Retrospective Analysis of Artifacts in Cone Beam Computed Tomography Images Used to Diagnose Chronic Rhinosinusitis

Abstract

Background: Cone beam computed tomography (CBCT) is frequently used to corroborate the signs and symptoms of chronic rhinosinusitis (CRS). However, artifacts induced by dental restorations might complicate the diagnosis of CRS. Here, we assessed the frequency and location of artifacts in CBCT images taken to confirm the CRS. Methods: All CBCT images of the patients referred to the Emergency Radiology unit, Turku University Hospital, with an indication of CRS in 2017 were re-examined. The prevalence of the artifacts was analyzed in three cross-sectional views and three horizontal levels delimited by anatomical landmarks. Results: In total, 214 CBCT images of patients with CRS were evaluated. The diagnosis of apical periodontitis (AP) was impaired by artifacts present in 150/214 images (70%). The diagnosis of CRS was impaired in 5 of the 214 images (2.3%). The main origins of the artifacts were large dental fillings or crowns, and endodontic fillings were present in 95% (203/214) and 52% (111/214) of the images, respectively. Conclusions: AP as an etiology of CRS is possible to miss because of artifacts originating from dental and endodontic fillings in the CBCT images of the paranasal sinuses.

Keywords

• cone beam CT
• artifact
• rhinosinusitis
• dental restorations
• apical periodontitis
• maxilla