Detection of vertical root fractures in the presence of artefacts by digital radiography and cone beam computed tomography

The correct diagnosis of vertical root fractures (VRF) in the presence of artifacts is a challenge for clinicians and endodontists. Moreover, there is controversy about which imaging technique is best for this purpose. In an in vitro model, we evaluated the diagnosis of VRF in teeth treated endodontically with and without intraradicular metal posts, using the Clark technique and cone beam computed tomography (CBCT), as well as the interference of artifacts with the diagnosis. Twenty-two first or second maxillary or mandibular premolars were included. Teeth were randomly allocated to three groups: G1 (two teeth without fracture with endodontic treatment and one with an intraradicular metal post); G2 (10 fractured teeth with endodontic treatment); and G3 (10 fractured teeth with endodontic treatment plus a metal post). The examiners recorded the presence or absence of fracture and its location and classified its type. There was no statistically significant difference between image acquisition systems. When differentiating the teeth (first vs. second premolars), there was a statistically significant difference among the examiners (p=0.020). However, when comparing the values obtained by the examiners regarding the visualization of the fracture site as well as the presence of fracture correlated with the presence of a metal post and angulation, there were no statistically significant differences (p>0.05). Digital radiographs and CBCT were similar for the diagnosis of VRF. High sensitivity was observed by CBCT image reconstructions. Therefore, the presence of metal posts generated artifacts, resulting in low sensitivity, specificity and accuracy.

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Comparison of intraoral radiography and cone-beam computed tomography for the detection of horizontal root fractures: an in vitro study

Clinical Oral Investigations ◽

10.1007/s00784-013-0940-4 ◽

2013 ◽

Vol 18 (1) ◽

pp. 285-292 ◽

Cited By ~ 18

Author(s):

Hakan Avsever ◽

Kaan Gunduz ◽

Kaan Orhan ◽

İsmail Uzun ◽

Bilal Ozmen ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

In Vitro Study ◽

Vitro Study ◽

Cone Beam ◽

Intraoral Radiography ◽

Root Fractures

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The effect of voxel size on the identification of vertical and horizontal root fractures by cone beam computed tomography: an in vitro study.

Oral Surgery Oral Medicine Oral Pathology and Oral Radiology ◽

10.1016/j.oooo.2014.02.034 ◽

2014 ◽

Vol 117 (5) ◽

pp. e403 ◽

Cited By ~ 1

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

In Vitro Study ◽

Vitro Study ◽

Cone Beam ◽

Voxel Size ◽

Root Fractures

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Detection of vertical root fractures in endodontically treated teeth in the absence and in the presence of metal post by cone-beam computed tomography

BMC Oral Health ◽

10.1186/s12903-016-0207-y ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 13

Author(s):

Rebeca Ferraz de Menezes ◽

Natália Costa de Araújo ◽

Joedy Maria Costa Santa Rosa ◽

Vanda Sanderana Macêdo Carneiro ◽

Alexandrino Pereira dos Santos Neto ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Cone Beam ◽

Endodontically Treated Teeth ◽

Root Fractures ◽

Metal Post

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Cone Beam Computed Tomography and Digital Periapical Radiography in Determining Horizontal Root Fractures: An In-vitro Comparative Study

Dentistry ◽

10.4172/2161-1122.1000513 ◽

2018 ◽

Vol 08 (09) ◽

Author(s):

Seyed Mohsen Hashemnia ◽

Sanaz Jahadi ◽

Shiva Shaygannia ◽

Ehsan Hekmatian ◽

Amirhosein Habibollahi ◽

...

