Reliability of CBCT diagnosing root fractures remains uncertain.

Data sourcesPubMed, Web of Science, Science Direct, Cochrane library, Embase, SCOPUS, CNKI and Wanfang databases were searched until April 2014 followed by hand searching of relevant references.Study selectionUsing no language restrictions two authors independently assessed for inclusion of in vivo and in vitro studies involving at least ten teeth on the use of CBCT for diagnosing complete root fractures on non-endodontically treated teeth.Data extraction and synthesisTwo authors independently assessed for inclusion and performed quality assessment using QUADAS-2 (quality assessment of studies of diagnostic accuracy-2). A random effects model was used to calculate pooled sensitivity, specificity and likelihood ratio (positive and negative). In addition, the correlation between voxel size and diagnostic accuracy was calculated.ResultsTwelve studies were included in the review. Seven used i-CAT with 372 teeth and four used 3D Accuitomo with 237 teeth (one study used both). For i-CAT pooled sensitivity was 0.83 (0.78 to 0.86), while specificity was 0.91(0.87 to 0.93). For 3D Accuitomo sensitivity was 0.95 (0.90 to 0.96) and the specificity 0.96 (0.92 to 0.99) Correlation between voxel size and diagnostic accuracy was analysed among five subgroups for i-CAT and two subgroups on the 3D Accuitomo group. No statistically significant difference was observed based on voxel size.ConclusionsAccording to the authors CBCT provides clinically relevant accuracy and reliability to detect root fractures in untreated teeth independently of the voxel size.