Efeito dos artefatos metálicos de implantes dentários na análise dos canais supranumerários de pré-molares inferiores por TCFC

Abstract

The objective of this study was to evaluate the influence of metallic artifacts generated by Titanium (Ti), Titanium-Zirconia (Ti-Zr), and Zirconia (Zr) dental implants on the detection of supernumerary root canals in mandibular premolars using CBCT examinations. This research was submitted to the Research Ethics Committee of UEPB for analysis and was approved under CAAE 86784925.3.0000.5187. An observational, ex vivo, cross-sectional, analytical, and qualitative study was conducted, using three types of implants: a 3.5×8 mm Zr dental implant (PURE Ceramic, Institute Straumann, Basel, Switzerland), a 3.3×8 mm Ti-Zr dental implant (Roxolid, Straumann, Basel, Switzerland), and a 3.5×8 mm Ti dental implant (Aqua, Neodent, Curitiba, PR, Brazil), along with 20 extracted mandibular premolars, which were divided into two groups: one with teeth presenting root bifurcation and another group without root bifurcation. The teeth were individually inserted into a dry human mandible. They were evaluated with one or two adjacent implants (Ti, Ti-Zr, or Zr), and CBCT images were acquired using a Kavo OP3D Pro® tomograph. Statistical analyses were performed in RStudio (version 2024.12.0; R Core Team, Vienna, Austria), including calculations of diagnostic performance metrics: sensitivity, specificity, and area under the curve (AUC). Comparison among the material groups was performed using the Kruskal-Wallis test, and comparisons between implant quantities were made using the Mann-Whitney U test. A Kendall’s Tau correlation analysis was conducted, and a 5% significance level was adopted for all analyses. The results of this study showed that Zr implants generated more artifacts and lower diagnostic performance, especially in cases with two implants, compromising sensitivity, specificity, and AUC. Ti and Ti-Zr implants maintained high accuracy regardless of the number of implants. A weak but significant positive correlation was found between artifacts and the detection of the second canal. It is concluded that the implant material influences image quality, with Zr implants causing greater impairment in anatomical detection, particularly in the presence of multiple implants.