Sains Malaysiana 50(10)(2021): 3067-3075

http://doi.org/10.17576/jsm-2021-5010-19

 

The Impact of Different Types of Orthodontic Appliances and Its Location in Producing CT Scan Artefacts

(Impak Jenis Peralatan Ortodontik yang Berbeza dan Lokasinya dalam Penghasilan Artefak Imbasan CT)

 

MAHMUD MOHAMMED1, NORMA AB. RAHMAN2* & AHMAD HADIF ZAIDIN SAMSUDIN3

 

1Conservative Dentistry & Endodontics, Delta Medical College & Maxillofacial Radiologist, ODC Healthcare, Dhaka, Bangladesh

 

2Orthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kota Bharu, Kelantan Darul Naim, Malaysia

 

3Radiology Department, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kota Bharu, Kelantan Darul Naim, Malaysia

 

Diserahkan: 19 Mac 2020/Diterima: 10 Februari 2021

 

ABSTRACT

Fixed orthodontic appliances can produce metal artefacts in CT images which may degrade the diagnostic image quality. The study aimed to evaluate the artefacts based on the types and location of the metallic and non-metallic orthodontic brackets. This is an in-vitro cross-sectional study. Four different types of orthodontic brackets (stainless steel, titanium, monocrystalline, and polycrystalline ceramic bracket) were bonded consecutively in four different locations of the cadaveric skull. All scans were performed by a single operator using the same CT machine followed by a standard scanning protocol. Artefact intensity for all data sets was quantified by calculating the standard deviation (SD) of the grey values within the dataset by following a standard method. The One-way ANOVA Bonferroni test was used for the data analysis. The mean artefact score of the stainless steel bracket was significantly (p < 0.001) high in comparison with other types of the orthodontic brackets. Besides, the mean artefact score was significantly (p=0.002) low when orthodontic brackets were placed unilaterally. Stainless steel brackets produced a significant amount of noise in CT images which can degrade the diagnostic image quality. Thus, the polycrystalline ceramic bracket can be a better alternative of stainless steel brackets for patient need frequent CT scan.

 

Keywords: Artefact; computed tomography; orthodontic bracket

 

ABSTRAK

Peralatan ortodontik tetap boleh menghasilkan artefak logam pada imej CT yang boleh merendahkan kualiti imej diagnostik. Tujuan kajian ini adalah untuk menilai artefak berdasarkan komposisi dan lokasi pendakap metalik dan bukan metalik. Empat jenis peralatan ortodontik tetap (keluli tahan karat, titanium, polikristalin dan mono-kristalin) dilekatkan secara berturut-turut di empat lokasi berbeza pada tengkorak kadaver. Kesemua imbasan dilakukan oleh seorang operator menggunakan mesin CT yang sama diikuti oleh protokol piawai pengimbasan. Keamatan artefak untuk kesemua set data diukur dengan menghitung sisihan piawai dengan mengikuti kaedah piawai. Ujian ANOVA Bonferroni sehala digunakan untuk menganalisis data. Skor artefak peralatan ortodontik tetap keluli tahan karat secara signifikannya adalah tinggi (p < 0.001) berbanding dengan peralatan ortodontik tetap ortodontik lain. Tambahan lagi, purata skor artefak adalah rendah secara signifikan (p=0.002) apabila peralatan ortodontik tetap dilekatkan secara unilateral. Peralatan ortodontik tetap keluli tahan karat menghasilkan sejumlah artefak yang signifikan dalam imej CT yang boleh merendahkan kualiti diagnostik imej. Dengan demikian, pendakap seramik polikristalin boleh menjadi alternatif kepada peralatan ortodontik tetap keluli tahan karat untuk pesakit yang memerlukan imbasan CT.

 

Kata kunci:  Artefak; pendakap ortodontik; tomografi berkomputer

 

RUJUKAN

Arshad, A.I., Alam, M.K. & Khamis, M.F. 2017. Assessment of complete unilateral cleft lip and palate treatment outcome using EUROCRAN index and associated factors. International Journal of Pediatric Otorhinolaryngology 100: 91-95.

