Abstract
Introduction
The purpose of this preliminary study was to evaluate the diagnostic accuracy of the
combined use of 2 cone-beam computed tomographic (CBCT) volumes obtained with the
tooth of interest positioned at different orientations in the detection of vertical
root fracture (VRF).
Methods
Thirty single-rooted teeth were divided into 2 main groups (n = 15): control and with VRF. The teeth were individually placed in a phantom composed
of a human skull and mandible, which was CBCT scanned in 2 spatial orientations: conventional
(with the Frankfurt plane parallel to the floor) and angled acquisition (tilted 90°
backward). Also, each tooth was scanned with gutta-percha, a metal post, and without
any intracanal material. Three oral radiologists individually evaluated the images
resulting from conventional acquisition and verified the presence or absence of VRF
(conventional CBCT assessment), setting a score on a 5-point scale. Subsequently,
the observers evaluated both images resulting from the conventional and angled acquisitions
(combined CBCT assessment). The diagnostic values of the conventional and combined
assessments were compared using 2-way analysis of variance with the post hoc Tukey
test. The significance level was set at 5% (α = 0.05).
Results
The combined CBCT assessment showed higher accuracy and sensitivity in the VRF diagnosis
of teeth filled with gutta-percha (P < .05). In teeth with a metal post, all diagnostic values were higher in the combined
CBCT assessment (P < .05).
Conclusions
This preliminary study suggests that the CBCT-based diagnosis of VRF in teeth with
intracanal material was improved when the assessment combines images obtained at 2
orientations.
Key Words
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Article info
Publication history
Published online: April 13, 2021
Identification
Copyright
© 2021 American Association of Endodontists.
