Comparison between photostimulable phosphor plates using one or two angulations and cone beam computed tomography scans in detecting root fracture in endodontically treated teeth

ABSTRACT Objective: To perform a descriptive study in order to evaluate apical periodontitis in endodontically treated teeth using cone beam computed tomography. Methods: Eighty-six exams presenting at least one apical periodontitis were selected and divided into two groups: 1 for the mandible and 2 for the maxilla. All the exams were done using the same cone beam computed tomography with standard acquisition settings. All the images were processed and manipulated using the same software. Then the lesions were classified according to the periapical index, but not considering the expansion and/or destruction of cortical. Results: 127 mandibular teeth and 180 maxillary teeth exhibited apical periodontitis with an average size of 0.49 mm in the mandible and 0.75 mm in the maxilla. It was found that the lower pre-molars were the teeth most affected. Lesions identified with scores between 0 and 1 correspond to 83.47% of the lesions in the mandible and 78.89% in the maxilla, and 55.12% of endodontically treated lower teeth and 50% of upper teeth presented no lesion recurrence or lesions under repair. Conclusion: There was a predominance of small apical periodontitis, the pre-molars being the teeth most affected.

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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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