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Combined Use of 2 Cone-beam Computed Tomography Scans in the Assessment of Vertical Root Fracture in Teeth with Intracanal Material

Published:April 13, 2021DOI:https://doi.org/10.1016/j.joen.2021.04.001

      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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