Chih-Chia Huang1, Ya-Chi Chang1, Meng-Che Chuang1, Hsueh-Jen Lin2, Yi-Ling Tsai3, Shu-Hui Chang3, Jyh-Cheng Chen4, Jiiang-Huei Jeng5. 1. Department of Dentistry, Cardinal Tien Hospital, New Taipei City, Taiwan. 2. Department of Dentistry, Show Chwan Memorial Hospital, Changhua, Taiwan. 3. Graduate Institute of Clinical Dentistry and Department of Dentistry, National Taiwan University Hospital and National Taiwan University Medical College, Taipei, Taiwan. 4. Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taipei, Taiwan. Electronic address: benson86778231@yahoo.com.tw. 5. Graduate Institute of Clinical Dentistry and Department of Dentistry, National Taiwan University Hospital and National Taiwan University Medical College, Taipei, Taiwan. Electronic address: jhjeng@ntu.edu.tw.
Abstract
INTRODUCTION: Early detection of vertical root fracture (VRF) is important for clinical endodontic practice. The purpose of this study was to measure the fracture width (distance between 2 sides of the fracture) of VRF teeth in vitro by using 2 micro-computed tomography (μ-CT) systems with different spatial resolution and voxel size. METHODS: Thirty-seven endodontically treated teeth with VRF were scanned by 80-μm pixel size μ-CT. Fifteen teeth with no obvious fracture line, blurred image, or fracture space less than 100 μm were scanned by 9-μm pixel size μ-CT. RESULTS: Presence of 2 VRF lines was more common in premolars (82%) than in molars (53%). In 7 premolars (32%) and 9 molars (60%), the VRF lines extended to within the apical 3 mm of the root. All fracture lines were detected by 9-μm pixel size μ-CT, but only 22 of 37 VRF teeth had vertical fracture identified by 80-μm μ-CT. From μ-CT examination, none of the fracture lines showed consistent and uniform fracture space. If 2 fracture lines were present, they were typically in opposite (not linear) directions. There was a significant correlation between 2 fracture lines or fracture lines extending within the 3 mm of the apex and fracture width greater than 100 μm. CONCLUSIONS: Application of 9-μm μ-CT can be accurately used for early detection of VRF. Fracture characteristics (eg, number of fracture lines, extension of fracture line) may affect the fracture width. Appropriate use of μ-CT technology can be helpful for early diagnosis of VRF.
INTRODUCTION: Early detection of vertical root fracture (VRF) is important for clinical endodontic practice. The purpose of this study was to measure the fracture width (distance between 2 sides of the fracture) of VRF teeth in vitro by using 2 micro-computed tomography (μ-CT) systems with different spatial resolution and voxel size. METHODS: Thirty-seven endodontically treated teeth with VRF were scanned by 80-μm pixel size μ-CT. Fifteen teeth with no obvious fracture line, blurred image, or fracture space less than 100 μm were scanned by 9-μm pixel size μ-CT. RESULTS: Presence of 2 VRF lines was more common in premolars (82%) than in molars (53%). In 7 premolars (32%) and 9 molars (60%), the VRF lines extended to within the apical 3 mm of the root. All fracture lines were detected by 9-μm pixel size μ-CT, but only 22 of 37 VRF teeth had vertical fracture identified by 80-μm μ-CT. From μ-CT examination, none of the fracture lines showed consistent and uniform fracture space. If 2 fracture lines were present, they were typically in opposite (not linear) directions. There was a significant correlation between 2 fracture lines or fracture lines extending within the 3 mm of the apex and fracture width greater than 100 μm. CONCLUSIONS: Application of 9-μm μ-CT can be accurately used for early detection of VRF. Fracture characteristics (eg, number of fracture lines, extension of fracture line) may affect the fracture width. Appropriate use of μ-CT technology can be helpful for early diagnosis of VRF.