Artifacts of Titanium, Zirconium, and Binary TitaniumZirconium 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, and titanium-zirconium abutments in computed tomography (CT), cone-beam computed tomography (CBCT), and magnetic resonance imaging (MRI) modalities. Methods: A 4×8-mm titanium fixture was inserted in a dry human mandible. Titanium, zirconium, and titanium-zirconium abutments measuring 10.5 mm in height were located on the fixture one by one. Each abutment was scanned four times by each imaging modality. The 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 the Image J software. Gray value differences (ΔGVs) between the control (i.e., fixture without abutment) and case (i.e., fixture and each type of abutment) images were calculated. Data analysis was performed by the analysis of variance and post hoc tests. Results: In the CBCT, ΔGV was significantly higher in zirconium-titanium images, compared with that in images with titanium abutments (P 0.05). In the distal, mesial, and buccal aspects of ROI in CT, the ΔGV was higher in zirconium images, compared with titanium abutments. In the MRI, ΔGV for zirconium was lower than those for titanium-zirconium and titanium samples, respectively. Furthermore, no significant differences in ΔGV 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.