OBJECTIVES: This study compared the ability of conventional radiographic and cone beam computed tomography (CBCT) examinations to detect vertical root fractures (VRF) in teeth with or without root canal treatment and metallic posts. Furthermore, the influence of using different voxel sizes from CBCT images was assessed. METHODOLOGY:Sixty single-rooted human teeth were randomly divided into two groups: experimental and control. Twenty teeth were endodontically prepared and obturated with gutta-percha, twenty had a metallic postcemented after the filling, and twenty had no preparation. The teeth from the experimental group were fractured. All teeth were radiographed with three different horizontal angles, and after, CBCT images were acquired following three protocols in which the variation was the voxel resolution (0.4, 0.3, and 0.2 mm). Three calibrated examiners assessed the images. RESULTS: Chi-squared test showed no statistical difference among the images in detecting VRFs. The results of the diagnostic performance tests presented similar ability to detect VRFs when conventional radiographic examination was compared with 0.2 and 0.3-voxel CBCTs scans, in roots without endodontic treatment and metallic post. Moreover, specificity, sensitivity, and accuracy findings were similar for both 0.2 and 0.3-voxel resolution scans for teeth that are not root filled. However, it was observed that in teeth with root canal treatment and a post, the accuracy was higher when 0.2-mm voxel resolution was used. CONCLUSION: The radiographic examination with horizontal angle variation should be encouraged as the first complementary approach to assess the presence of VRFs. If conventional imaging is not capable to provide adequate information, CBCT can be indicated if a root fracture is strongly suspected. The root condition should then guide the voxel resolution choice, selecting 0.3-voxel for not root filled teeth and 0.2-voxel for teeth with filling and/or a post.
RCT Entities:
OBJECTIVES: This study compared the ability of conventional radiographic and cone beam computed tomography (CBCT) examinations to detect vertical root fractures (VRF) in teeth with or without root canal treatment and metallic posts. Furthermore, the influence of using different voxel sizes from CBCT images was assessed. METHODOLOGY: Sixty single-rooted human teeth were randomly divided into two groups: experimental and control. Twenty teeth were endodontically prepared and obturated with gutta-percha, twenty had a metallic postcemented after the filling, and twenty had no preparation. The teeth from the experimental group were fractured. All teeth were radiographed with three different horizontal angles, and after, CBCT images were acquired following three protocols in which the variation was the voxel resolution (0.4, 0.3, and 0.2 mm). Three calibrated examiners assessed the images. RESULTS: Chi-squared test showed no statistical difference among the images in detecting VRFs. The results of the diagnostic performance tests presented similar ability to detect VRFs when conventional radiographic examination was compared with 0.2 and 0.3-voxel CBCTs scans, in roots without endodontic treatment and metallic post. Moreover, specificity, sensitivity, and accuracy findings were similar for both 0.2 and 0.3-voxel resolution scans for teeth that are not root filled. However, it was observed that in teeth with root canal treatment and a post, the accuracy was higher when 0.2-mm voxel resolution was used. CONCLUSION: The radiographic examination with horizontal angle variation should be encouraged as the first complementary approach to assess the presence of VRFs. If conventional imaging is not capable to provide adequate information, CBCT can be indicated if a root fracture is strongly suspected. The root condition should then guide the voxel resolution choice, selecting 0.3-voxel for not root filled teeth and 0.2-voxel for teeth with filling and/or a post.
Authors: Daniel Berretta Moreira Alves; Fabrício Mesquita Tuji; Fábio Abreu Alves; André Caroli Rocha; Alan Roger Dos Santos-Silva; Pablo Agustin Vargas; Márcio Ajudarte Lopes Journal: Dentomaxillofac Radiol Date: 2018-06-05 Impact factor: 2.419
Authors: S J M Jakobson; V P D Westphalen; U X Silva Neto; L F Fariniuk; A G D Schroeder; E Carneiro Journal: Dentomaxillofac Radiol Date: 2013-11-04 Impact factor: 2.419
Authors: Gabriella Lopes de Rezende Barbosa; Jeyhan S Wood; Luiz A Pimenta; Solange Maria de Almeida; Donald A Tyndall Journal: Dentomaxillofac Radiol Date: 2015-12-09 Impact factor: 2.419
Authors: Liliane Rosas Gomes; Marcelo Regis Gomes; João Roberto Gonçalves; Antônio Carlos O Ruellas; Larry M Wolford; Beatriz Paniagua; Erika Benavides; Lúcia Helena Soares Cevidanes Journal: Oral Surg Oral Med Oral Pathol Oral Radiol Date: 2015-10-20