showed greater sensitivity and specificity values than the two other techniques. The MAR tool application was found to significantly improve the image quality in the presence of a fractured file with root filling in curved canals.
Conclusions: Periapical radiography is the imaging technique of choice for diagnosing fractured instruments in filled and unfilled root canals with minimal radiation dose.
Keywords: Beam hardening artifact, Cone beam computed tomography, Metal artifact reduction tool, Separated instrument.