Evaluation of Cone-beam Computed Tomography in the Diagnosis of Vertical Root Fractures: The Influence of Imaging Modes and Root Canal Materials

Neves, Frederico Sampaio; Freitas, Deborah Queiroz; Campos, Paulo Sérgio Flores; Ekestubbe, Annika; Lofthag-Hansen, Sara

doi:10.1016/j.joen.2014.06.012

Cited by 120 publications

(115 citation statements)

References 42 publications

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“…Difficulties in the diagnosis of root fractures in roots filled with high-density materials owing to artefact formation is one well-established problem in the literature. 7,8,12,14,15,17,18 The AR has emerged as an alternative to control artefact formation and thus increase diagnostic certainty. However, we could not confirm this hypothesis, as some have already reported.…”

Section: Discussionmentioning

confidence: 99%

“…Sample selection and preparation 30 uniradicular human teeth were selected and prepared according to the methodology applied by Neves et al 15 In short, dental crowns were removed at the cementoenamel junction, and root canals were prepared endodontically with the rotary system Mtwo ® NiTi (VDW, Munich, Germany). Subsequently, preparations for metal post placement were performed with a drill (# 2, Exacto; Angelus, Londrina, Brazil) at low speed up to two-thirds the length of the root canal.…”

Section: Methodsmentioning

confidence: 99%

“…Three human vertebrae (C1, C2 and C3) were placed in the same container dorsally to the mandible to simulate in vivo X-ray beam attenuation and dispersion. 15,25 CBCT scans were performed with the Picasso Trio imaging device (Vatech, Hwaseong, South Korea) with the following exposure protocol: 90 kVp; 5 mA; field of view of 8 3 5 cm; and 0.2-mm voxel. Two acquisitions were made for each root, with and without AR activation ( Figure 1).…”

Section: Image Acquisitionmentioning

confidence: 99%

“…5,12,13 If filling materials are present, the reports are inconclusive, but there seems to be some level of compromise in diagnostic accuracy. 8,12,14,15 In CT imaging of cases in which high-density intracanal materials such as gutta percha or metal posts are present, there will be artefact formation. Artefacts affect image quality and may increase difficulty of root fracture diagnosis substantially.…”

Section: Introductionmentioning

confidence: 99%

“…Artefacts affect image quality and may increase difficulty of root fracture diagnosis substantially. 4,12,[15][16][17][18] In teeth with intracanal fillings, artefacts occur owing to differences in the attenuation and absorption of X-ray beams by high-density material physics that cause beam-hardening phenomenon. The resulting image is altered by hypodense bands (dark bands), hyperdense striations (white streaks) and distortion of metal objects (cupping artefacts), which can all interfere with fracture detection and may lead to falsepositive results.…”

Section: Introductionmentioning

confidence: 99%

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Influence of the artefact reduction algorithm of Picasso Trio CBCT system on the diagnosis of vertical root fractures in teeth with metal posts

Bezerra¹,

Neves²,

Vasconcelos³

et al. 2015

Dentomaxillofacial Radiology

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Objectives: To assess the influence of the artefact reduction algorithm (AR) available on the Picasso Trio 3D ® imaging system (Vatech, Hwaseong, Republic of Korea) on image quality [greyscale values, contrast-to-noise ratio (CNR) and artefact formation] and diagnosis of vertical root fractures (VRFs) in the teeth with intracanal metal posts. Methods: 30 uniradicular teeth had their crowns removed and their roots endodontically treated to receive intracanal metal posts. In 20 teeth, both complete (n 5 10) and incomplete (n 5 10) VRFs were created. Each tooth was scanned twice, with and without AR activation. The mean and variation of greyscale values, as well as CNR, were calculated for all images. Subsequently, an evaluator compared the amount of artefact (cupping, white streaks and dark bands) in all images. Five evaluators rated for VRF presence using a five-point scale.Results: Mean greyscale values and CNR were significantly decreased in images acquired with the AR. The usage of the algorithm promoted an overall reduction of image artefacts. Regarding the diagnosis of complete and incomplete VRFs, the use of the AR had an overall negative impact on specificity and accuracy. Conclusions: While indeed reducing artefact formation, the use of the AR, instead of improving the impact on the diagnosis of VRFs in teeth with intracanal metal posts, had a negative impact on the diagnosis.

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