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Artifacts in orthodontic bracket systems in cone-beam computed tomography and multislice computed tomography

Artefaktdarstellung kieferorthopädischer Brackets in der dentalen Volumentomographie und der Mehrschicht-Spiral-Computertomographie

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Objectives

The purpose of this study was to quantify artifacts caused by different bracket systems in cone-beam computed tomography (CBCT) and multislice computed tomography (MSCT) scans.

Methods

Orthodontic brackets of four different systems were consecutively bonded to the surface of a residual molar on a human cadaveric mandible. One MSCT system and three CBCT units were used to scan each of the four bonded brackets, in addition to obtaining a blank reference scan of the tooth surface. All datasets were registered to the reference dataset using visualization software (Analyze 11.0® by AnalyzeDirect). Artifact-related reductions in image quality were expressed in percent of theoretical maximum standard deviations (SD) obtained for the gray values of the adjacent voxels, with higher percentages correlating more pronounced artifacts.

Results

Both the SD percentages for three defined line profiles and their mean values were almost invariably higher with the MSCT system than with the CBCT units. Looking into the individual SD percentages, two of the CBCT units (Pax Zenith 3D® and Picasso Trio®; both Vatech) produced higher values than the MSCT system (SOMATOM Definition AS+®; Siemens) in some line profiles. The titanium bracket, in particular, was associated with marked differences between the two scanner technologies, as the mean artifact intensities from this bracket were particularly high with the MSCT unit and relatively low with the CBCT units. The artifact intensities observed with the other three bracket systems varied widely depending on which scanner was used.

Conclusion

Different artifact intensities were noted depending on the composition of the bracket system and on the scanner technology (MSCT/CBCT). While the artifacts manifested themselves differently with different scanners, their adverse effects were comparable. However, given the variable severity of the artifacts observed depending on the materials scanned and the scanners used, a blanket recommendation for or against MSCT or CBCT units cannot be given on the basis of this study.

Zusammenfassung

Zielsetzung

Ziel der Studie war die Quantifizierung von Artefakten verschiedener Bracketsysteme in MSCT(Mehrschicht-Spiral-Computertomographie)- und DVT(dentale Volumentomographie)-Datensätzen.

Methode

Ein Molar in einem humanen Kieferpräparat wurde nacheinander mit Brackets 4 unterschiedlicher Bracketsysteme beklebt. Mit 3 verschiedenen DVT-Geräten und einem MSCT-Geräte wurden radiologische Volumenaufnahmen erstellt, die mithilfe der Software Analyze 11.0® zueinander registriert wurden. Der Ausprägungsgrad der Artefakte wurde in Prozent der theoretisch möglichen Standardabweichung (SD) der Grauwerte benachbarter Voxel angegeben, höhere Prozentwerte korrelierten mit einer stärkeren Beeinträchtigung durch Artefakte.

Ergebnisse

Die maximale Standardabweichung und die Mittelwerte der 3 Linienprofile waren beim MSCT fast durchweg größer als bei den DVT-Geräten. Betrachtet man die einzelnen Prozentwerte der maximalen Standardabweichung, so wiesen das Pax Zenith 3D® sowie das Picasso Trio® in einzelnen Linienprofilen geringfügig höhere Prozentwerte auf als das MSCT. Besonders deutlich waren die Unterschiede zwischen den Gerätegruppen hinsichtlich des Bracketsystems aus Titan: Während die Artefakte beim MSCT besonders stark ausgeprägt waren, verursachte das Titanbracket in der DVT die wenigsten Artefakte. Die übrigen Bracketsysteme zeigten in Abhängigkeit vom untersuchten Gerät sehr unterschiedliche Artefaktausprägungen.

Schlussfolgerungen

Der Ausprägungsgrad der Artefakte divergierte in Abhängigkeit von der Zusammensetzung des Brackets und dem untersuchten Gerätesystem. Die Artefakte äußerten sich in den Geräten unterschiedlich, insgesamt war die Beeinträchtigung allerdings vergleichbar. Eine pauschale Empfehlung für oder gegen MSCT- oder DVT-Geräte kann aufgrund dieser Studie allerdings nicht ausgesprochen werden, da der Ausprägungsgrad der Artefakte in Abhängigkeit vom Material und vom untersuchten Gerätesystem deutlich differierte.

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Compliance with ethical guidelines

Conflict of interest. V. Hirschinger, S. Hanke, U. Hirschfelder, and E. Hofmann state that there are no conflicts of interest.

The accompanying manuscript does not include studies on humans or animals.

Einhaltung ethischer Richtlinien

Interessenkonflikt. V. Hirschinger, S. Hanke, U. Hirschfelder und E. Hofmann geben an, dass kein Interessenkonflikt besteht.

Der Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Department of Orthodontics and Orofacial Orthopedics, Zahnklinik 3 – Kieferorthopädie, Universitätsklinikum Erlangen, Glückstr. 11, 91054, Erlangen, Germany

    V. Hirschinger, S. Hanke, U. Hirschfelder &  E. Hofmann

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  1. V. Hirschinger
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  2. S. Hanke
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Correspondence to E. Hofmann.

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Hirschinger, V., Hanke, S., Hirschfelder, U. et al. Artifacts in orthodontic bracket systems in cone-beam computed tomography and multislice computed tomography. J Orofac Orthop 76, 152–163 (2015). https://doi.org/10.1007/s00056-014-0278-9

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