CBCT Visualization of Furcation Perforation Repair Materials Using Different Voxel Sizes

Background: Three-dimensional cone-beam computed tomography is gaining popularity as an imaging modality aiding the performance of difficult endodontic treatment procedures. For this reason, we assessed the visualization of bioactive furcal perforation repair materials in an ex vivo study using CBCT with different voxel sizes and determined which voxel size yielding the best images with least artefacts. Visualization of endodontic restorative material is affected by the appearance of various artifacts. This study was conducted to evaluate the CBCT visualization of three perforation repair materials using five different voxel sizes. Methods: This study was performed with 84 mandibular molars that had been extracted for various reasons. All samples were measured with a digital caliper (Digimess, São Paulo, Brazil), marked at 3 mm above the cementoenamel junction, and decoronized at this line. The root segments were amputated at 3 mm below the furcation site using diamond discs under water cooling. Endodontic access cavities were then created, and the perforations were formed. Biodentine, MTA, and EndoSequence were mixed following the manufacturers’ instructions and applied to the perforation sites. Five image sets were obtained: 0.075 mm3; 0.1 mm3; 0.15 mm3; 0.2 mm3; and 0.4 mm3. Each scan was evaluated by 2 observers with 8 to 12 years of experience in CBCT imaging. Results: The best image quality for repair all materials was achieved with a voxel size of 0.1 mm3. Image clarity of repair materials was no statistically difference between voxel sizes of 0.075 mm3 and 0.15 mm3. Image quality was significantly reduced at voxel sizes of 0.2 mm3 and 0.4 mm3, and was the worst quality at 0.4 mm3 voxels in all groups. Conclusions: CBCT imaging can be used to examine endodontic repair materials with adjustment of the effective radiation dose rate and selection of the appropriate voxel size.