Are Optimised CBCT Protocols Suitable to Detect Simulated Vertical Root Fracture in the Presence of Metal Outside and/or Inside the Fov?

Abstract

\n Dose optimisation has been revisited in the literature due to the high frequency of cone-beam CT (CBCT) scans and, the reduction of the field-of-view (FOV) size has shown to be an effective strategy. However, small FOV scans have negative influences of the truncation effect from the exomass.The aim of this study was to evaluate the diagnostic accuracy of an optimised CBCT protocol for the detection of simulated vertical root fracture (VRF) in the presence of metallic artefacts from the exomass and/or endomass.Twenty teeth were endodontically instrumented and VRF was induced in half of them. All teeth were individually placed in a human mandible, metallic materials were placed in the exomass and/or endomass, and CBCT scans were obtained at two dose protocols: standard and optimised. Three radiologists evaluated the images and indicated the presence of VRF using a 5-point scale. Sensitivity, specificity and area under the ROC curve (AUC) were obtained and compared using ANOVA (α=0.05). Overall, sensitivity, specificity and AUC did not differ significantly (p>0.05) between the dose protocols.In conclusion, optimised protocols should be considered in the detection of simulated VRF irrespective of the occurrence of artefacts from metallic materials in the exomass and/or endomass.