Cone-beam CT for vertical root fracture detection

Objectives: To evaluate the influence of exomass-related metal artefacts on the detection of simulated vertical root fracture (VRF) in cone-beam computed tomography (CBCT). Methods: Twenty teeth were endodontically instrumented and VRF was induced in half of them. All teeth were individually placed in an empty socket of a human mandible. Metallic materials were differently arranged in the exomass [zone outside of the field of view (FOV) but between the X-ray source and the receptor] and/or endomass (zone inside of the FOV), and CBCT scans were obtained. Four radiologists evaluated the presence of VRF using a 5-point scale. Sensitivity, specificity, and area under the receiver operating curve (AUC) were compared using ANOVA. Also, the tooth of interest was replaced with a tube filled with a radiopaque solution and all CBCT scans were repeated to analyse the data objectively. Mean grey and noise values were obtained from the tube and compared using ANOVA followed by Tukey’s test (α = 0.05). Results: Mean grey values were significantly lower and noise was significantly higher when metallic materials were present in the endomass or both the exomass and endomass. Sensitivity, specificity, and AUC were not influenced by the artefacts from the metallic materials irrespective of the arrangement condition. Conclusions: Exomass-related metal artefacts did not influence the diagnosis of simulated VRF in CBCT.

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Cone beam CT scans with and without artefact reduction in root fracture detection of endodontically treated teeth

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20120245 ◽

2013 ◽

Vol 42 (5) ◽

pp. 20120245 ◽

Cited By ~ 57

Author(s):

B Bechara ◽

C Alex McMahan ◽

WS Moore ◽

M Noujeim ◽

FB Teixeira ◽

...

Keyword(s):

Cone Beam Ct ◽

Ct Scans ◽

Cone Beam ◽

Fracture Detection ◽

Endodontically Treated Teeth ◽

Root Fracture ◽

Artefact Reduction

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Are Optimised CBCT Protocols Suitable to Detect Simulated Vertical Root Fracture in the Presence of Metal Outside and/or Inside the Fov?

10.21203/rs.3.rs-543582/v1 ◽

2021 ◽

Author(s):

Amanda Pelegrin Candemil ◽

Benjamin Salmon ◽

Karla F Vasconcelos ◽

Anne C Oenning ◽

Reinhilde Jacobs ◽

...

Keyword(s):

High Frequency ◽

Cone Beam Ct ◽

Field Of View ◽

Cone Beam ◽

Metallic Materials ◽

Point Scale ◽

Root Fracture ◽

Vertical Root Fracture ◽

Dose Optimisation ◽

Sensitivity Specificity

Abstract Dose optimisation has been revisited in the literature due to the high frequency of cone-beam CT (CBCT) scans and, the reduction of the field-of-view (FOV) size has shown to be an effective strategy. However, small FOV scans have negative influences of the truncation effect from the exomass.The aim of this study was to evaluate the diagnostic accuracy of an optimised CBCT protocol for the detection of simulated vertical root fracture (VRF) in the presence of metallic artefacts from the exomass and/or endomass.Twenty teeth were endodontically instrumented and VRF was induced in half of them. All teeth were individually placed in a human mandible, metallic materials were placed in the exomass and/or endomass, and CBCT scans were obtained at two dose protocols: standard and optimised. Three radiologists evaluated the images and indicated the presence of VRF using a 5-point scale. Sensitivity, specificity and area under the ROC curve (AUC) were obtained and compared using ANOVA (α=0.05). Overall, sensitivity, specificity and AUC did not differ significantly (p>0.05) between the dose protocols.In conclusion, optimised protocols should be considered in the detection of simulated VRF irrespective of the occurrence of artefacts from metallic materials in the exomass and/or endomass.

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Cone beam CT optimisation for detection of vertical root fracture with metal in the field of view or the exomass

Scientific Reports ◽

10.1038/s41598-021-98345-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Amanda P. Candemil ◽

Benjamin Salmon ◽

Karla F. Vasconcelos ◽

Anne C. Oenning ◽

Reinhilde Jacobs ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Cone Beam Ct ◽

Field Of View ◽

Cone Beam ◽

Equivalent Material ◽

Metallic Materials ◽

Root Fracture ◽

Vertical Root Fracture ◽

Frequent Use ◽

Negative Effect

AbstractDose optimisation has been revisited in the literature due to the frequent use of cone beam computed tomography (CBCT). Although the reduction of the field-of-view (FOV) size has shown to be an effective strategy, this indirectly increases the negative effect from the exomass. The aim of this study was to evaluate the diagnostic accuracy of an optimised CBCT protocol in the detection of simulated vertical root fracture (VRF) in the presence of metal in the exomass and/or inside the FOV. Twenty teeth were endodontically instrumented and VRF was induced in half of them. All teeth were individually placed in a human mandible covered with a soft tissue equivalent material, metallic materials were placed at different dispositions in the exomass and/or endomass, and CBCT scans were obtained at two dose protocols: standard and optimised. Five radiologists evaluated the images and indicated the presence of VRF using a 5-point scale. Area under the ROC curve (AUC), sensitivity, and specificity were calculated and compared using ANOVA (α = 0.05). Overall, AUC, sensitivity, and specificity did not differ significantly (p > 0.05) between the dose protocols. In conclusion, optimised dose protocols should be considered in the detection of simulated VRF irrespective of the occurrence of artefacts from metallic materials in the exomass and/or inside the FOV.

