The detection of vertical root fractures in root filled teeth with periapical radiographs and <scp>CBCT</scp> scans

Patel, Shanon; Brady, Ewing P.; Wilson, Ron; Brown, Jackie; Mannocci, Francesco

doi:10.1111/iej.12109

Cited by 99 publications

(101 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%

“…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%

“…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. 8,14,19,20 Recently, an artefact reduction algorithm (AR) that applies algorithms during image reconstruction has been introduced by some CBCT systems. However, few studies have evaluated this tool, and the results are inconclusive as to its influence on the final image quality.…”

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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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“…In this and other studies, a universal testing machine was used, as it provides discrete root fractures and can, therefore, simulate incipient cases of fracture in patients. 25 Despite the fact that the CBCT is treated as the best complementary examination available for detecting root fractures, a caveat should be taken into consideration due to the presence of filling materials inside the root canal. Several studies have shown that possible variations in the results can be influenced by artifacts in the images obtained by CBCT, such as gutta-percha, endodontic cements, and metal cores.…”

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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“…Vertikal kök kırıklarının teĢhisinde; konvansiyonel radyografiler ve bilgisayarlı tomografi gibi görüntüleme tekniklerinden, x-ray, periodontal sondlama, boyama, cerrahi inceleme, ısırma testi, kırığın direkt olarak gözlemlenmesi, operasyon mikroskobu ile incelemesi gibi yöntemlerden faydalanılmaktadır 6,7 . Mevcut vakada, kırık hattının direkt olarak gözlemle-nebilmesi ve x-ray incelemesiyle de doğrulanabilmesi açısından daha ileri diagnostik tekniklerin kullanılma-sına gerek kalmamıĢtır.…”

Section: Discussionunclassified

Verti̇kal Kök Kiriği Olan Mandi̇bular Molar Di̇şi̇n Hemi̇seksi̇yon Yöntemi̇ İle Tedavi̇si̇: Olgu Sunumu

Uysal¹,

Kaya²,

NİĞİZ³

et al. 2016

Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi

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ÖZETAĢırı kron harabiyeti, periodontal hastalığı ve kök kırığı bulunan çok köklü bir diĢin hemiseksiyon yöntemi ile ağız içinde tutulması mümkündür. Bu çalıĢmada, meziyal kökünde vertikal kök kırığı bulunan sağ alt ikinci molar diĢin distal kanalında kanal tedavisi yenilendi. Vertikal kök kırığına sahip mesial kök, distal kökten ayrılarak hemiseksiyon yöntemiyle uzaklaĢtı-rıldı. Bir sonraki seans distal kök fiber post uygulanarak restore edildi ve mesial köke ait çekim kavitesinin iyileĢmesinin ardından sağ birinci mandibular molar ve sağ ikinci mandibular molar diĢlere metal destekli porselen köprü protezi uygulanmasıyla tedavi tamamlandı. Üç yıl sonra gerçekleĢtirilen kontrol seansında, diĢin klinik ve radyografik olarak sağlıklı olduğu görül-dü. Hemiseksiyon tekniği, dental oklüzyonun devamlılığının sağlanması, tedavi iĢlemlerinin kısa sürmesi ve tedavi maliyetinin düĢük olması gibi nedenlerle günümüzde tercih edilen bir tedavi yöntemidir. Anahtar Kelimeler: Hemiseksiyon, vertikal kök kırığı, fiber post GİRİŞVertikal kök kırığı, apikal uçtan baĢlayıp koronere doğru uzunlamasına ilerleyen bir kırık tipi olarak adlandırılmaktadır 1 . Kök kanallarının fazla geniĢ-letilmesi, lateral-vertikal kompaksiyon sırasında ve post uygulanması sırasında aĢırı kuvvet uygulanması, geniĢ post yuvası oluĢturulması ve aĢırı kron harabiyeti nedeniyle diĢ bütünlüğündeki bozulmalar vertikal kök kırığını oluĢturan risk faktörleri olarak sıralanabilir 2 . ABSTRACTRetaining the teeth is possible with hemisection teqnique by many reasons such as extreme crown destruction, periodontal troubles and root fracture. In this study, distal canal endodontic treatment of right second molar tooth which has vertical fracture on mesial root has been renewed. Fractured mesial root has been removed from distal root by hemisection technique. In the next appointment, fiber post-core restoration has been generated and after healing extraction cavity caused by being removed of mesial root, has been completed with the porcelain-fused-tometal bridge to the mandibular right first molar and mandibular right second molar teeth. After tree year follow-up, it's observed that the teeth are healty clinically and radiographically. Hemisection teqnique may be prefered because of some reasons such as having progression of dental occlusion, short treatment process and the low treatment cost. Key Words: Hemisection, vertical root fracture, fiber post Hemiseksiyon; mandibular molar diĢlerde uygulanan, diĢin kökünün ve ilgili kuron parçasının furkasyon hattı boyunca ikiye ayrılarak, zarar görmüĢ kısmın çıkarılıp sağlam kalan bölümünün yerinde bırakılarak korunması iĢlemidir 3 . Çok köklü diĢin bir kökünü içeren ilerlemiĢ periodontitis vakaları, komplike kron-kök kırıkları, kanalda kırık alet bulunması ve strip kök perforasyonları gibi iyatrojenik komplikasyonlar, alveolar kemiğe kadar uzanan derin çürükler hemiseksiyon yönteminin endikasyonları arasında bulunmaktadır 4 .

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The detection of vertical root fractures in root filled teeth with periapical radiographs and CBCT scans

Cited by 99 publications

References 42 publications

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

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

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

Verti̇kal Kök Kiriği Olan Mandi̇bular Molar Di̇şi̇n Hemi̇seksi̇yon Yöntemi̇ İle Tedavi̇si̇: Olgu Sunumu

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