Comparison of Five Cone Beam Computed Tomography Systems for the Detection of Vertical Root Fractures

Hassan, Bassam; Metska, Maria Elissavet; Özok, A.R.; Stelt, P F van der; Wesselink, Paul R.

doi:10.1016/j.joen.2009.09.013

Cited by 161 publications

(170 citation statements)

References 32 publications

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“…Gray values obtained with CBCT are used in an analog way as the HU values for the determination of mineral density [16] and show a linear relationship with the attenuation coefficients of the materials [13,15] , HU values obtained with medical CT [11,12,37,38] , and density values from DEXA [14] . Despite the correlation between gray values obtained with MSCT and CBCT, errors are expected when CBCT images are used to define the density of scanned structures [39] because these images present with inconsistencies and arbitrariness of gray values [16,40] , especially when related to abrupt changes of density in the object [41,42] , X-ray beam hardening effect [39,43] , scattered radiation [43] and projection data discontinuity-related effect [16] , making the validity of the measurements obtained questionable (Table 1).…”

Section: Cone Beam Ctmentioning

confidence: 99%

Bone mineral density in cone beam computed tomography: Only a few shades of gray

Campos

Souza

Júnior

et al. 2014

WJR

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Cone beam computed tomography (CBCT) has often been used to determine the quality of craniofacial bone structures through the determination of mineral density, which is based on gray scales of the images obtained. However, there is no consensus regarding the accuracy of the determination of the gray scales in these exams. This study aims to provide a literature review concerning the reliability of CBCT to determine bone mineral density. The gray values obtained with CBCT show a linear relationship with the attenuation coefficients of the materials, Hounsfield Units values obtained with medical computed tomography, and density values from dual energy X-ray absorciometry. However, errors are expected when CBCT images are used to define the quality of the scanned structures because these images show inconsistencies and arbitrariness in the gray values, particularly when related to abrupt change in the density of the object, X-ray beam hardening effect, scattered radiation, projection data discontinuity-related effect, differences between CBCT devices, changes in the volume of the field of view (FOV), and changes in the relationships of size and position between the FOV and the object evaluated. A few methods of mathematical correction of the gray scales in CBCT have been proposed; however, they do not generate consistent values that are independent of the devices and their configurations or of the scanned objects. Thus, CBCT should not be considered the examination of choice for the determination of bone and soft tissue mineral density at the current stage, particularly when values obtained are to be compared to predetermined standard values. Comparisons between symmetrically positioned structures inside the FOV and in relation to the exomass of the object, as it occurs with the right and left sides of the skull, seem to be viable because the effects on the gray scale in the regions of interest are the same.

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Section: Cone Beam Ctmentioning

confidence: 99%

Bone mineral density in cone beam computed tomography: Only a few shades of gray

Campos

Souza

Júnior

et al. 2014

WJR

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“…The accuracy of CBCT for detection of VRFs also appears to be dependent on the CBCT device used. Several studies have assessed different CBCT scanners and found varying degrees of diagnostic accuracy for detecting simulated VRFs (16). The quality of CBCT scans, their contrast and resolution depend on the detector type, size of FOV, voxel size, artifact level and the amount of basic images and algorithm of scan reconstruction (16).…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have assessed different CBCT scanners and found varying degrees of diagnostic accuracy for detecting simulated VRFs (16). The quality of CBCT scans, their contrast and resolution depend on the detector type, size of FOV, voxel size, artifact level and the amount of basic images and algorithm of scan reconstruction (16). The difference between the sensitivity of CBCT device obtained in the present study and that of previous studies may be due to the type of detector, detector sensitivity, exposure parameters, voxel settings and reconstruction algorithms of the assessed CBCT scanners (16).…”