Boas, F.E. & Fleischmann, D. 2012. CT artifacts: Causes and reduction techniques. Imaging in Medicine 4(2): 229-240.

Chindasombatjaroen, J., Kakimoto, N., Murakami, S., Maeda, Y. & Furukawa, S. 2011. Quantitative analysis of metallic artifacts caused by dental metals: Comparison of cone-beam and multi-detector row CT scanners. Oral Radiology 27(2): 114-120.

Filli, L., Luechinger, R., Frauenfelder, T., Beck, S., Guggenberger, R., Farshad-Amacker, N. & Andreisek, G. 2015. Metal-induced artifacts in computed tomography and magnetic resonance imaging: Comparison of a biodegradable magnesium alloy versus titanium and stainless steel controls. Skeletal Radiology 44(6): 849-856.

Graber, L.W., Vanarsdall, R.L., Vig, K.W. & Huang, G.J. 2016. Orthodontics-e-book: Current Principles and Techniques. New York: Elsevier Health Sciences.

Gunzinger, J.M., Delso, G., Boss, A., Porto, M., Davison, H., von Schulthess, G.K., Huellner, M., Stolzmann, P., Veit-Haibach, P. & Burger, I.A. 2014. Metal artifact reduction in patients with dental implants using multispectral three-dimensional data acquisition for hybrid PET/MRI. EJNMMI Physics 1(1): 1-14.

Hirschinger, V., Hanke, S., Hirschfelder, U. & Hofmann, E. 2015. Artifacts in orthodontic bracket systems in cone-beam computed tomography and multislice computed tomography. Journal of Orofacial Orthopedics 76(2): 152-163.

Hokamp, N.G., Eck, B., Siedek, F., Dos Santos, D.P., Holz, J.A., Maintz, D. & Haneder, S. 2020. Quantification of metal artifacts in computed tomography: Methodological considerations. Quantitative Imaging in Medicine and Surgery 10(5): 1033.

Huang, J.Y., Kerns, J.R., Nute, J.L., Liu, X., Balter, P.A., Stingo, F.C., Followill, D.S., Mirkovic, D., Howell, R.M. & Kry, S.F. 2015. An evaluation of three commercially available metal artifact reduction methods for CT imaging. Physics in Medicine & Biology 60(3): 1047.

Klinke, T., Daboul, A., Maron, J., Gredes, T., Puls, R., Jaghsi, A. & Biffar, R. 2012. Artifacts in magnetic resonance imaging and computed tomography caused by dental materials. PLoS ONE 7(2): e31766.

Miracle, A. & Mukherji, S. 2009. Conebeam CT of the head and neck, part 2: Clinical applications. American Journal of Neuroradiology 30(7): 1285-1292.

Pauwels, R., Stamatakis, H., Bosmans, H., Bogaerts, R., Jacobs, R., Horner, K. & Tsiklakis, K. 2013. Quantification of metal artifacts on cone beam computed tomography images. Clinical Oral Implants Research 24(A100): 94-99.

Prell, D., Kyriakou, Y., Kachelrie, M. & Kalender, W.A. 2010. Reducing metal artifacts in computed tomography caused by hip endoprostheses using a physics-based approach. Investigative Radiology 45(11): 747-754.

Queiroz, P.M., Oliveira, M.L., Groppo, F.C., Haiter-Neto, F. & Freitas, D.Q. 2018. Evaluation of metal artefact reduction in cone-beam computed tomography images of different dental materials. Clinical Oral Investigations 22(1): 419-423.

Sanders, M., Hoyjberg, C., Chu, C., Leggitt, V. & Kim, J. 2007. Common orthodontic appliances cause artifacts that degrade the diagnostic quality of CBCT images. Journal of the California Dental Association 35(12): 850-857.

 

*Pengarang untuk surat-menyurat; email: drnorma@usm.my

 

 

 

 

sebelumnya