Contributions to the study of common artifacts and errors in conventional and three-dimensional radio-imaging used in the evaluation of odontal, endodontic and periodontal pathology

Diana-Florina Kulcsar 1, Oana Elena Stoica 1, Monica Dana Monea 1, Alexandra Mihaela Stoica 1
1 George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu-Mures, Romania

Introduction: X-ray radio imaging is commonly used because most diseases in the oral area can only be diagnosed by using this method. Proper identification of elements on a radiological image may also be difficult due to errors that may occur before, during or after the X-ray. These errors are called artifacts.
Aim of the study: The aim of our study is to distinguish the artifacts that can occur on two-dimensional and three-dimensional dental X-rays (intraoral or extraoral) from the actual pathology of the investigated area, by performing control X-rays.
Material and Methods: In our study we viewed, assessed and compared a number of 80 retroalveolar X-rays, 45 orthopantomographs (OPG) and 35 Cone Beam Computer Tomography (CBCT). In case of artifacts or errors, X-rays were repeated within 5 days or a CBCT was performed. In the case of OPGs, another option was to perform retroalveolar X-rays to establish the final diagnosis.
Results: From a total of 80 retroalveolar X-rays, in 13 cases (16.25%) we found artifacts. Of these, in only 4 cases (5%) diagnosis and treatment plan were changed following a clinical examination or a CBCT. In the case of OPGs, out of a total of 45 OPGs, 17 (37.7%) presented artifacts, but only in a percentage of 17.7% (8 cases) they affected the diagnosis. Of the 35 CBCTs, in 10 of them (28.57%) prosthetic works with a metal component or implants were present, with specific artifacts found, but their presence did not influence the diagnosis.
Conclusion: It is necessary for doctors to know the anatomy of the oral region, the most fervent appearance of the components and the different types of artifacts that may occur. Control X-ray is a very commonly used possibility, but there are cases where radiation exposure needs to be minimized.