Assessment of Volumetric Distortion Artifact in Filled Root Canals Using Different Cone-beam Computed Tomographic Devices

Introduction: Artifacts in cone-beam computed tomographic (CBCT) imaging may compromise radiodiagnosis. Obturation materials for endodontic treatment may present with variable material density and thus also cause distinct artifact expression. The aim of this study was to assess the volume distortion artifact of root canal sealers using CBCT devices and micro-CT imaging as a reference. Methods: Thirty single-root mandibular central incisors were used for this study. Teeth were prepared with EndoSequence rotary nickel-titanium files (Brasseler USA, Savannah, GA) and divided into 3 groups. Canals were obturated with gutta-percha and AH Plus root canal sealer (Dentsply Maillefer, Ballaigues, Switzerland) using single-cone filling techniques. Each tooth was scanned with different CBCT devices (ie, Promax 3D Max [Planmeca Inc, Roselle, IL], NewTom VGi evo [NewTom, Verona, Italy], and 3D Accuitomo 170 [J Morita, Kyoto, Japan]) with the same voxel size (0.2 mm3) and compared with micro CT imaging as a reference standard. Results: The results showed a significant difference in terms of volume distortion between micro-CT and CBCT images (P < .05). There were also significant differences among CBCT devices. Promax 3D Max measurements showed significantly larger root canal volumes than the other CBCT machines (P < .05). However, NewTom VGi evo and 3D Accuitomo 170 showed similar results without any significant difference (P > .05). Conclusions: CBCT devices showed more volumetric distortion artifact than micro-CT imaging. The volume was variable for different CBCT devices while scanning at the same voxel size. However, to assess the effect of sealer materials on CBCT imaging, further studies should be conducted for different sealers.