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

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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Influence of the exomass on the detection of simulated root fracture in cone-beam ct – an ex-vivo study

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20200450 ◽

2020 ◽

pp. 20200450

Author(s):

Amanda Pelegrin Candemil ◽

Francesca Mangione ◽

Karla Farias Vasconcelos ◽

Anne Caroline Oenning ◽

Reinhilde Jacobs ◽

...

Keyword(s):

Ex Vivo ◽

Cone Beam Ct ◽

Receiver Operating Curve ◽

Cone Beam ◽

Metallic Materials ◽

Root Fracture ◽

Vertical Root Fracture ◽

Metal Artefacts ◽

Sensitivity Specificity ◽

Ex Vivo Study

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 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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Cone-beam CT for vertical root fracture detection

Dental Abstracts ◽

10.1016/j.denabs.2011.09.021 ◽

2012 ◽

Vol 57 (3) ◽

pp. 135-136

Keyword(s):

Cone Beam Ct ◽

Cone Beam ◽

Fracture Detection ◽

Root Fracture ◽

Vertical Root Fracture

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Accuracy of three cone-beam CT devices and two software systems in the detection of vertical root fractures

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20200334 ◽

2020 ◽

pp. 20200334

Author(s):

Aline PF Caetano ◽

Thiago O Sousa ◽

Mariana R Oliveira ◽

Karine Evanglista ◽

Juliano M Bueno ◽

...

Keyword(s):

Cone Beam Ct ◽

Roc Curves ◽

Cone Beam ◽

Software Systems ◽

Vertical Root Fracture ◽

Before And After ◽

Interexaminer Reliability ◽

Image Set ◽

Root Fractures ◽

Sensitivity Specificity

Objectives : The aim of this study was to compare the accuracy of vertical root fracture (VRF) detection using three tomography devices and two software systems in teeth with different endodontic fillings. Methods : The sample consisted of 45 premolars divided into 3 groups: No filling (NF, n=15); Gutta percha (GP, n=15) and Metallic Post (MP, n=15). Cone-beam computed tomography (CBCT) images were acquired in Kodak 9000 3D, Orthopantomography 300 (OP300) and PreXion 3D devices, before and after induced root fractures. Two oral radiologists analyzed all images using InVivoDental and e-Vol DX software systems. The analysis was repeated after 15 days in 30% of the sample. Data analysis compared receiver operating characteristic (ROC) curves, as well the areas under the ROC curves. Accuracy, sensitivity, specificity, positive and negative predictive value were calculated according to each tomographic device and software. Intra- and interexaminer reliability were tested using the Kappa coefficient. Results: The highest accuracy was seen in the image set from the PreXion 3D, using InVivo (0.96) or e-Vol DX (0.92) in image analysis. The OP300 device presented a similar performance of the PreXion 3D in teeth with different endodontic fillings. When using e-Vol DX, the accuracy of Kodak 9000 3D improved from 0.62 to 0.74. Conclusions: The PreXion 3D device is the most accurate when detecting VRF, with a performance similar to the OP300 in endodontic filled teeth. Kodak 9000 3D is indicated for teeth without fillings, with better accuracy using e-Vol DX software.

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