(Open access funding provided by Semmelweis University)
Szakterületek:
Fogászat
Radiológia, sugárgyógyászat és orvosi képalkotás
Background Before the magnetic resonance imaging (MRI) examination fixed orthodontic
devices, such as brackets and wires, cause challenges not only for the orthodontist
but also for the radiologist. Essentially, the MRI-safe scan of the fixed orthodontic
tools requires a proper guideline in clinical practice. Therefore, this systematic
review aimed to examine all aspects of MRI-safe scan, including artifact, thermal,
and debonding effects, to identify any existing gaps in knowledge in this regard and
develop an evidence-based protocol. Methods The Preferred Reporting Items for Systematic
Reviews and Meta-analysis (PRISMA) statement was used in this study. The clinical
question in "PIO" format was: "Does MRI examination influence the temperature of the
orthodontic devices, the size of artifacts, and the debonding force in patients who
have fixed orthodontic bracket and/or wire?" The search process was carried out in
PubMed, PubMed Central, Scopus, and Google Scholar databases. The search resulted
in 1310 articles. After selection according to the eligibility criteria, 18 studies
were analyzed by two reviewers. The risk of bias was determined using the Quality
In Prognosis Studies tool. Results Out of the eligible 18 studies, 10 articles examined
the heating effect, 6 were about the debonding effect, and 11 measured the size of
artifact regarding brackets and wires. Considering the quality assessment, the overall
levels of evidence were high and medium. The published studies showed that heating
and debonding effects during MRI exposure were not hazardous for patients. As some
wires revealed higher temperature changes, it is suggested to remove the wire or insert
a spacer between the appliances and the oral mucosa. Based on the material, ceramic
and plastic brackets caused no relevant artifact and were MRI-safe. Stainless steel
brackets and wires resulted in susceptibility artifacts in the orofacial region and
could cause distortion in the frontal lobe, orbits, and pituitary gland. The retainer
wires showed no relevant artifact. Conclusions In conclusion, the thermal and debonding
effects of the fixed orthodontic brackets and wires were irrelevant or resoluble;
however, the size of the artifacts was clinically relevant and determined most significantly
the feasibility of fixed brackets and wires in MRI examination.
