Detection of Vertical Root Fractures in Endodontically Treated Teeth by a Cone Beam Computed Tomography Scan

Abstract

Our aim was to compare the accuracy of cone beam computed tomography (CBCT) scans and periapical radiographs (PRs) in detecting vertical root fractures (VRFs) and to assess the influence of root canal filling (RCF) on fracture visibility. Eighty teeth were endodontically prepared and divided into four groups. The teeth in groups A and B were artificially fractured, and teeth in groups C and D were not. Groups A and C were root filled. Four observers evaluated the CBCT scans and PR images. Sensitivity and specificity for VRF detection of CBCT were 79.4% and 92.5% and for PR were 37.1% and 95%, respectively. The specificity of CBCT was reduced (p = 0.032) by the presence of RCF, but its overall accuracy was not influenced (p = 0.654). Both the sensitivity (p = 0.006) and overall accuracy (p = 0.008) of PRs were reduced by the presence of RCF. The results showed an overall higher accuracy for CBCT (0.86) scans than PRs (0.66) for detecting VRF.

Diagnosis Made Precise and Perfect – CBCT It’s Application in Dentistry.

“…CBCT can assessing the vertical roots fractures under the influence of the root canal filling. Potentially, it demonstrated a highly accurate image compare to periapical radiographs [19]. In fact, CBCT also can be used to detect the horizontal root fractures as we can see in figure 3 (b).…”

Endodonti̇de Koni̇k Işinli Bi̇lgi̇sayarli Tomografi̇

“…Yapılan ex-vivo çalışma-larda VKK'nın CBCT ile periapikal radyografilerden daha hassas tespit edildiği gösterilmiştir. 22 CBCT dento-alveolar travmaların teşhisinde faydalı olabilmektedir. 1,23,24 Alveolar lüksasyon yaralanmalarının yapısı ve şiddeti CBCT metodu ile herhangi bir geometrik distorsiyonuna ve anatomik görüntü bozukluğuna uğramadan tespit edilebilmektedir.…”

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

“…After flap elevation, the fracture line is visualized under light and magnification following staining with methylene blue (4). Superposition of the adjacent structures may complicate detection of fracture lines on periapical radiographs (5,6). A VRF may be visible on a periapical radiograph only when the fracture line and x-ray beam lie in the same plane or have a 4° difference at most (7).…”

“…Cone beam computed tomography (CBCT) is an advanced three-dimensional imaging technique studied for this purpose. However, presence of metal posts and some root canal filling materials may decrease its accuracy (5,10). Some previous studies compared the accuracy of conventional and digital intraoral radiography and CBCT for detection of VRFs and reported that CBCT and CT were significantly superior for this purpose (6), while some others reported similar accuracy of CBCT and digital radiography.…”

“…Because of its two-dimensional nature and multiple superpositions, intraoral radiography has many limitations for detecting VRFs. This is especially the case when the fracture line has a mesiodistal orientation; in this condition, the sensitivity decreases to about 7.7% (5). CBCT provides high quality images; it also eliminates the overlapping of the structures.…”