Keyword(s):

Computed Tomography ◽

Comparative Study ◽

Cone Beam Computed Tomography ◽

Cone Beam ◽

Root Fractures ◽

Periapical Radiography

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Diagnostic value of Cone-Beam Computed Tomography in diagnosing vertical root fractures in endodontically treated teeth – an in vitro study

Journal of Stomatology ◽

10.5604/00114553.1201356 ◽

2016 ◽

Vol 69 (1) ◽

pp. 4-18

Author(s):

Oskar Armata ◽

Elżbieta Bołtacz-Rzepkowska

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

In Vitro Study ◽

Diagnostic Value ◽

Vitro Study ◽

Cone Beam ◽

Endodontically Treated Teeth ◽

Root Fractures

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Number of basis images effect on detection of root fractures in endodontically treated teeth using a cone beam computed tomography machine: an in vitro study

Oral Surgery Oral Medicine Oral Pathology and Oral Radiology ◽

10.1016/j.oooo.2013.01.026 ◽

2013 ◽

Vol 115 (5) ◽

pp. 676-681 ◽

Cited By ~ 26

Author(s):

Boulos Bechara ◽

C. Alex McMahan ◽

Ibrahim Nasseh ◽

Hassem Geha ◽

Elie Hayek ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

In Vitro Study ◽

Vitro Study ◽

Cone Beam ◽

Endodontically Treated Teeth ◽

Root Fractures

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Comparison of intraoral radiography and cone-beam computed tomography for the detection of vertical root fractures: an in vitro study

Oral Radiology ◽

10.1007/s11282-012-0098-9 ◽

2012 ◽

Vol 29 (1) ◽

pp. 6-12 ◽

Cited By ~ 9

Author(s):

Kaan Gunduz ◽

Hakan Avsever ◽

Kaan Orhan ◽

Peruze Çelenk ◽

Bilal Ozmen ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

In Vitro Study ◽

Vitro Study ◽

Cone Beam ◽

Intraoral Radiography ◽

Root Fractures

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Performance of Bioceramic-based Root Filling Material with Artifact Reduction Properties in the Detection of Vertical Root Fractures Using Cone-beam Computed Tomography

The Open Dentistry Journal ◽

10.2174/1874210602115010170 ◽

2021 ◽

Vol 15 (1) ◽

pp. 170-175

Author(s):

Ali Bahmani ◽

Hamed Karkehabadi ◽

Abbas Shokri ◽

Maryam Farhadian

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Predictive Value ◽

Testing Machine ◽

Cone Beam ◽

Filling Material ◽

Filling Materials ◽

Gutta Percha ◽

Significant Difference ◽

Root Fractures

Introduction: In Cone-beam Computed Tomography (CBCT) images, metallic artifacts by root filling materials reduce the quality of images. It seems that bioceramic sealers produce fewer artifacts than gutta-percha. In this situation, the possibility of VRF detection could increase, and therefore, flap and exploratory surgery would not be needed. The purpose of this study was to evaluate the performance of a bioceramic-based root filling material in the detection of Vertical Root Fractures (VRF) in CBCT imaging. Materials and Methods: This study was conducted at the dental school from March to August 2019, and 100 healthy human mandibular premolar teeth were obtained and randomly divided into two equal groups. The teeth were filled with either AH26 and gutta-percha or bioceramic root filling materials. VRF was induced on half of the decoronated teeth in each group using a Global Testing Machine, and the others were considered control. CBCT imaging was performed by the Cranex 3D machine. Comparisons of the 2 groups were made using the Mann-Whitney test. Results: There was a significant difference between the two groups of bioceramic and gutta-percha in the measured indices, including sensitivity (P=0.017), specificity (P=0.018), positive predictive value (P=0.018), negative predictive value (P=0.018), and accuracy (P=0.011). The Area Under Curve (AUC) also showed a significant difference between the two groups (P=0.011). According to Kappa test results, no significant difference was obtained between the findings of the two observers. Conclusion: Different root filling materials showed a different extent of artifact in CBCT images. Bioceramic root filling material induces fewer artifacts in CBCT images, and the diagnostic value of VRF in CBCT images in the root canals filled with it is greater than those filled with AH26 and gutta-percha.

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