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Assessment of vertical root fracture using cone-beam computed tomography

Imaging Science in Dentistry ◽

10.5624/isd.2014.44.1.37 ◽

2014 ◽

Vol 44 (1) ◽

pp. 37 ◽

Cited By ~ 17

Author(s):

Ehsan Moudi ◽

Sina Haghanifar ◽

Zahrasadat Madani ◽

Abdolhamid Alhavaz ◽

Ali Bijani ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Cone Beam ◽

Root Fracture ◽

Vertical Root Fracture

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Accuracy of High-resolution Small-volume Cone-Beam Computed Tomography in the Diagnosis of Vertical Root Fracture: An In Vivo Analysis

Journal of Endodontics ◽

10.1016/j.joen.2020.04.015 ◽

2020 ◽

Vol 46 (8) ◽

pp. 1059-1066 ◽

Cited By ~ 2

Author(s):

Debora R. Dias ◽

Lilian C.V. Iwaki ◽

Alexandre C.A. de Oliveira ◽

Felipe S. Martinhão ◽

Robson M. Rossi ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Cone Beam Computed Tomography ◽

Small Volume ◽

Cone Beam ◽

Root Fracture ◽

Vertical Root Fracture ◽

In Vivo Analysis

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Usefulness of cone-beam CT in the evaluation of a spontaneously healed root fracture case

Dental Traumatology ◽

10.1111/j.1600-9657.2012.01166.x ◽

2012 ◽

Vol 29 (6) ◽

pp. 489-493 ◽

Cited By ~ 6

Author(s):

Anne Caroline Costa Oenning ◽

Sergio Lins de Azevedo Vaz ◽

Saulo Leonardo Sousa Melo ◽

Francisco Haiter-Neto

Keyword(s):

Cone Beam Ct ◽

Cone Beam ◽

Root Fracture

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Accuracy of intraoral radiography, multidetector helical CT, and limited cone-beam CT for the detection of horizontal tooth root fracture

Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology ◽

10.1016/j.tripleo.2009.07.009 ◽

2009 ◽

Vol 108 (5) ◽

pp. e70-e74 ◽

Cited By ~ 33

Author(s):

Masahiro Iikubo ◽

Kaoru Kobayashi ◽

Akira Mishima ◽

Shinji Shimoda ◽

Takayoshi Daimaruya ◽

...

Keyword(s):

Cone Beam Ct ◽

Helical Ct ◽

Cone Beam ◽

Tooth Root ◽

Intraoral Radiography ◽

Root Fracture

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Vertical Tooth Root Fracture Detection through Cone-beam Computed Tomography: An Umbrella Review Protocol Testing Four Hypotheses

The Open Dentistry Journal ◽

10.2174/1874210601913010449 ◽

2019 ◽

Vol 13 (1) ◽

pp. 449-453

Author(s):

Kelvin Ian Afrashtehfar ◽

David MacDonald

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Conventional Radiography ◽

Cone Beam ◽

Sufficient Evidence ◽

Tooth Root ◽

Fracture Detection ◽

Root Fracture ◽

Clinical Recommendation ◽

Root Fractures

Detecting vertical root fractures represents an immense challenge for oral health professionals. One of the main tools used to detect this type of biological complication is the periapical radiograph. However, conventional radiography consists of two-dimensional imaging that is limited by the superimposition of bony structures that complicate the detection of root fractures. The alternative, a Cone-Beam Computed Tomography (CBCT) scan, cannot be prescribed in every case since radiation should be kept to a minimum as stipulated by the “As Low As Reasonably Achievable” (ALARA) principle. Therefore, to justify the use of a CBCT scan to detect a vertical tooth root fracture, the clinician must prove that it has significant benefits over traditional imaging. Since few systematic reviews have compared CBCT technology to traditional radiography for the diagnosis of vertical root fractures, it is of utmost importance in clinical practice, especially in endodontology and clinical dental medicine, where the available reviews are examined to generate a clinical recommendation. The four hypotheses of this protocol are that (1) CBCT is superior to traditional radiography for detecting vertical root fractures of vital teeth; (2) CBCT is superior to traditional radiography for detecting longitudinal root fractures of vital teeth with radiopaque restorations; (3) CBCT is superior to traditional radiography for detecting vertical root fractures of root-filled teeth without a radiopaque post that may cause artifacts; and (4) CBCT is superior to traditional radiography for detecting vertical root fractures of root-filled teeth with a radiopaque post regardless of its longitude. To test these hypotheses, all the current secondary resources related to the aim of this meta-review are evaluated. If there is sufficient evidence to support clinical decisions, then the appropriate recommendations will be formulated. PROSPERO ID: CRD42018067792

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

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1997 ◽

2017 ◽

Vol 18 (2) ◽

pp. 94-99 ◽

Cited By ~ 1

Author(s):

Ricardo Raitz ◽

Mariana Tiepo ◽

Gabriel Magrin ◽

Ana C Kovalik ◽

Belkiss Marmora ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Testing Machine ◽

Kappa Statistic ◽

Cone Beam ◽

Fracture Detection ◽

Kappa Index ◽

Operating Characteristics ◽

Endodontically Treated Teeth ◽

Root Fracture

ABSTRACT 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). Conclusion Although the regular CBCTs represent the imaging examination of choice for assisting root fracture diagnosis in endodontically treated teeth, their performance in this study demonstrated an imprecise diagnosis of fractures in a good many cases, irrespective of the tomography machine used. 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. How to cite this article Tiepo M, Magrin G, Kovalik AC, Marmora B, Silva MF, Raitz R. Evaluation of Root Fracture in endodontically treated Teeth using Cone Beam Computed Tomography. J Contemp Dent Pract 2017;18(2):94-99.

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