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Diagnostic value of cone-beam computed tomography and periapical radiography in detection of vertical root fracture.

Ezzodini Ardakani F, Razavi SH, Tabrizizadeh M - Iran Endod J (2015)

Bottom Line: The level of significance was set at 0.05.Sensitivity and specificity values of CBCT were 97.5% and 95%, respectively.Two methods were not significantly different when testing specificity (P=0.298).

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Radiology, Dental Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Iran;

ABSTRACT

Introduction: Vertical root fracture (VRF) is the longitudinal fracture of the root in endodontically treated teeth. Considering the limitations of two-dimensional radiographic images in detection of VRF and introduction of cone-beam computed tomography (CBCT), this study was designed to find the sensitivity, specificity and accuracy of CBCT and periapical (PA) radiography in detection of VRFs.

Methods and materials: This was a cross-sectional in vitro study on 80 extracted human single canal teeth including 40 maxillary and 40 mandibular teeth. After standardized endodontic treatment of the roots, VRF was induced in half of the teeth in each group, and other half were left without fracture. Teeth were inserted in dry maxillary and mandibular alveoli. PA radiographs and CBCT images were taken from the specimens. Data were analyzed with SPSS software. The McNemar test was used to evaluate the sensitivity, specificity and accuracy of images, and kappa coefficient was used to assess the degree of agreement between the observers. The level of significance was set at 0.05.

Results: Sensitivity and specificity values of CBCT were 97.5% and 95%, respectively. However, for PA radiography the sensitivity and specificity were 67.5% and 92.5%, in order of appearance. Accuracy of CBCT (96.25%) and PA radiography (80%) in both jaws were significantly different (P=0.022). Two methods were not significantly different when testing specificity (P=0.298).

Conclusion: This study showed that the sensitivity and accuracy of CBCT in detection of vertical root fracture are higher than periapical radiography. CBCT can be recommended to be used in detection of vertical root fractures.

No MeSH data available.


Related in: MedlinePlus

A) A tooth with vertical root fracture under stereomicroscope (×10 magnnification); B) Jaws used in the study were covered by two layers of a boxing wax for reconstruction of soft tissue; C) One of the mandibles and maxillae used in CBCT device; D) Axial plane of CBCT showing two teeth with vertical root fracture; E) A tooth with vertical root fracture in a periapical radiograph
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Figure 1: A) A tooth with vertical root fracture under stereomicroscope (×10 magnnification); B) Jaws used in the study were covered by two layers of a boxing wax for reconstruction of soft tissue; C) One of the mandibles and maxillae used in CBCT device; D) Axial plane of CBCT showing two teeth with vertical root fracture; E) A tooth with vertical root fracture in a periapical radiograph

Mentions: Maillefer, Ballaigues, Switzerland) and step-back preparation of the canals. After filing and flaring, 40 teeth were included in the study as the control group and 40 (20 maxillary and 20 mandibular) teeth were randomly selected for inducing VRF (n=40). The roots were covered by a thin layer of red wax. For all teeth, two third of the root length was mounted in acrylic blocks from apical region. The method of inducing VRF was similar to that used by Hassan et al. [15]. In this method, a sharp chisel was placed perpendicular to the root canal and fracture was created by fine impacts of a hammer. If the two parts of tooth were splited due to the fracture, the specimen was excluded. Direct observation under a stereomicroscope (Wild M5A, Heerbrugg, Switzerland) with 10× magnification was used as the gold standard for detection of the fracture (Figure 1A). The other specimens in the control group were also assessed by similar method to assure that they were fracture free.


Diagnostic value of cone-beam computed tomography and periapical radiography in detection of vertical root fracture.

Ezzodini Ardakani F, Razavi SH, Tabrizizadeh M - Iran Endod J (2015)

A) A tooth with vertical root fracture under stereomicroscope (×10 magnnification); B) Jaws used in the study were covered by two layers of a boxing wax for reconstruction of soft tissue; C) One of the mandibles and maxillae used in CBCT device; D) Axial plane of CBCT showing two teeth with vertical root fracture; E) A tooth with vertical root fracture in a periapical radiograph
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4372787&req=5

Figure 1: A) A tooth with vertical root fracture under stereomicroscope (×10 magnnification); B) Jaws used in the study were covered by two layers of a boxing wax for reconstruction of soft tissue; C) One of the mandibles and maxillae used in CBCT device; D) Axial plane of CBCT showing two teeth with vertical root fracture; E) A tooth with vertical root fracture in a periapical radiograph
Mentions: Maillefer, Ballaigues, Switzerland) and step-back preparation of the canals. After filing and flaring, 40 teeth were included in the study as the control group and 40 (20 maxillary and 20 mandibular) teeth were randomly selected for inducing VRF (n=40). The roots were covered by a thin layer of red wax. For all teeth, two third of the root length was mounted in acrylic blocks from apical region. The method of inducing VRF was similar to that used by Hassan et al. [15]. In this method, a sharp chisel was placed perpendicular to the root canal and fracture was created by fine impacts of a hammer. If the two parts of tooth were splited due to the fracture, the specimen was excluded. Direct observation under a stereomicroscope (Wild M5A, Heerbrugg, Switzerland) with 10× magnification was used as the gold standard for detection of the fracture (Figure 1A). The other specimens in the control group were also assessed by similar method to assure that they were fracture free.

Bottom Line: The level of significance was set at 0.05.Sensitivity and specificity values of CBCT were 97.5% and 95%, respectively.Two methods were not significantly different when testing specificity (P=0.298).

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Radiology, Dental Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Iran;

ABSTRACT

Introduction: Vertical root fracture (VRF) is the longitudinal fracture of the root in endodontically treated teeth. Considering the limitations of two-dimensional radiographic images in detection of VRF and introduction of cone-beam computed tomography (CBCT), this study was designed to find the sensitivity, specificity and accuracy of CBCT and periapical (PA) radiography in detection of VRFs.

Methods and materials: This was a cross-sectional in vitro study on 80 extracted human single canal teeth including 40 maxillary and 40 mandibular teeth. After standardized endodontic treatment of the roots, VRF was induced in half of the teeth in each group, and other half were left without fracture. Teeth were inserted in dry maxillary and mandibular alveoli. PA radiographs and CBCT images were taken from the specimens. Data were analyzed with SPSS software. The McNemar test was used to evaluate the sensitivity, specificity and accuracy of images, and kappa coefficient was used to assess the degree of agreement between the observers. The level of significance was set at 0.05.

Results: Sensitivity and specificity values of CBCT were 97.5% and 95%, respectively. However, for PA radiography the sensitivity and specificity were 67.5% and 92.5%, in order of appearance. Accuracy of CBCT (96.25%) and PA radiography (80%) in both jaws were significantly different (P=0.022). Two methods were not significantly different when testing specificity (P=0.298).

Conclusion: This study showed that the sensitivity and accuracy of CBCT in detection of vertical root fracture are higher than periapical radiography. CBCT can be recommended to be used in detection of vertical root fractures.

No MeSH data available.


Related in: MedlinePlus