Artifact expression of polyetheretherketone in cone beam computed tomography: An in vitro study

Köse T. E., Günaçar D. N., Ateş S. M., Çağlar İ.

JOURNAL OF PROSTHETIC DENTISTRY, vol.126, no.6, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 126 Issue: 6
  • Publication Date: 2021
  • Doi Number: 10.1016/j.prosdent.2021.09.028
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Recep Tayyip Erdoğan University Affiliated: Yes


Statement of problem

Dental prosthetic materials can cause artifacts in cone beam computed tomography (CBCT) images, adversely affecting diagnostic quality, although the problem may be less with polyetheretherketone (PEEK). Studies evaluating the artifacts caused by frequently used prosthetic materials are lacking.


The purpose of this in vitro study was to compare the artifacts in CBCT images caused by PEEK, zirconia, cobalt-chromium (Co-Cr) alloy, and titanium (Ti).

Material and methods

polymethylmethacrylate phantom (Ø4.0×4.0 cm) with a central cylindrical aperture (Ø0.5×0.5 cm) was produced. Co-Cr, Ti, zirconia, and PEEK cylinders (0.5×0.5 cm) were manufactured, and CBCT images of the empty phantom (control group) with the test cylinders inside were made 3 times. In all images, the axial sections passing through the middle of the materials were evaluated. Eight regions of interest (ROI) area were determined around the materials (0.5×0.5 cm). The presence of artifacts was evaluated by making gray value standard deviation (SD) calculations in these ROI areas. The average SD values of 8 ROI fields from the 3 CBCT scans were made, and the materials were compared with each other in terms of the presence of artifacts by using 1-way analysis of variance (α=.05).


The difference between the SD values of the control and the PEEK cylinder was not statistically significant (P>.05). The SD values of both the control and PEEK groups were significantly lower than those of the zirconia, Co-Cr, and Ti groups (P<.05).


Zirconia, Ti, and Co-Cr caused artifacts in CBCT images, but the artifacts with PEEK were similar to those in the control group, suggesting it was the optimal choice in terms of achieving diagnostic quality.