Assessment of the Influence of Different Intracanal Materials on the Detection of Root Fracture in Birooted Teeth by Cone-beam Computed Tomography

Vieira, Luiz Eduardo Marinho; Lima, Elisa Diniz de; Peixoto, Larissa Rangel; Pinto, Martina Gerlane Oliveira; Melo, Saulo Leonardo Sousa; Oliveira, Matheus Lima; Rovaris, Karla; Bento, Patrícia Meira; Melo, Daniela Pita de

doi:10.1016/j.joen.2019.10.028

Cited by 18 publications

(18 citation statements)

References 23 publications

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“…Hassan et al 32 concluded that the presence of gutta-percha did not influence the sensitivity of CBCT images, although it reduced the specificity. According to Marinho Vieira et al, 22 teeth with gutta-percha displayed the highest artefact interference of the groups studied, disfavouring the detection of root fractures. Oliveira et al 15 evaluated the performance of the MAR algorithm with a methodology similar to that used in this study and found that all measures of diagnostic accuracy decreased when MAR was applied.…”

Section: Discussionmentioning

confidence: 88%

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Effect of cone-beam computed tomography metal artefact reduction on incomplete subtle vertical root fractures

et al. 2023

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Purpose This study compared the accuracy of detection of incomplete vertical root fractures (VRFs) in filled and unfilled teeth on cone-beam computed tomography images with and without a metal artefact reduction (MAR) algorithm. Materials and Methods Forty single-rooted maxillary premolars were selected and, after endodontic instrumentation, were categorized as unfilled teeth without fractures, filled teeth without fractures, unfilled teeth with fractures, or filled teeth with fractures. Each VRF was artificially created and confirmed by operative microscopy. The teeth were randomly arranged, and images were acquired with and without the MAR algorithm. The images were evaluated with OnDemand software (Cybermed Inc., Seoul, Korea). After training, 2 blinded observers each assessed the images for the presence and absence of VRFs 2 times separated by a 1-week interval. P -values<0.05 were considered to indicate significance. Results Of the 4 protocols, unfilled teeth analysed with the MAR algorithm had the highest accuracy of incomplete VRF diagnosis (0.65), while unfilled teeth reviewed without MAR were associated with the least accurate diagnosis (0.55). With MAR, an unfilled tooth with an incomplete VRF was 4 times more likely to be identified as having an incomplete VRF than an unfilled tooth without this condition, while without MAR, an unfilled tooth with an incomplete VRF was 2.28 times more likely to be identified as having an incomplete VRF than an unfilled tooth without this condition. Conclusion The use of the MAR algorithm increased the diagnostic accuracy in the detection of incomplete VRF on images of unfilled teeth.

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Section: Discussionmentioning

confidence: 88%

“… 11 20 The present results indicate that the use of the MAR algorithm in unfilled teeth improved the diagnosis rate of incomplete VRF, in accordance with several previous studies. 1 6 8 21 22 …”

Section: Discussionmentioning

confidence: 99%

Effect of cone-beam computed tomography metal artefact reduction on incomplete subtle vertical root fractures

et al. 2023

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“…1 Neste sentido, Huang CC et al 38 Os estudos tanto in vitro, quanto in vivo revelam que a TCFC é uma excelente opção para diagnosticar a FRV em dentes não endodonticamente tratados, sem preenchimento intrarradicular, ou ainda nos casos que incluem a colocação de um pino de fibra de vidro. 13,16,20,21 Já em casos de presença de materiais de preenchimento, o poder diagnóstico tende a diminuir significativamente 13, 16,…”

Section: Resultadounclassified

“…, sendo a dificuldade maior em presença de pinos metálicos 11,20,21 , que guta-percha. A mais baixa sensibilidade e precisão também foi observada por estudos in vivo.…”

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Diagnóstico Da Fratura Radicular Vertical: Uma Revisão De Literatura

