Diagnostic Ability of a Cone-Beam Computed Tomography Scan to Assess Longitudinal Root Fractures in Prosthetically Treated Teeth

Impact of Voxel Size Variation on CBCT-Based Diagnostic Outcome in Dentistry: a Systematic Review

“…Of those, four assessed the detection of root fractures [18][19][20][21] (and used the clinical truth (an induced root fracture) as the gold standard), three assessed internal or external root resorption [22][23][24] also using the clinical truth as the gold standard, three assessed caries lesion detection [25][26][27] (and used sectioning and histology of the teeth as the gold standard), one assessed the detection of erosions in the temporomandibular joint [28] (using the clinical truth as the gold standard), and one assessed the presence of root canals in molars [29] using sectioning and histology of the teeth as the gold standard. The remaining eight studies were based on numerical outcomes measured in the images.…”

“…The diagnostic tasks evaluated in the studies included in this review were diverse. Four studies assessed the detection of root fractures [18][19][20][21] using the clinical truth as a gold standard. Wenzel et al [21] and Melo et al [19] suggested that high-resolution CBCT (voxel size smaller than 0.2 mm) should be used when root fracture is suspected but not visualized in a periapical image.…”

“…Four studies assessed the detection of root fractures [18][19][20][21] using the clinical truth as a gold standard. Wenzel et al [21] and Melo et al [19] suggested that high-resolution CBCT (voxel size smaller than 0.2 mm) should be used when root fracture is suspected but not visualized in a periapical image. In opposition to that, Ozer [20] and da Silveira et al [18] did not find significant differences among voxel sizes ranging from 0.125 to 0.4 mm.…”

“…Both CBCT and micro-CT suffer from beam hardening artifacts [42]. As an example, specific materials such as guttapercha and intra-canal metallic posts may contribute to artifact formation, decreasing the diagnostic quality of the image [19,43]. However, the influence of beam hardening artifacts is lower in micro-CT compared with CBCT because it operates at a higher kVp and offers more uniform filtration as well as a higher spatial resolution [30].…”

“…The difference between CBCT in high and low resolution was highly significant, and also between CBCT in high resolution and PSP images. There was no difference between CBCT in the low resolution and PSP images Melo et al [19] One observer scored the images "with" or "without" fracture. The clinical truth was the gold standard Sensitivity was significantly higher for the 0.2-mm voxel resolution.…”