Assessment of vertical root fracture using cone-beam computed tomography

Abstract

PurposeThe aim of this study was to investigate the accuracy of cone-beam computed tomography (CBCT) in the diagnosis of vertical root fractures in a tooth with gutta-percha and prefabricated posts.Materials and MethodsThis study selected 96 extracted molar and premolar teeth of the mandible. These teeth were divided into six groups as follows: Groups A, B, and C consisted of teeth with vertical root fractures, and groups D, E, and F had teeth without vertical root fractures; groups A and D had teeth with gutta-percha and prefabricated posts; groups B and E had teeth with gutta-percha but without prefabricated posts, and groups C and F had teeth without gutta-percha or prefabricated posts. Then, the CBCT scans were obtained and examined by three oral and maxillofacial radiologists in order to determine the presence of vertical root fractures. The data were analyzed using IBM SPSS 20.0 (IBM Corp., Armonk, NY, USA).ResultsThe kappa coefficient was 0.875±0.049. Groups A and D showed a sensitivity of 81% and a specificity of 100%; groups E and B, a sensitivity of 94% and a specificity of 100%; and groups C and F, a sensitivity of 88% and a specificity of 100%.ConclusionThe CBCT scans revealed a high accuracy in the diagnosis of vertical root fractures; the accuracy did not decrease in the presence of gutta-percha. The presence of prefabricated posts also had little effect on the accuracy of the system, which was, of course, not statistically significant.

Influence of CBCT enhancement filters on diagnosis of vertical root fractures: a simulation study in endodontically treated teeth with and without intracanal posts

“…10 CBCT has allowed dental practitioners to visualize teeth three-dimensionally and with high spatial resolution. 11 While recent studies have demonstrated the superiority of CBCT in detecting root fractures, 1,3,4,6,[12][13][14][15] there are some limitations to proper imaging when high-density materials such as guttapercha and intracanal metal posts are present. These materials may create artefacts that impair the quality of CBCT images.…”

“…Beam hardening and streak artefacts can be superimposed on the root, creating difficulties for image assessment and may even mimic root fractures. 4,6,7,9,12,[15][16][17] Some specific tools can be used to analyse CBCT images, including filters that use mathematical algorithms to minimize image noise and improve image quality. 18,19 Some studies have shown that CBCT filters improve the diagnosis of root fractures in nonendodontically treated teeth, 5,19 but studies evaluating the influence of filters on the diagnosis of fractures in endodontically treated roots are still missing.…”

Maksi̇llofasi̇yal Fraktürleri̇n Koni̇k Işinli Bi̇lgi̇sayarli Tomografi̇ İle Retrospekti̇f Olarak Değerlendi̇ri̇lmesi̇

“…Son yıllarda, radyasyon dozu, görüntü kalitesi ve hasta rahatlığı açısından BT'ye göre daha avantajlı olan konik ışınlı bilgisayarlı tomografi (KIBT) tekniği öne çıkmıştır 3 . Bilgimiz dâhilinde, literatürde maksillofasiyal fraktürlerin KIBT ile değerlendirildiği az sayıda araştır-ma bulunmaktadır ve bu çalışmalarda genellikle dental fraktürler incelenmiştir 4,5 . Bu çalışmanın amacı, maksillofasiyal bölgedeki fraktürlerin radyografik özelliklerini KIBT ile retrospektif olarak değerlendirmektir.…”

“…Maksillofasiyal fraktürlerin KIBT ile değerlendirildiği çalışmalarda araştırmacılar genellikle dental fraktürlere odaklanmışlardır [4][5][6] . Bu konuda genellikle olgu sunumları, derlemeler, panoramik radyografi, BT ve KIBT'nin etkinliğinin karşılaştırıldığı ça-lışmalar yapılmıştır [7][8][9][10] .…”

Diagnostic accuracy of cone beam computed tomography with and without metal artifact reduction algorithm in detection of vertical root fractures of teeth with metallic posts

“…Beam hardening and streak artifacts can be superimposed on the root, creating difficulties for image assessment and may even mimic root fractures. [5,6] Recent CBCT machines can apply metal artifact reduction algorithms that may be effective in reducing metallic posts artifacts which will provide 3-dimensional CBCT images with metallic artifacts reduction and thus allow for better detection of root fractures in teeth with metallic posts. It was demonstrated that the artifact reduction algorithm in the Master 3D machine (Vatech, Hwaseong, South Korea) enhances the contrast-tonoise ratio of the resulting images.…”