Journal of endodontics | 2021
Combined use of two cone-beam computed tomography scans in the assessment of vertical root fracture in teeth with intracanal material.
Abstract
INTRODUCTION\nThe purpose of this preliminary study was to evaluate the diagnostic accuracy of the combined use of two cone-beam computed tomography (CBCT) volumes obtained with the tooth of interest positioned at different orientations in the detection of vertical root fracture (VRF).\n\n\nMETHODS\nThirty single-rooted teeth were divided into two 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 two spatial orientations: conventional (with the Frankfurt plane parallel to the floor) and angled acquisition (tilted 90 degrees backward). Also, each tooth was scanned with gutta-percha, 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 two-way analysis of variance with 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<0.05). In teeth with a metal post, all diagnostic values were higher in the combined CBCT assessment (p<0.05).\n\n\nCONCLUSIONS\nThis preliminary study suggests that the CBCT-based diagnosis of VRF in teeth with intracanal material was improved when the assessment combines images obtained at two orientations.