By considering the importance of vertical root fractures (VRF) and the known complications of incorrect diagnoses, the present study aimed to evaluate the effect of different kilovoltage peak (kVp) and milliampere (mA) settings in conebeam computed tomography (CBCT) on the diagnosis of VRFs in endodontically treated single-canal premolars. Eighty intact human premolars were endodontically treated and coded. The roots of half of the samples were fractured, and CBCT images were taken by using four different combinations of maximum (max) and minimum (min) kVp (60-86) and mA (6-10) settings under the same conditions. The images were randomly observed twice by an experienced oral and maxillofacial radiologist over a two-week interval. The results were analyzed by Chi-square test. In the kVp max/mA max group, none of the images were diagnostic. In the kVp max/mA min group, 62 images (77.5%) were nondiagnostic. The results of these two groups showed signifi cant statistical differences with the other two groups (P<0.001). Incorrect diagnoses were equal to 22.5% in the kVp min/mA min group, and 16.2% in the kVp min/mA max group with no signifi cant statistical differences (P<0.4). It seems that the best view for identifying VRFs on CBCT images in axial sections can be obtained with kVp min/mA max setting. It can be concluded that kVp min/mA max and kVp min/mA min settings are suitable for the diagnosis of VRFs. Also, a lower kVp renders a lower patient radiation dose.
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