Computed Tomographic Artifacts in Maxillofacial Surgery.

OBJECTIVES: The present study aimed to present 4 cases and to undertake a systematic review on the current knowledge of the impact of cone beam computed tomographic (CBCT) artifacts on oral and maxillofacial surgical planning and follow-up.

METHODS: The MEDLINE (PubMed) database was searched for the period from February 2004 to February 2017, for studies on the impact of CBCT artifacts on surgical planning of oral and maxillofacial surgeries. The PRISMA statement was followed during data assessment and extraction. As a result, data extraction included information regarding: the use of CBCT to plan or follow-up oral and maxillofacial surgeries, presence and type identification of a CBCT artifact, and details on the impact of artifacts on image quality and/or surgical planning. Four cases were selected to illustrate the topic.

RESULTS: The search strategy yielded 408 publications in MEDLINE (PubMed). An initial screening of the publications was performed using abstracts and key words. After application of exclusion criteria, a total of 11 studies were finally identified as eligible to be discussed. Studies revealed 3 main types of artifact: beam hardening, streak, and motion artifacts. Most of the studies suggest that artifacts significantly affect oral and maxillofacial surgical planning and follow-up, despite of allowing for identification of metal projectiles in cases of maxillofacial trauma.

CONCLUSION: CBCT artifacts have a significant impact on oral and maxillofacial surgical planning and follow-up.