Falcão¹,

Muniz²,

Nogueira-Lima³

et al. 2023

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O objetivo do presente artigo foi identificar os principais fatores associados à fratura radicular vertical e, apresentar os principais métodos diagnósticos com ênfase na tomografia computadorizada, e comparar estudos quantitativos in vitro e in vivo, referente à sensibilidade, especificidade e precisão da técnica diagnóstica. Foi realizada uma busca por artigos publicados entre 2011-2021 nas bases de dados Lilacs e Pubmed. Dos 446 registros encontrados, 38 artigos foram eleitos para fins de revisão bibliográfica intergativa. Em relação aos sinais e sintomas, dor, fístula, abcesso ou inchaço periodontal, e radiolucências periapicais e halo em forma de J são achados comuns. A tomografia computadorizada de feixe cônico foi evidenciada como método não-invasivo mais adequado para a detecção da fratura radicular. A técnica se destaca pela produção de imagens 3D de alta resolução que permitem a visualização precisa de linhas de fraturas. Em dentes com preenchimento por materiais radiopacos, tais como guta-percha e pinos metálicos, é comum ocorrerem distorções com produção de artefatos, que diminuem significativamente o poder diagnóstico.

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“…Imaging artefacts such as beam hardening due to the presence of radio‐dense materials (i.e., gutta‐percha, metal posts) and/or motion/misalignment artefacts reduce the image quality and can increase the likelihood of false positives (Khedmat et al, 2012; Schulze et al, 2011; Wang et al, 2011). Due to their lower atomic number and reduced radiodensity, fibre (non‐metallic) posts have less impact on the diagnostic accuracy when compared to metal posts (Marinho Vieira et al, 2020 et al, 2020; Figure 2). Recent advances in image reconstruction such as motion correction (Spin‐Neto et al, 2020) and metal artefact reduction algorithms (MAR) (Queiroz et al, 2018) have been used to reduce imaging artefact, and therefore, improve diagnostic accuracy.…”

Section: Radiographic Presentationmentioning

confidence: 99%

Present status and future directions: vertical root fractures in root filled teeth

2022

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Vertical root fracture (VRF) is a common reason for the extraction of root filled teeth. The accurate diagnosis of VRF may be challenging due to the absence of clinical signs, whilst conventional radiographic assessment is often inconclusive. However, an understanding of the aetiology of VRFs, and more importantly, the key predisposing factors, is crucial in identifying teeth that may be susceptible. Thorough clinical examination with magnification and co‐axial lighting is essential in identifying VRFs, and although CBCT is unable to reliably detect VRFs per se, the pattern of bone loss typically associated with VRF can be fully appreciated, and therefore, increases the probability of correct diagnosis and management. The prevalence of VRFs in root filled teeth is significantly greater than in teeth with vital pulps, demonstrating that the combination of loss of structural integrity, presence of pre‐existing fractures and biochemical effects of loss of vitality is highly relevant. Careful assessment of the occlusal scheme, presence of deflective contacts and identification of parafunctional habits are imperative in both preventing and managing VRFs. Furthermore, anatomical factors such as root canal morphology may predispose certain teeth to VRF. The influence of access cavity design and root canal instrumentation protocols should be considered although the impact of these on the fracture resistance of root filled teeth is not clearly validated. The post‐endodontic restoration of root filled teeth should be expedient and considerate to the residual tooth structure. Posts should be placed ‘passively’ and excessive ‘post‐space’ preparation should be avoided. This narrative review aims to present the aetiology, potential predisposing factors, histopathology, diagnosis and management of VRF and present perspectives for future research. Currently, there are limited options other than extraction for the management of VRF, although root resection may be considered in multi‐rooted teeth. Innovative techniques to ‘repair’ VRFs using both orthograde and surgical approaches require further research and validation. The prevention of VRFs is critical; identifying susceptible teeth, utilizing conservative endodontic procedures, together with expedient and appropriate post‐endodontic restorative procedures is paramount to reducing the incidence of terminal VRFs.

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Assessment of the Influence of Different Intracanal Materials on the Detection of Root Fracture in Birooted Teeth by Cone-beam Computed Tomography

Cited by 18 publications

References 23 publications

Effect of cone-beam computed tomography metal artefact reduction on incomplete subtle vertical root fractures

Effect of cone-beam computed tomography metal artefact reduction on incomplete subtle vertical root fractures

Diagnóstico Da Fratura Radicular Vertical: Uma Revisão De Literatura

Present status and future directions: vertical root fractures in root filled teeth

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