Abstract
Background. Metal artifacts generated by dental implants may impair cone-beam computed tomography (CBCT) image quality and reduce the accuracy of peri-implant bone assessment. Although metal artifact reduction (MAR) algorithms are widely available, their effectiveness may vary according to implant characteristics. This study aimed to evaluate CBCT gray-value artifact profiles of different commercially available dental implant brands and to assess the effect of MAR under standardized in vitro conditions. Methods. Eleven commercially available dental implant systems were individually embedded in a standardized wax phantom and scanned using a CS 9600 CBCT unit with identical acquisition parameters (120 kVp, 5 mA, 12 s, 12 × 5 cm field of view, 0.3-mm voxel size). Each implant was scanned three times and reconstructed with and without MAR. Gray-value measurements were obtained from eight standardized circular regions of interest positioned around each implant on the mid-axial slice. Results. A total of 528 region-of-interest measurements were analyzed. The overall effect of MAR was evaluated using paired brand-level mean values with the Wilcoxon signed-rank test. MAR significantly reduced the overall gray-value artifact measurements from 41.81 to 35.75 (p = 0.002), corresponding to a 14.5% reduction. Artifact values decreased in 10 of the 11 implant brands, whereas Meisinger demonstrated a slight increase. The greatest reductions were observed for Straumann (27.9%), iRES (26.2%), and NTA (20.9%) implants. ROI-level exploratory analyses showed significant reductions for seven implant brands, while no significant changes were observed for the remaining brands. Conclusion.The findings indicate that dental implant brands exhibit distinct CBCT artifact profiles and that the effectiveness of MAR is not uniform across implant systems. Although MAR reduced gray-value alterations under standardized experimental conditions, these quantitative improvements should not be interpreted as direct evidence of enhanced diagnostic performance for peri-implant bone defects.Dental implant brands demonstrate variable CBCT gray-value artifact behavior, and the impact of MAR differs among implant systems. These findings provide experimental evidence that implant-specific factors should be considered when interpreting CBCT images and evaluating the potential benefits of MAR in peri-implant imaging.