Effect of exposure parameters and gutta-percha cone size on fracture-like artifacts in endodontically treated teeth on cone-beam computed tomography images

Objectives To ascertain the effects of exposure parameters (tube current and tube voltage) and the gutta-percha cone (GPC) size on root fracture-like artifacts obtained with cone-beam computed tomography (CBCT). Methods Fracture-like artifacts appearing on CBCT images of nine extracted human mandibular premolars filled with GPCs of size #50 or #80 were analyzed using six exposure factors: two tube voltages (80 kV and 110 kV); and three tube currents (4 mA, 7 mA, and 10 mA). On axial images, the gray value (GV) was recorded at three points: the mesiobuccal portion (MBP) as the sound dentin, the mesial portion (MP) as the artifact line, and the water area (WA). The rate of decrease in the GV (RDGV) of the artifact line was calculated using the formula: RDGV (%) = (GV of MBP − GV of MP) × 100/(GV of MBP − GV of WA). Results Comparison of the #80 group and the #50 group with equal tube voltages and tube currents shows that artifact lines in the #80 group were more obvious than those in the #50 group. The artifact lines with 80 kV were markedly more visible than those with 110 kV for each tube current and GPC size. Tube current changes did not affect the artifact line for any tube voltage or GPC size. Conclusions For the reduction of artifacts, we recommend selection of higher tube voltages and lower tube currents when taking CBCT images of teeth with each GPC size.