Original Article

Effect of Exposure Parameters on Metal Artifacts in Cone Beam Computed Tomography


Objectives: The aim of this study was to assess the effect of tube current, kilovoltage peak (kVp), metal type, and the position of metal objects on metal artifacts in cone-beam computed tomography (CBCT) images.
Materials and Methods: Titanium and cobalt-chromium rods were fabricated and placed in a dry human mandible. Samples were scanned using a Promax 3D CBCT unit with different milli-amperages and kVp. The artifacts induced by metal objects were evaluated using the Image J software in four regions of interest (ROIs) on each image.
Results: A higher kVp decreased artifacts of the buccal surface of the rods in 97% of the cases (P=0.046) but did not affect the severity of artifacts between the two metal objects (P>0.05). Increasing the tube current had no effect on metal artifacts in 93% of the cases (P>0.05). Artifacts induced by a cobalt-chromium alloy were more severe than those with titanium (P<0.001). Artifacts were more intense in the buccal surface of anterior rods compared to the posterior rods (P<0.003).
Conclusions: Tube voltage, metal type and the position of metal objects affected the severity of metal artifacts on CBCT images. The metal type had the greatest effect on metal artifact intensity in this study.


- Brullmann D, Schulze RK. Spatial resolution in CBCT machines for dental/maxillofacial applications-what do we know today? Dentomaxillofac Radiol. 2015;44(1):20140204.

- Bornstein MM, Scarfe WC, Vaughn VM, Jacobs R. Cone beam computed tomography in implant dentistry: a systematic review focusing on guidelines, indications, and radiation dose risks. Int J Oral Maxillofac Implants. 2014 Jan;29 Suppl:55-77

- Benavides E, Rios HF, Ganz SD, An CH, Resnik R, Reardon GT, et al. Use of cone beam computed tomography in implant dentistry: the International Congress of Oral Implantologists consensus report. Implant Dent. 2012 Apr;21(2):78-86.

- Harris D, Horner K, Grondahl K, Jacobs R, Helmrot E, Benic GI, et al. E.A.O. guidelines for the use of diagnostic imaging in implant dentistry 2011. A consensus workshop organized by the European Association for Osseointegration at the Medical University of Warsaw. Clin Oral Implants Res. 2012 Nov;23(11):1243-53.

- American Association of Endodontists; American Academy of Oral and Maxillofacial Radiology. Use of cone-beam computed tomography in endodontics Joint Position Statement of the American Association of Endodontists and the American Academy of Oral and Maxillofacial Radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Feb;111(2):234-7.

- Scarfe WC, Levin MD, Gane D, Farman AG. Use of cone beam computed tomography in endodontics. Int J ent.2009;2009:634567.

- Garib DG, Calil LR, Leal CR, Janson G. Is there a consensus for CBCT use in Orthodontics? Dental Press J Orthod. 2014 Sep-Oct;19(5):136-49.

- Ahmad M, Jenny J, Downie M. Application of cone beam computed tomography in oral and maxillofacial surgery. Aust Dent J. 2012 Mar;57 Suppl 1:82-94.

- Pauwels R, Araki K, Siewerdsen JH, Thongvigitmanee SS. Technical aspects of dental CBCT: state of the art. Dentomaxillofac Radiol.2015;44(1):20140224.

- Jaju PP, Jain M, Singh A, Gupta A. Artefacts in cone beam CT. Open J Stomatol. 2013 Jul;3(05):292.

- Schulze RK, Berndt D, d'Hoedt B. On cone-beam computed tomography artifacts induced by titanium implants. Clin Oral Implants Res. 2010 Jan;21(1):100-7.

- Bechara B, McMahan CA, Geha H, Noujeim M. Evaluation of a cone beam CT artefact reduction algorithm. Dentomaxillofac Radiol. 2012 Jul;41(5):422-8.

- Gong XY, Meyer E, Yu XJ, Sun JH, Sheng LP, Huang KH, et al. Clinical evaluation of thenormalized metal artefact reduction algorithm caused by dental fillings in CT. Dentomaxillofac Radiol.


- Ibraheem I. Reduction of artifacts in dental cone beam CT images to improve the three dimensional image reconstruction. J Biomed Sci Eng. 2012 Aug;5 (8):409-15.

- Bechara BB, Moore WS, McMahan CA, Noujeim M. Metal artefact reduction with cone beam CT: an in vitro study. Dentomaxillofac Radiol. 2012 Mar;41 (3):248-53.

- Barrett JF, Keat N. Artifacts in CT: recognition and avoidance. Radiographics. 2004 Nov-Dec;24(6):1679-91.

- Pauwels R, Stamatakis H, Bosmans H, Bogaerts R, Jacobs R, Horner K, et al. Quantification of metal artifacts on cone beam computed tomography images. Clin Oral Implants Res. 2013 Aug;24 Suppl A100:94-9.

- Katsumata A, Hirukawa A, Noujeim M, Okumura S, Naitoh M, Fujishita M, et al. Image artifact in dental cone-beam CT. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 May;101(5):652-7.

- Benic GI, Sancho-Puchades M, Jung RE, Deyhle H, Hammerle CH. In vitro assessment of artifacts induced by titanium dental implants in cone beam computed tomography. Clin Oral Implants Res. 2013


- Chindasombatjareon J, Kakimoto N, Murakami S, Maeda Y, Furukawa S. Quantitative analysis of metallic artifacts caused by dental metals: comparison of cone-beam and multi-detector row CT scanners. Oral Radiol. 2011 Dec;27(2):114-20.

- Schulze R, Heil U, Gross D, Bruellmann DD, Dranischnikow E, Schwanecke U, et al. Artefacts in CBCT: a review. Dentomaxillofac Radiol. 2011 Jul;40(5):265-73.

- Kataoka ML, Hochman MG, Rodriguez EK, Lin PJ, Kubo S, Raptopolous VD. A review of factors that affect artifact from metallic hardware on multi-row detector computed tomography. Curr Probl Diagn Radiol. 2010 Jul-Aug;39(4):125-36.

- Schulze D, Heiland M, Blake F, Rother U, Schmelzle R. Evaluation of quality of reformatted images from two cone-beam computed tomographic systems. J Craniomaxillofac Surg. 2005 Feb;33(1):19-23.

- Hunter A, McDavid D. Analyzing the beam hardening artifact in the Planmeca Promax. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Apr;107(4):e28-9.

- Draenert FG, Coppenrath E, Herzog P, Muller S, Mueller-Lisse UG. Beam hardening artefacts occur in dental implant scans with the NewTom cone beam CT but not with the dental 4-row multidetector CT.Dentomaxillofac Radiol. 2007 May;36(4):198-203.

- Kuusisto N, Vallittu PK, Lassila LV, Huumonen S. Evaluation of intensity of artefacts in CBCT by radio-opacity of composite simulation models of implants in vitro. Dentomaxillofac Radiol.2015;44(2):20140157.

- White SC, Pharoah MJ. Oral radiology: principles and interpretation. 7th Ed., St. Louis, Missouri, Elsevier-Mosby,2014:196.

IssueVol 13, No 3 (2016) QRcode
SectionOriginal Article
cone-beam computed tomography artifacts metals

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Panjnoush M, Kheirandish Y, Mohseni Kashani P, Bashizadeh Fakhar H, Younesi F, Mallahi M. Effect of Exposure Parameters on Metal Artifacts in Cone Beam Computed Tomography. Front Dent. 2016;13(3):143-150.

Most read articles by the same author(s)