Artifacts of Titanium, Zirconium, and Binary Titanium-Zirconium Abutments in Compute Tomography, Cone Beam Computed Tomography, and Magnetic Resonance Imaging

Aim: The aim of this in vitro study was to evaluate imaging artifacts induced by Titanium, Zirconium, Titanium-Zirconium abutments in CT, MRI and CBCT imaging modalities.Methods: A 4×8mm titanium fixture was inserted in a dry human mandible. Titanium, Zirconium and Titanium–Zirconium abutments measuring 10.5 mm in height are located on the fixture, one by one. Each abutment was scanned 4 times by each imaging modality. Gray value of the images was evaluated in four determined regions adjacent to distal, mesial, buccal and lingual aspects of the implant as the region of interest (ROI) by two observers using image J software. Gray value differences (∆GV) between the control (fixture without abutment) and case images (fixture and each type of abutments) were calculated. Data evaluation was done by analysis of variance and Post Hoc tests.Results: In CBCT, ∆GV was significantly higher in zirconium-titanium images comparing with titanium abutments. (P Value < 0.05)In distal, mesial and buccal aspects of ROI in CT, ∆GV was higher in zirconium images comparing with titanium abutments.In MRI, ∆GV for zirconium were lower than titanium-zirconium and titanium samples, respectively. Also, no significant differences in ∆GV were seen between T1 and T2 protocols, for all samples. Conclusion: In MRI, image artifacts are the least around Zirconium abutments, while in CT and CBCT, titanium abutments produced the least amount of artifacts.