Investigation on the frequency of streak artifacts resulted from different sealers in cone-beam computed tomography images

Aim: This ex-vivo study aimed to investigate streaking artifacts produced by three different sealers to prevent false-positive diagnosis of vertical root fractures (VRF) in clinical settings using cone-beam computed tomography (CBCT).

Materials and Methods: The present experimental study included 60 mandibular teeth, single-rooted premolars prepared using a Protaper F3 file and randomly classified into 4 groups, which were obturated using gutta-percha F3 cones alone (control group) or with one of the sealers: MTA Fillapex (FA), Sealapex, and AH26. The teeth underwent CBCT scan with a 5×8 cm field of view (FOV), and the images were qualitatively evaluated in axial sections by two observers and were coded as follows: Code 1: absence of dark streaks, Code 2: slight dark streaks, Code 3: pronounced dark streaks not extending to the root surface, Code 4: dark streaks extending to the root surface, resembling a fracture.

Data were analyzed using SPSS software version 20.chi-square test was used for artifact frequency comparison at P≤0.05 level of significance.

Result: According to both observers, there was no significant inter-group difference in artifact frequency (P>0.05), while Code 3 was the most common artifact observed in all groups.

Conclusions: Dark streaks not extending to the root surface (code 3) were the most common artifact in the teeth obturated using gutta-percha cones alone or with sealers MTA Fillapex (FA), Sealapex, and AH26.