Aim:To evaluate the performance of three cone beam computed tomography (CBCT) machines in detecting vertical root fractures (VRFs) in teeth filled with different sealers. Materials and methods: A total of 80 single-rooted premolars were subjected to instrumentation and restoration with gutta-percha + AH Plus sealer, gutta-percha + sealer 26, gutta-percha + fill canal, and gutta-percha without sealer as the control. Half of the samples were randomly subjected to root fracture and all the teeth were scanned by i-CAT (Imaging Sciences International, Hatfield, USA), PreXion (PreXion Inc., San Mateo, USA), and OrthoPhos XG (Sirona Dental System, Bensheim, Germany). Three examiners analyzed the images for the presence of fractures. Results: The highest accuracy was obtained with the PreXion device, with Az = 0.85, while the i-CAT device provided higher sensitivity (0.93).The specificity values observed ranged between 0.75 and 0.70. Chi-squared tests (p > 0.05) demonstrated that the sealers did not exert a significant influence on the diagnosis of VRF. Conclusion: It may be concluded that endodontic sealers do not influence the detection of VRF. The PreXion device was the most accurate, having the highest specificity value. Clinical significance: Radiopaque materials might affect the diagnosis of VRFs because they can simulate fracture lines, leading to false-positive results. Moreover, CBCT machines present different specificities that could exert some influence on that.Coronal access cavities were prepared, and the root canal treatment was done with a ProTaper Rotary System (DENTSPLY, Maillefer, Tulsa, OK, USA) up to size F3.The samples were divided into 4 groups with 20 teeth per group. The filling materials used per group were gutta-percha without a sealer, gutta-percha + AH Plus (DENTSPLY, Maillefer Tulsa, OK, USA), gutta-percha + sealer 26 (DENTSPLY, Maillefer Tulsa, OK, USA), and gutta-percha + fill canal (TechNew, Rio de Janeiro, Brazil).Teeth were wrapped in a thin layer of wax no.7 (TechNew, Rio de Janeiro, Brazil) until the region of the cervical collar. The teeth were then embedded in polyvinyl chloride (PVC) tubes containing acrylic resin.

Aim: Our objective was to perform an in vitro evaluation of root fracture in endodontically treated teeth using two cone beam computed tomography (CBCT) machines. Materials and methods:The sample comprised 86 singlerooted human premolars that had been fractured by a universal testing machine. The tomographic images were acquired using an Orthopantomograph OP300 ® and an Orthophos XG 3D ® and evaluated by three examiners, by means of specific software. The teeth were classified into presence or absence of root fracture, then the root third where the fracture occurred, was determined. With regard to the detection of the fracture, the Kappa statistic was used for intra and interexaminer reproducibility at two distinct points in time. Chi-squared test was employed to analyze the sensitivity and specificity of the two tomographs (p < 0.05). Results:The results showed a good or excellent Kappa index between examiners. As for the absolute frequency, the sensitivity (0.6) of the Orthophos XG 3D ® equipment was superior, while specificity (0.91) was higher with the Orthopantomograph OP300 ® . On the receiver operating characteristics curve, moderate performance was found with an accuracy of 0.73 (OrthopantomographOP300 ® ) and 0.74 (Orthophos XG 3D ® ) respectively. As far as the location of the root fracture is concerned, moderate agreement was verified using the Kappa statistic (k = 0.56). Evaluation of Root Fracture in endodontically treated Clinical significance:An early and precise detection of root fractures is of the utmost clinical importance, but the radiopaque and/or metallic filling materials in the CBCT viewing field may generate artifacts, known as the beam-hardening effect, which could compromise root fracture detection.

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