Influence of cone beam CT enhancement filters on diagnosis ability of longitudinal root fractures

Abstract

Objectives: To determine whether cone beam CT (CBCT) enhancement filters influence the diagnosis of longitudinal root fractures. Methods: 40 extracted human posterior teeth were endodontically prepared, and fractures with no separation of fragments were made in 20 teeth of this sample. The teeth were placed in a dry mandible and scanned using a Classic i-CAT® CBCT device (Imaging Sciences International, Inc., Hatfield, PA). Evaluations were performed with and without CBCT filters (Sharpen Mild, Sharpen Super Mild, S9, Sharpen, Sharpen 3 3 3, Angio Sharpen Medium 5 3 5, Angio Sharpen High 5 3 5 and Shadow 3 3 3) by three oral radiologists. Inter-and intraobserver agreement was calculated by the kappa test. Accuracy, sensitivity, specificity and positive and negative predictive values were determined. McNemar test was applied for agreement between all images vs the gold standard and original images vs images with filters (p , 0.05). Results: Means of intraobserver agreement ranged from good to excellent. Angio Sharpen Medium 5 3 5 filter obtained the highest positive predictive value (80.0%) and specificity value (76.5%). Angio Sharpen High 5 3 5 filter obtained the highest sensitivity (78.9%) and accuracy (77.5%) value. Negative predictive value was the highest (82.9%) for S9 filter. The McNemar test showed no statistically significant differences between images with and without CBCT filters (p . 0.05). Conclusions: Although no statistical differences was observed in the diagnosis of root fractures when using filters, these filters seem to improve diagnostic capacity for longitudinal root fractures. Further in vitro studies with endodontic-treated teeth and research in vivo should be considered.

Influence of Cone‐Beam Computed Tomography filters on diagnosis of simulated endodontic complications

“…Nascimento et al . () and Ferreira et al . () reported the influence of CBCT filters on vertical root fracture detection, which was not a condition simulated in the present study, and concluded that there was no significant difference when applying some XoranCat ® filters.…”

“…, Nascimento et al . , Ferreira et al . ), highlighting the need of conducting further investigations into other clinical situations.…”

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

“…In a recent study with CBCT filters for aiding the diagnosis of VRFs, the authors believed that filter application somehow improved the diagnostic capability; yet, significant differences between the original and filtered images were not observed. 19 Again, endodontically treated teeth were not included in the above-cited study, which makes the results of the present study and theirs difficult to compare.…”

“…It appears that the application of enhancement filters in digital radiography makes diagnosis of 23,25 As one may conclude, the influence of filters on aiding dental diagnosis is still controversial; furthermore, most studies about the diagnostic advantages of filters used periapical radiographs, and the few studies that evaluated the application of CBCT filters for diagnosis of root fractures did not include teeth with intracanal materials. 5,19 The importance of this study is that it is the first to evaluate the influence of CBCT filters on diagnosis of VRF in endodontically treated teeth with and without metal posts.…”

“…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.…”