Detection of Vertical Root Fractures In Vivo in Endodontically Treated Teeth by Cone-Beam Computed Tomography Scans

Metska, Maria Elissavet; Aartman, I.H.A.; Wesselink, Paul R.; Özok, A.R.

doi:10.1016/j.joen.2012.05.003

Cited by 162 publications

(72 citation statements)

References 21 publications

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“…Beam hardening and streak artefacts can be superimposed on the root, creating difficulties for image assessment and may even mimic root fractures. 4,6,7,9,12,[15][16][17] Some specific tools can be used to analyse CBCT images, including filters that use mathematical algorithms to minimize image noise and improve image quality. 18,19 Some studies have shown that CBCT filters improve the diagnosis of root fractures in nonendodontically treated teeth, 5,19 but studies evaluating the influence of filters on the diagnosis of fractures in endodontically treated roots are still missing.…”

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

Dentomaxillofacial Radiology

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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.

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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

Dentomaxillofacial Radiology

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“…[7][8][9][10][11][12][13][14][15][16] The literature, mainly based on in vitro studies, supports the hypothesis that CBCT is a method with greater accuracy than periapical radiographs in detecting apical periodontitis, resorptions and root fractures. [17][18][19][20][21][22][23][24][25][26][27] The effective radiation dose using the state-of-the-art radiologic technique with rectangular collimator and a high-speed film or digital sensor is extremely low. 28 For a CBCT examination to be justified, it needs to be of potential benefit to the patient, i.e.…”

Section: Introductionmentioning

confidence: 99%

The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics

Almeida¹,

Knutsson²,

Flygare³

2014

Dentomaxillofacial Radiology

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Objectives: The aim was to assess to what extent cone beam CT (CBCT) used in accordance with current European Commission guidelines in a normal clinical setting has an impact on therapeutic decisions in a population referred for endodontic problems. Methods: The study includes data of consecutively examined patients collected from October 2011 to December 2012. From 2 different endodontic specialist clinics, 57 patients were referred for a CBCT examination using criteria in accordance with current European guidelines. The CBCT examinations were performed using similar equipment and standardized among clinics. After a thorough clinical examination, but before CBCT, the examiner made a preliminary therapy plan which was recorded. After the CBCT examination, the same examiner made a new therapy plan. Therapy plans both before and after the CBCT examination were plotted for 53 patients and 81 teeth. As four patients had incomplete protocols, they were not included in the final analysis. Results: 4% of the patients referred to endodontic clinics during the study period were examined with CBCT. The most frequent reason for referral to CBCT examination was to differentiate pathology from normal anatomy, this was the case in 24 patients (45% of the cases). The primary outcome was therapy plan changes that could be attributed to CBCT examination. There were changes in 28 patients (53%). Conclusions: CBCT has a significant impact on therapeutic decision efficacy in endodontics when used in concordance with the current European Commission guidelines.

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“…It should be highlighted that the variation in the results between studies may be influenced by specific characteristics of the tomographs employed. Metska et al, 23 Thus, the influence of different CBCT machines on diagnostic precision, in terms of root fracture detection, is still a question of some debate. The separation of fragments is a facilitating factor in root fracture diagnosis; the smaller the space between fragments, the lower is the capacity for detection.…”

Section: Discussionmentioning

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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Detection of Vertical Root Fractures In Vivo in Endodontically Treated Teeth by Cone-Beam Computed Tomography Scans

Cited by 162 publications

References 21 publications

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

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

The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics

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

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