# Efficacy of a Metal Artifact Reduction Algorithm in CBCT Images of Teeth With Ceramic Brackets With/Without Coated Archwires: An In Vitro Study

## TL;DR

This study tested a metal artifact reduction algorithm on CBCT scans of teeth with ceramic brackets and found it did not significantly improve image quality.

## Contribution

The study evaluates the effectiveness of a MAR algorithm in reducing artifacts in CBCT images of teeth with ceramic brackets and coated archwires.

## Key findings

- The MAR algorithm did not significantly improve contrast-to-noise ratio (CNR) in CBCT scans with or without archwires.
- CNR increased significantly at greater distances from the tooth center, regardless of the MAR algorithm's use.
- Tooth type and distance from the tooth center had a significant impact on CNR values.

## Abstract

This study aimed to assess the efficacy of a metal artifact reduction (MAR) algorithm for cone‐beam computed tomography (CBCT) scans of teeth with ceramic brackets with/without coated archwires.

In this in vitro study, 10 ceramic brackets were bonded to maxillary anterior teeth from the second premolar of one side to the second premolar of the other side on a dry human skull. CBCT scans (85 kVp, 8 mA, 14.5 s) were taken twice in the presence and absence of coated nickel–titanium (NiTi) archwires. The skull was placed in a water container for soft tissue simulation during scanning. The images were reconstructed with and without the MAR algorithm, and imported to ImageJ software in DICOM format to calculate the contrast‐to‐noise ratio (CNR) at 15‐, 20‐, and 25‐mm distances from the tooth center. Data were analyzed by independent t‐test, ANOVA, and Bonferroni test (α = 0.05).

Application of the MAR algorithm had no significant effect on the CNR in the presence or absence of archwire (p > 0.05). Significant differences were found in the CNR according to tooth type and distance from the tooth center, such that the CNR significantly increased in farther distances (p < 0.05).

Within the limitations of this in vitro study, the results showed that the application of the MAR algorithm had no significant efficacy in improving the quality of CBCT scans of teeth with ceramic brackets with/without coated archwire.