Objectives: Cone beam CT (CBCT) is used widely to depict root fracture (RF) in endodontically treated teeth. Beam hardening and other artefacts due to gutta-percha may increase the time of the diagnosis and result in an incorrect diagnosis. Two CBCT machines, ProMax ® (Planmeca, Helsinki, Finland) and Master 3D ® (Vatech, Hwaseong, Republic of Korea), have the option of applying an artefact reduction (AR) algorithm. The aim of this study was to determine whether using an AR algorithm in two CBCT machines enhances the accuracy of detecting RFs in endodontically treated teeth. Methods: 66 roots were collected and decoronated. All roots were treated endodontically using the same technique with gutta-percha and zinc oxide cement. One-half of the roots were randomly selected and fractured using a nail that was tapped gently with a hammer until complete fracture resulted in two root fragments; the two root fragments were glued together with one layer of methyl methacrylate. The roots were placed randomly in eight prepared beef rib fragments. Results: The highest accuracy was obtained when the ProMax was used without AR. The lowest accuracy was obtained with the Master 3D when used with AR. For both machines, accuracy was significantly higher without AR than with AR. Both with and without AR, the ProMax machine was significantly more accurate than the Master 3D machine. The same rank ordering was obtained for both sensitivity and specificity. Conclusions: For both machines, AR decreased the accuracy of RF detection in endodontically treated teeth. The highest accuracy was obtained when using the ProMax without AR.

Improved quality of images and regaining of the control gray values of a phantom were achieved when the MAR algorithm was used in the presence of a metallic bead.

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CBCT small FOVs should be acquired for depicting RFs of endodontically treated teeth. Images obtained using PSP plates had the lowest rate of false-positive results and their use can save the patient a radiation dose.

PurposeThe purpose of this study was to evaluate and compare the efficacy of cone-beam computed tomography (CBCT) and digital intraoral radiography in diagnosing simulated small external root resorption cavities.Materials and MethodsCavities were drilled in 159 roots using a small spherical bur at different root levels and on all surfaces. The teeth were imaged both with intraoral digital radiography using image plates and with CBCT. Two sets of intraoral images were acquired per tooth: orthogonal (PA) which was the conventional periapical radiograph and mesioangulated (SET). Four readers were asked to rate their confidence level in detecting and locating the lesions. Receiver operating characteristic (ROC) analysis was performed to assess the accuracy of each modality in detecting the presence of lesions, the affected surface, and the affected level. Analysis of variation was used to compare the results and kappa analysis was used to evaluate interobserver agreement.ResultsA significant difference in the area under the ROC curves was found among the three modalities (P=0.0002), with CBCT (0.81) having a significantly higher value than PA (0.71) or SET (0.71). PA was slightly more accurate than SET, but the difference was not statistically significant. CBCT was also superior in locating the affected surface and level.ConclusionCBCT has already proven its superiority in detecting multiple dental conditions, and this study shows it to likewise be superior in detecting and locating incipient external root resorption.

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