Detection of Incomplete Root Fractures in Endodontically Treated Teeth Using Different High-resolution Cone-beam Computed Tomographic Imaging Protocols

Wanderley, Victor Aquino; Neves, Frederico Sampaio; Nascimento, Monikelly do Carmo Chagas; Monteiro, Gabriela Queiroz de Melo; Lobo, Natália Siqueira; Oliveira, Matheus Lima; Neto, João B. S. Nascimento; Araujo, Luciane Farias de

doi:10.1016/j.joen.2017.05.017

Cited by 24 publications

(16 citation statements)

References 32 publications

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“…CBCT imaging is the technique indicated for VRF diagnosis when 2D images do not provide adequate information, especially in endodontically treated teeth. 9,10 Growing interest exists in elucidating the influence of root fillings on the detection of VRFs using CBCT images, although the filling material used has been restricted to only gutta-percha. 3,5 The accuracy of CBCT images in VRF detection is higher in unfilled teeth than in root-filled teeth.…”

Section: Discussionmentioning

confidence: 99%

“…6,13,15 Different from the artifact appearance, the hypodense fracture line can be visualized at multiple planes in a fine slice reconstruction. 10 Elsaltani et al 6 and Hassan et al 7 stated that the axial section of the root is the most suitable for the detection of VRFs.…”

Section: Discussionmentioning

confidence: 99%

“…It was followed by i-CAT and then OrthoPhos XG, with normal and poor performances, respectively. The good performance of the PreXion device may be attributable to its reduced voxel size 10,14 and lowest focal point of 0.2 mm, among the devices involved in the study. The focal point of i-CAT is 0.5 mm and that of OrthoPhos XG is 0.4 mm.…”

Section: Discussionmentioning

confidence: 99%

“…18 A small voxel size also improves the CBCT image quality due to higher spatial resolution. 26 A recent study 10 reported the good performance of high-resolution protocols and highlighted the necessity for consideration of the exposure dose of radiation. The effective dose of the PreXion device is 189 and 388 µSv for standard exposure (19 seconds) and high resolution (37 seconds), respectively.…”

Section: Discussionmentioning

confidence: 99%

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CBCT Performance and Endodontic Sealer Influence in the Diagnosis of Vertical Root Fractures

Freitas-E-Silva

Mármora

Barriviera

et al. 2019

The Journal of Contemporary Dental Practice

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Aim:To evaluate the performance of three cone beam computed tomography (CBCT) machines in detecting vertical root fractures (VRFs) in teeth filled with different sealers. Materials and methods: A total of 80 single-rooted premolars were subjected to instrumentation and restoration with gutta-percha + AH Plus sealer, gutta-percha + sealer 26, gutta-percha + fill canal, and gutta-percha without sealer as the control. Half of the samples were randomly subjected to root fracture and all the teeth were scanned by i-CAT (Imaging Sciences International, Hatfield, USA), PreXion (PreXion Inc., San Mateo, USA), and OrthoPhos XG (Sirona Dental System, Bensheim, Germany). Three examiners analyzed the images for the presence of fractures. Results: The highest accuracy was obtained with the PreXion device, with Az = 0.85, while the i-CAT device provided higher sensitivity (0.93).The specificity values observed ranged between 0.75 and 0.70. Chi-squared tests (p > 0.05) demonstrated that the sealers did not exert a significant influence on the diagnosis of VRF. Conclusion: It may be concluded that endodontic sealers do not influence the detection of VRF. The PreXion device was the most accurate, having the highest specificity value. Clinical significance: Radiopaque materials might affect the diagnosis of VRFs because they can simulate fracture lines, leading to false-positive results. Moreover, CBCT machines present different specificities that could exert some influence on that.Coronal access cavities were prepared, and the root canal treatment was done with a ProTaper Rotary System (DENTSPLY, Maillefer, Tulsa, OK, USA) up to size F3.The samples were divided into 4 groups with 20 teeth per group. The filling materials used per group were gutta-percha without a sealer, gutta-percha + AH Plus (DENTSPLY, Maillefer Tulsa, OK, USA), gutta-percha + sealer 26 (DENTSPLY, Maillefer Tulsa, OK, USA), and gutta-percha + fill canal (TechNew, Rio de Janeiro, Brazil).Teeth were wrapped in a thin layer of wax no.7 (TechNew, Rio de Janeiro, Brazil) until the region of the cervical collar. The teeth were then embedded in polyvinyl chloride (PVC) tubes containing acrylic resin.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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CBCT Performance and Endodontic Sealer Influence in the Diagnosis of Vertical Root Fractures

