The Effect of Basis Images and a Metal Artifact Reduction Algorithm on Artifact Expression and Trabecular Bone Architecture in the Vicinity of a Zirconia Dental Implant Placed in Different Mandibular Regions: An Ex Vivo Study.

This study investigates the effects of the number of basis images and the use of a metal artifact reduction (MAR) algorithm on artifact expression and trabecular bone architecture assessment near zirconia (Zr) dental implants placed in anterior and posterior mandibular regions using cone beam computed tomography (CBCT). Results showed that the presence of Zr implants increased artifact expression—measured by the standard deviation of gray values—especially in the posterior mandible without MAR activation, which also led to decreased fractal dimension (FD) and connectivity density (ConnD) values in trabecular bone analysis. Increasing the number of basis images from 450 to 720 had minimal impact on artifact reduction or bone parameter assessment but increased radiation exposure. Conversely, activating the MAR tool effectively reduced artifact expression and mitigated reductions in FD and ConnD values. The findings suggest that, for the CBCT device tested (Picasso Trio), using MAR with a lower number of basis images is preferable for evaluating medullary bone near Zr implants to optimize image quality while minimizing radiation dose.