Diagnosis of vertical root fracture in teeth close and distant to implant: an in vitro study to assess the influence of artifacts produced in cone beam computed tomography

Freitas, Deborah Queiroz; Vasconcelos, Taruska Ventorini; Noujeim, Marcel

doi:10.1007/s00784-018-2558-z

Cited by 37 publications

(51 citation statements)

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“…, Freitas et al . ). On the other hand, in clinical situations, one assesses not only the presence of the fracture itself but also the shape, localization, and size of bone resorption adjacent to the fracture; that is, the fracture may not be detected, but can be diagnosed (Fayad et al .…”

Section: Introductionmentioning

confidence: 97%

“…The presence of multiple metal constructions in teeth with VRF as well as in adjacent teeth (e.g. posts, post-cores, crowns, implants) may also decrease the efficacy of CBCT for the detection of a fracture because of artefacts causing significant image degradation and misrepresentation in the region of interest (Tadinada et al 2015, Freitas et al 2018). On the other hand, in clinical situations, one assesses not only the presence of the fracture itself but also the shape, localization, and size of bone resorption adjacent to the fracture; that is, the fracture may not be detected, but can be diagnosed (Fayad et al 2012).…”

Section: Introductionmentioning

confidence: 99%

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The accuracy of CBCT for the detection and diagnosis of vertical root fractures in vivo

et al. 2019

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Aim To compare the in vivo accuracy of CBCT for the detection of fracture lines versus the diagnosis of vertical root fractures (VRFs) according to characteristic patterns of associated bone resorption. Methodology Eighty‐eight patients with symptoms typical of VRFs in root filled teeth, who underwent a CBCT examination and later had the teeth extracted, were divided into two groups: the fracture group (n = 65) and the control group (n = 23). Five blinded observers assessed the CBCT images in two sessions. During the first session, they were asked to state the diagnosis according to the CBCT and clinical data. During the second session after 2 weeks, they assessed only axial slices and were asked to detect a fracture line. The mean CBCT specificity, sensitivity, accuracy values and area under the receiver operating characteristic (AUROC) curve were calculated and compared using the Wilcoxon signed‐rank test. Results The average sensitivity of CBCT for the diagnosis of VRFs was 0.84 ± 0.2. The accuracy and AUC values were 0.81 ± 0.08 and 0.84 ± 0.17, respectively. The sensitivity, accuracy and AUC values for the detection of VRFs were significantly lower: 0.17 ± 0.24 (P = 0.042), 0.54 ± 0.07 (P = 0.043), and 0.52 ± 0.09 (P = 0.043), respectively. The specificity of CBCT for the detection and diagnosis of VRFs did not differ significantly (P = 0.50). Conclusion Cone‐beam computed tomography was helpful in VRF diagnosis even when it was not possible to visualize the fracture line.

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Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

The accuracy of CBCT for the detection and diagnosis of vertical root fractures in vivo

et al. 2019

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“…Such materials include dental restorations and metal crowns, dental implants, gutta-percha, and metal posts. Restorations and crowns create artifacts at the level of dental crowns, which may affect the diagnosis of carious lesions, 4 while the other materials generate artifacts at the level of dental roots and alveolar bone, negatively influencing the ability of clinicians to detect conditions such as root fractures, 5,6 root resorptions, 7 and bone defects. 8 The production of artifacts in regions adjacent to highdensity materials is relatively well understood.…”