Freitas-E-Silva

Mármora

Barriviera

et al. 2019

The Journal of Contemporary Dental Practice

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“…Using high-resolution CBCT images is an alternative for a more reliable diagnosis of root fractures in endodontically treated teeth due to its high accuracy by using the high-resolution/standard (HI-STD) protocol, which reduces the radiation dose [18].To detect root perforations, the high-resolution mode provides significantly greater accuracy than the low-resolution mode [19]. In comparison with the results of ex vivo cross-sections (gold standard), in the general range of correct diagnosis with CBCT, the accuracy increased from 92% to 100% within each assessment parameter, and the diagnoses obtained with 3D Accuitomo 170 were as accurate or more accurate than other systems [20].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Fractures in Endodontically Treated Teeth Restored with and without Root Canal Posts Using High-Resolution Cone Beam Computed Tomography

Aristizábal-Elejalde¹,

Arriola-Guillén

Castillo

et al. 2019

Preprint

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Background: Root fractures are a diagnostic challenge for dentists because their signs and symptoms are not present in all cases, and they are difficult to differentiate from endodontic treatment failures, the purpose of the present study was to determine the relationship between the characteristics of tooth fractures and the presence of root canal posts in endodontically treated teeth using high-resolution cone beam computed tomography (CBCT). Methods: Fifty high-resolution CBCT scans of endodontically treated teeth with a diagnosis of fracture were obtained, of which 30 were from women and 20 were from men. These scans were acquired with three Veraviewepocs 3D units and one 3D Accuitomo 170 unit, with a 40 × 40-mm field of view and 125 μm voxel size. The variables assessed included the type of fracture, extent of fracture, type of retention, post length, cause of endodontic failure, location of the lesion, and time required to detect the fracture (difficulty score). For data analysis, the chi-squared test, Student's t-test, and multiple linear regression (α ˂0.05) were used. Results: No association was found between the type of fracture and type of retention or between the type of fracture and its extent (P ˃0.05). On the other hand, the type of fracture significantly influenced the time required for its detection. Additionally, the most difficult plane for detecting the fracture and the difficulty score were associated, with statistically significant results. Conclusions: The type of fracture in endodontically treated teeth was not associated with the type of post used for restoration. All of the CBCT systems used to detect tooth fracture showed the same efficiency. Keywords: Cone Beam Computed Tomography, Tooth Fracture, Root Canal Post, High Resolution

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Comparison of microcomputed tomography, cone beam tomography, stereomicroscopy, and scanning electron microscopy techniques for detection of microcracks on root dentin and effect of different apical sizes on microcrack formation

Çapar

Gök

Uysal³

et al. 2019

Microscopy Res & Technique

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The aim of the study was to compare different imaging methods in the diagnosis of microcracks on root dentin and to evaluate the frequency of dentinal microcracks observed after root canal preparation using the ProTaper Universal (PTU) system of different sizes. A total of 30 mandibular molars' mesial roots were scanned with microcomputed tomography (micro‐CT) and cone beam computed tomography (CBCT) imaging methods before instrumentation. Root canal instrumentation was performed up to PTU F2 and F4 files. After instrumentation stages, the roots were scanned again with micro‐CT and then with CBCT in same parameters. All roots were sectioned horizontally at 2, 4, 6, 8, and 10 mm from the apices of the specimens. The sections were imaged under a stereomicroscope. Finally, imaging of the sections was done by scanning electron microscopy (SEM). Statistical data analysis of instrumentation steps was performed using Friedman and Wilcoxon tests, and the data of imaging methods were analyzed using Kruskal–Wallis and Mann–Whitney U tests (p = .05). Instrumentation with the PTU system up to F2 and F4 files significantly increased the number of microcracks compared with preoperative samples according to micro‐CT imaging (p < .05). For detecting microcracks on the root dentin, there were no statistically significant differences between micro‐CT (43.9%) and stereomicroscopy (45.8%) (p < .05). SEM showed significantly higher percentage of microcracks (88.3%) (p > .05). No microcrack was observed using the CBCT method. There were no statistically differences between micro‐CT and stereomicroscopy. SEM showed more dentinal microcracks while no microcrack was observed with CBCT.

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Detection of Incomplete Root Fractures in Endodontically Treated Teeth Using Different High-resolution Cone-beam Computed Tomographic Imaging Protocols

Cited by 24 publications

References 32 publications

CBCT Performance and Endodontic Sealer Influence in the Diagnosis of Vertical Root Fractures

CBCT Performance and Endodontic Sealer Influence in the Diagnosis of Vertical Root Fractures

Assessment of Fractures in Endodontically Treated Teeth Restored with and without Root Canal Posts Using High-Resolution Cone Beam Computed Tomography

Comparison of microcomputed tomography, cone beam tomography, stereomicroscopy, and scanning electron microscopy techniques for detection of microcracks on root dentin and effect of different apical sizes on microcrack formation

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