الفهرس 
Influence of artifacts induced by dental implants on the detection of vertical root fractures in cone beam computed tomographic scans : An in-vitro study
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Abstract
Aim: the aim of this study was to evaluate the influence of implant metal artifact on the detection of
vertical root fracture of teeth adjacent to dental implants.
Methodology: Sixty extracted single rooted human teeth were randomly divided into vertical root
fracture (VRF) and non-fractured groups (NVF) (n=30). Root fracture was induced in half of the
samples. Teeth were randomly positioned in the right and left posterior areas of epoxy-resin mandible
model mesial and distal to two titanium implants. CBCT scanning was done by Planmeca ProMax
3D-Mid machine and Planmeca Romexis 4.6.2.R software at fixed exposure parameters of 90 kVp,
10 mA and 15.033 seconds with 0.15mm voxel size and 8.0 x 5.0 cm field of view. Three scan
protocols were done: roots without implants, roots with implant without artifact reduction and roots
with implant with artifact reduction. The images were evaluated by three observers. The area under
the receiver operating characteristic curve (ROC), diagnostic accuracy, sensitivity, and specificity
were calculated and compared by analysis of variance with a significance level of 5%.
Results: There was no statistically significant difference in the diagnostic accuracy of CBCT of
vertical root fracture between three test groups with highest accuracy in scan group without implant
(p =0.174). Sensitivity and specificity were higher in scan group without implant but there was no
statistically significant difference between the three groups.
Conclusions: Implant metal artifacts influenced the diagnostic accuracy, sensitivity and specificity
for detection of vertical root fracture but still high levels were achieved and all image possessed high
diagnostic quality. Artifact reduction tool improved the accuracy and specificity and can be
recommended when the teeth involved are near dental implant.