Detection of horizontal root fracture using four different protocols of cone-beam computed tomography

Abstract

The purpose of this study was to analyze four different cone-beam computed tomography (CBCT) protocols to identify horizontal root fractures (HRF) in endodontically treated teeth, with or without the presence of a metallic post. Thirty extracted single-rooted human premolars were treated endodontically. Afterwards, an observer induced a horizontal fracture in 15 teeth. Each tooth was inserted in an empty mandibular socket and submitted to a computed tomography scan taken with and without the metallic post. The acquisition followed four different protocols, with different fields of view (FOV) and voxel sizes, as follows: FOV 6X16 cm/0.2 mm voxel; FOV 6X16 cm/0.25 mm voxel; FOV 8X8 cm/0.2 mm voxel; FOV 8X8 cm/0.25 mm voxel. Two observers checked all the acquisitions within a two-week interval, and the values of sensitivity, specificity, accuracy and kappa were calculated. The sensitivity, specificity and accuracy values were better for the 8X8 cm/0.2 mm and 16X6 cm/0.25 mm protocols, ranging from 0.60 to 0.86 and 0.53 to 0.80, respectively. The intra-and interobserver concordance ranged from 0.65 to 0.72. The protocols where FOV and voxel were proportional showed better results. The 8x8 cm/0.2 mm protocol had the least interference from the metallic artifact. All four protocols showed a decline in values in the presence of the metallic artifact.

Abordagem terapêutica de fratura radicular com 30 meses de acompanhamento. Relato de caso clínico

“…A Tomografia Computadorizada de Feixe cônico (TCFC) têm sido muito utilizada no diagnóstico e acompanhamento dos dentes traumatizados, uma vez que possibilita uma avaliação tridimensional das estruturas envolvidas 8-10, 19 . Assim como outros estudos, neste caso foi possível observar por meio dos cortes sagitais que a fratura transversa no terço médio da raiz antes observada nas radiografias periapicais, apresentava-se oblíqua na tomografia 8 .…”

Detection of furcation involvement using periapical radiography and 2 cone-beam computed tomography imaging protocols with and without a metallic post: An animal study

“…In our study, we used a small FOV and the 2 smallest voxel sizes available in the CBCT scan to analyze the furcation area and obtained good results in both protocols. Accordingly, Salineiro et al11 observed that proportional FOV and voxel size resulted in better diagnosis results.…”

“…Endodontically treated teeth present intracanal metallic posts, and dental implants may produce artifacts in CBCT images 11. These artifacts are represented by radiopaque, radiolucent, and bright tracks that can overlap the teeth12 or bone and mimic bone loss 13.…”

“…These artifacts are represented by radiopaque, radiolucent, and bright tracks that can overlap the teeth12 or bone and mimic bone loss 13. Previous studies have compared images in which metallic posts are present or absent,1112 different metallic post compositions,14 metallic and fiber posts,15 and PR or CBCT imaging for tooth fracture diagnosis 16. In all studies, the artifacts created by the presence of the posts reduced the diagnostic accuracy of the observers.…”

Effect of different exposure settings on the diagnosis of vertical root fractures on cone-beam computed tomography images

“…Root fractures have become diagnosable since 1896 when twodimensional (2D) radiography was introduced to dentistry (Li et al 2002). However, if the angle of the projection is not perpendicular to the fracture line, these fractures may remain undiagnosed (Salineiro et al 2015).…”