Quantitative evaluation of artifact expression of mesoporous calcium silicate nanoparticles as a new promising root canal sealer in cone-beam computed tomography

Objectives: To quantitatively evaluate the artifact area of the image of mesoporous calcium silicate nanoparticles (MCSNs) using cone-beam computed tomography (CBCT).Methods: Forty single-rooted mandibular premolars were selected and prepared with NiTi rotary instruments to 35/0.04, and divided into four groups (n=10): (I) AH Plus sealer; (II) MCSNs sealer; (III) iRoot SP sealer and (IV) no sealer. There were filled with a single cone (35/0.04 taper) method. The roots were scanned using a CBCT with the same parameters before and after filling. The images were evaluated using ImageJ’s threshold tool to quantitatively determine the hyperdense and hypodense artifacts, and non-affected teeth areas within 8-bit images extracted from the scans.Results: MCSNs showed fewer hyperdense artifacts than AH plus and iRoot SP (P < 0.01), while the hypodense artifacts were not statistically significant among groups (P > 0.05).Conclusion: MSCNs can effectively reduce the generation of hyperdense artifacts in CBCT images and show better image qualities, indicating that they have a minor adverse effect on evaluating the quality of root canal filling and diagnosing root canal diseases in CBCT images.Clinical Relevance: As a novel type of root canal filling nanomaterials, MSCNs have less artifact expression and higher quality in CBCT images. Therefore, this new root filling material is expected to play a positive role in improving the correct clinical evaluation of root canal filling teeth and the visualization of root canal cracks and fractures.