Comparison of conventional radiography with cone beam computed tomography for detection of vertical root fractures: an in vitro study

Objectives: To assess the influence of the artefact reduction algorithm (AR) available on the Picasso Trio 3D ® imaging system (Vatech, Hwaseong, Republic of Korea) on image quality [greyscale values, contrast-to-noise ratio (CNR) and artefact formation] and diagnosis of vertical root fractures (VRFs) in the teeth with intracanal metal posts. Methods: 30 uniradicular teeth had their crowns removed and their roots endodontically treated to receive intracanal metal posts. In 20 teeth, both complete (n 5 10) and incomplete (n 5 10) VRFs were created. Each tooth was scanned twice, with and without AR activation. The mean and variation of greyscale values, as well as CNR, were calculated for all images. Subsequently, an evaluator compared the amount of artefact (cupping, white streaks and dark bands) in all images. Five evaluators rated for VRF presence using a five-point scale.Results: Mean greyscale values and CNR were significantly decreased in images acquired with the AR. The usage of the algorithm promoted an overall reduction of image artefacts. Regarding the diagnosis of complete and incomplete VRFs, the use of the AR had an overall negative impact on specificity and accuracy. Conclusions: While indeed reducing artefact formation, the use of the AR, instead of improving the impact on the diagnosis of VRFs in teeth with intracanal metal posts, had a negative impact on the diagnosis.

Section: Discussionmentioning

confidence: 99%

Influence of the artefact reduction algorithm of Picasso Trio CBCT system on the diagnosis of vertical root fractures in teeth with metal posts

Bezerra¹,

Neves²,

Vasconcelos³

et al. 2015

“…10 CBCT has allowed dental practitioners to visualize teeth three-dimensionally and with high spatial resolution. 11 While recent studies have demonstrated the superiority of CBCT in detecting root fractures, 1,3,4,6,[12][13][14][15] there are some limitations to proper imaging when high-density materials such as guttapercha and intracanal metal posts are present. These materials may create artefacts that impair the quality of CBCT images.…”

Section: Introductionmentioning

confidence: 99%

“…1 The aetiology of VRFs is mainly iatrogenic, usually owing to excessive canal shaping, excessive pressure during gutta-percha compaction or excessive pressure during post-placement. 2 In non-endodontically treated teeth, high occlusal forces following biting on hard objects and/or malocclusions are the main cause of VRFs.…”

Section: Introductionmentioning

confidence: 99%

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

Ferreira

Visconti²,

Nascimento³

et al. 2015

Objectives: To evaluate the influence of CBCT enhancement filters on the diagnosis of vertical root fractures (VRFs) in teeth with and without metal posts. Methods: The crowns of 40 uniradicular human teeth were removed and all roots were prepared. 20 teeth were randomly selected, and VRFs were induced using a universal testing machine. The i-CAT (Imaging Sciences International, Hatfield, PA) CBCT was used to scan teeth with and without intracanal metal posts using the following parameters: 0.2 voxel size, 8 3 8-cm scan size and acquisition time of 26.9 s. Images were evaluated by three observers with and without the use of the following filters: S9, smooth, smooth 3 3 3, sharpen, sharpenmild and sharpen 3 3 3. Results: Intra-and interobserver agreement ranged from poor to moderate. Images with and without CBCT filters did not show significant differences regarding the area under the receiver operating characteristic curve, as well as sensitivity (p . 0.05). As for accuracy, the sharpen-mild filter was superior to the sharpen (p 5 0.03), but these filters did not differ from all others. For specificity, S9, smooth and original images were superior to sharpen (p , 0.01). Results for teeth without posts differed from those for teeth with metal posts in all cases (p , 0.05). Conclusions: The use of enhancement filters in CBCT images has no influence on the diagnosis of VRFs in teeth with metal posts, and their use is not justified.

“…13,17,19,20 Endodontically treated teeth with posts are most susceptible to VRFs; 1,2,4 therefore, it is necessary to investigate the reliability of CBCT images in these cases.…”

Section: Introductionmentioning

confidence: 99%

The influence of metallic posts in the detection of vertical root fractures using different imaging examinations

Jakobson¹,

Westphalen²,

Neto³

et al. 2014

Objectives: To assess the influence of metallic posts in the detection of simulated vertical root fractures (VRFs) using the following imaging examinations: 2 cone beam CT (CBCT) systems [CBCT1: NewTom ® 3G (QR Srl, Verona, Italy) and CBCT2: i-CAT Next Generation ® (Imaging Sciences International, Hatfield, PA)] and film and digital radiographs. Additionally, the influence of the orientation of the fracture line in the detection of VRFs was evaluated. Methods: 100, human, single-rooted endodontically treated premolars were divided into 5 groups (Group 1: with posts and buccolingual VRFs, Group 2: with posts and mesiodistal VRFs, Group 3: without posts and with buccolingual VRFs, Group 4: without posts and with mesiodistal VRFs, and Group 5: with posts and without VRFs). The premolars were placed in human mandibles and imaged using the four examination modalities. The sensitivity and the specificity of each examination in the experimental groups were calculated. The data were analysed using Student's t-test.Results: The presence of metallic posts reduced the sensitivity of the CBCT1 system (p 5 0.0244). Digital radiographs and the CBCT1 and CBCT2 systems had a higher sensitivity in detecting buccolingual fractures in teeth with posts, whereas film and digital radiographs had a higher sensitivity in detecting buccolingual fractures in teeth without posts (p , 0.05). The CBCT1 examination demonstrated the lowest specificity (p , 0.05). Conclusions:The presence of metallic posts did not influence the sensitivity of most of the examinations, excluding the CBCT1 system. The fracture line orientation may influence VRF detection.