Section: Discussionmentioning

confidence: 99%

Effect of Time Lapse on the Diagnostic Accuracy of Cone Beam Computed Tomography for Detection of Vertical Root Fractures

et al. 2016

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Accurate and early diagnosis of vertical root fractures (VRFs) is imperative to prevent extensive bone loss and unnecessary endodontic and prosthodontic treatments. The aim of this study was to assess the effect of time lapse on the diagnostic accuracy of cone beam computed tomography (CBCT) for VRFs in endodontically treated dog's teeth. Fortyeight incisors and premolars of three adult male dogs underwent root canal therapy. The teeth were assigned to two groups: VRFs were artificially induced in the first group (n=24) while the teeth in the second group remained intact (n=24). The CBCT scans were obtained by NewTom 3G unit immediately after inducing VRFs and after one, two, three, four, eight, 12 and 16 weeks. Three oral and maxillofacial radiologists blinded to the date of radiographs assessed the presence/absence of VRFs on CBCT scans. The sensitivity, specificity and accuracy values were calculated and data were analyzed using SPSS v.16 software and ANOVA. The total accuracy of detection of VRFs immediately after surgery, one, two, three, four, eight, 12 and 16 weeks was 67.3%, 68.7%, 66.6%, 64.6%, 64.5%, 69.4%, 68.7%, 68% respectively. The effect of time lapse on detection of VRFs was not significant (p>0.05). Overall sensitivity, specificity and accuracy of CBCT for detection of VRFs were 74.3%, 62.2%, 67.2% respectively. Cone beam computed tomography is a valuable tool for detection of VRFs. Time lapse (four months) had no effect on detection of VRFs on CBCT scans.

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“…During the image analysis, the examiners were able to use all the available program resources (different reconstruction plans, zoom, brilliance, contrast, and filters) with no time limit. Using a table, the examiners recorded their reports of presence or absence of fracture 8,10,[18][19][20] and, in positive cases of fracture, the location of the fracture was determined (cervical, middle, or apical third).…”

Section: Tomographic Analysismentioning

confidence: 99%

Evaluation of Root Fracture in endodontically treated Teeth using Cone Beam Computed Tomography

Tiepo

Magrin

Kovalik

et al. 2017

The Journal of Contemporary Dental Practice

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Aim: Our objective was to perform an in vitro evaluation of root fracture in endodontically treated teeth using two cone beam computed tomography (CBCT) machines. Materials and methods:The sample comprised 86 singlerooted human premolars that had been fractured by a universal testing machine. The tomographic images were acquired using an Orthopantomograph OP300 ® and an Orthophos XG 3D ® and evaluated by three examiners, by means of specific software. The teeth were classified into presence or absence of root fracture, then the root third where the fracture occurred, was determined. With regard to the detection of the fracture, the Kappa statistic was used for intra and interexaminer reproducibility at two distinct points in time. Chi-squared test was employed to analyze the sensitivity and specificity of the two tomographs (p < 0.05). Results:The results showed a good or excellent Kappa index between examiners. As for the absolute frequency, the sensitivity (0.6) of the Orthophos XG 3D ® equipment was superior, while specificity (0.91) was higher with the Orthopantomograph OP300 ® . On the receiver operating characteristics curve, moderate performance was found with an accuracy of 0.73 (OrthopantomographOP300 ® ) and 0.74 (Orthophos XG 3D ® ) respectively. As far as the location of the root fracture is concerned, moderate agreement was verified using the Kappa statistic (k = 0.56). Evaluation of Root Fracture in endodontically treated Clinical significance:An early and precise detection of root fractures is of the utmost clinical importance, but the radiopaque and/or metallic filling materials in the CBCT viewing field may generate artifacts, known as the beam-hardening effect, which could compromise root fracture detection.

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Comparison of Five Cone Beam Computed Tomography Systems for the Detection of Vertical Root Fractures

Cited by 161 publications

References 32 publications

Bone mineral density in cone beam computed tomography: Only a few shades of gray

Bone mineral density in cone beam computed tomography: Only a few shades of gray

Effect of Time Lapse on the Diagnostic Accuracy of Cone Beam Computed Tomography for Detection of Vertical Root Fractures

Evaluation of Root Fracture in endodontically treated Teeth using Cone Beam Computed Tomography

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