Section: Introductionmentioning

confidence: 99%

Magnitude of beam-hardening artifacts produced by gutta-percha and metal posts on cone-beam computed tomography with varying tube current

et al. 2020

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Purpose: This study was performed to evaluate the magnitude of artifacts produced by gutta-percha and metal posts on cone-beam computed tomography (CBCT) scans obtained with different tube currents and with or without metal artifact reduction (MAR). Materials and Methods: A tooth was inserted in a dry human mandible socket, and CBCT scans were acquired after root canal instrumentation, root canal filling, and metal post placement with various tube currents with and without MAR activation. The artifact magnitude was assessed by the standard deviation (SD) of gray values and the contrastto-noise ratio (CNR) at the various distances from the tooth. Data were compared using multi-way analysis of variance. Results: At all distances, a current of 4 mA was associated with a higher SD and a lower CNR than 8 mA or 10 mA (P<0.05). For the metal posts without MAR, the artifact magnitude as assessed by SD was greatest at 1.5 cm or less (P<0.05). When MAR was applied, SD values for distances 1.5 cm or closer to the tooth were reduced (P<0.05). MAR usage did not influence the magnitude of artifacts in the control and gutta-percha groups (P>0.05). Conclusion: Increasing the tube current from 4 mA to 8 mA may reduce the magnitude of artifacts from metal posts. The magnitude of artifacts arising from metal posts was significantly higher at distances of 1.5 cm or less than at greater distances. MAR usage improved image quality near the metal post, but had no significant influence farther than 1.5 cm from the tooth.

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“…Another study recommended removing root canal filling material before taking images to increase the potential of CBCT [36]. Using the metal artifact reduction (MAR) algorithm improves the specificity; its use is recommended when there are metal objects near teeth with suspected VRF [37]. Other authors have reported protocols with smaller FOVs and voxels and achieved better sensitivities and specificities when detecting horizontal root fracture [38,39].…”

Section: Discussionmentioning

confidence: 99%

Assessment of Fractures in Endodontically Treated Teeth Restored with and without Root Canal Posts Using High-Resolution Cone Beam Computed Tomography

Aristizábal-Elejalde¹,

Arriola-Guillén

Castillo

et al. 2019

Preprint

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Background: Root fractures are a diagnostic challenge for dentists because their signs and symptoms are not present in all cases, and they are difficult to differentiate from endodontic treatment failures, the purpose of the present study was to determine the relationship between the characteristics of tooth fractures and the presence of root canal posts in endodontically treated teeth using high-resolution cone beam computed tomography (CBCT). Methods: Fifty high-resolution CBCT scans of endodontically treated teeth with a diagnosis of fracture were obtained, of which 30 were from women and 20 were from men. These scans were acquired with three Veraviewepocs 3D units and one 3D Accuitomo 170 unit, with a 40 × 40-mm field of view and 125 μm voxel size. The variables assessed included the type of fracture, extent of fracture, type of retention, post length, cause of endodontic failure, location of the lesion, and time required to detect the fracture (difficulty score). For data analysis, the chi-squared test, Student's t-test, and multiple linear regression (α ˂0.05) were used. Results: No association was found between the type of fracture and type of retention or between the type of fracture and its extent (P ˃0.05). On the other hand, the type of fracture significantly influenced the time required for its detection. Additionally, the most difficult plane for detecting the fracture and the difficulty score were associated, with statistically significant results. Conclusions: The type of fracture in endodontically treated teeth was not associated with the type of post used for restoration. All of the CBCT systems used to detect tooth fracture showed the same efficiency. Keywords: Cone Beam Computed Tomography, Tooth Fracture, Root Canal Post, High Resolution

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Diagnosis of vertical root fracture in teeth close and distant to implant: an in vitro study to assess the influence of artifacts produced in cone beam computed tomography

Abstract: Since nowadays, many patients who undergo CBCT show implants and they definitively produce artifacts, it is important to evaluate the influence of such artifacts in the diagnosis of teeth that are close to the generator-artifact object.

Cited by 37 publications

References 36 publications

The accuracy of CBCT for the detection and diagnosis of vertical root fractures in vivo

The accuracy of CBCT for the detection and diagnosis of vertical root fractures in vivo

Magnitude of beam-hardening artifacts produced by gutta-percha and metal posts on cone-beam computed tomography with varying tube current

Assessment of Fractures in Endodontically Treated Teeth Restored with and without Root Canal Posts Using High-Resolution Cone Beam Computed Tomography

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