The Effect of Intra-Canal Posts on Diagnostic Accuracy of Cone Beam Computed Tomography and Digital Radiography in Detection of Vertical Root Fractures
Journal of Dental School, Shahid Beheshti University of Medical Sciences,
Vol. 33 No. 4 (2015),
10 Esfand 2019
,
Page 296-304
https://doi.org/10.22037/jds.v33i4.24720
Abstract
Objective: Diagnosis of vertical root fractures (VRFs) is critical in endodontics. Cone Beam Computed Tomography (CBCT) has significantly enhanced image quality compared to digital radiography (DR) and greatly aids the diagnosis of VRFs but, metal artifacts has remained as a problem in VRF detection. This study evaluated the effect of intra canal posts on the diagnostic accuracy of CBCT and DR for detection of VRFs.
Methods: In this experimental in vitro study eighty extracted human premolar teeth were cut at the cement-enamel junction .After root canal preparation, the casting posts were made. Samples were randomly divided into 2 groups of 40; group one with induced fracture and group 2 as the control group. Radiographs were taken for all specimens with and without posts with both imaging systems. Three observers assessed the presence or absence of VRF. Accuracy of the two imaging systems and the effect of post on VRF detection were assessed, using two-way ANOVA test and inter observer coefficient agreement was calculated.
Results: Absolute diagnostic sensitivity and specificity of CBCT and absolute sensitivity of DR in the group with intracanal posts were significantly lower than those in the group without posts (p=0.023, p=0.034 and p=0.034 respectively). Absolute specificity of DR in the group with posts was significantly higher than that of the CBCT (p=0.014). The absolute and complete specificity of CBCT in the group without posts was significantly higher than those of DR (p=0.024, p=0.04). No statistically significant difference was found in inter observer agreement coefficient in presence or absence of posts or between the two imaging systems (p=0.119).
Conclusion: Intra canal posts decreased the diagnostic accuracy of CBCT and DR for detection of VRFs and this reduction was greater in CBCT. However, absolute specificity of DR in the group with posts was significantly higher than that of the CBCT, where as CBCT images of teeth without posts still had higher diagnostic accuracy than DR.
- Artifact
- Cone Beam Computed Tomography
- Digital radiography
- Intra canal post
- Vertical root fracture
How to Cite
References
Mora MA, Mol A, Tyndall DA, Rivera EM.,Effect of the number of basis images on the detection of longitudinal tooth fractures using local computed tomography. Dentomaxillofac Radiol 2007; 36: 382-386.
da Silveira PF, Vizzotto MB, Liedke GS, da Silveira HL, Montagner F, da Silveira HE., Detection of vertical root fractures by conventional radiographic examination and cone beam computed tomography - an in vitro analysis. Dent Traumatol 2013; 29: 41-46.
Melo SL, Bortoluzzi EA, Abreu M Jr, Corrêa LR, Corrêa M., Diagnostic ability of a cone-beam computed tomography scan to assess longitudinal root fractures in prosthetically treated teeth. J Endod 2010; 36: 1879-1882.
Wenzel A, Kirkevang LL. High resolution charge-coupled device sensor vs. medium resolution photostimulable phosphor plate digital receptors for detection of root fractures in vitro. Dent Traumatol 2005; 21: 32-36.
Kambungton J, Janhom A, Prapayasatok S, Pongsiriwet S. Assessment of vertical root fractures using three imaging modalities: cone beam CT, intraoral digital radiography and film. Dentomaxillofac Radiol 2012; 41: 91-95.
Bernardes RA, de Moraes IG, Húngaro Duarte MA, Azevedo BC, de Azevedo JR, Bramante CM.Use of
cone-beam volumetric tomography in the diagnosis of root fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: 270-277.
Kositbowornchai S, Nuansakul R, Sikram S, Sinahawattana S, Saengmontri S. Root fracture detection: a comparison of direct digital radiography with conventional radiography. Dentomaxillofac Radiol 2001; 30: 106-109.
Kositbowornchai S, Sikram S, Nuansakul R, Thinkhamrop B. Root fracture detection on digital images: effect of the zoom function. Dent Traumatol 2003; 19: 154-159.
Kamburoglu K, Murat S, Pehlivan SY. The effects of digital image enhancement on the detection of vertical root fracture. Dent Traumatol 2010; 26: 47-51.
Tofangchiha M, Bakhshi M, Shariati M, Valizadeh S, Adel M, Sobouti F.Detection of vertical root fractures using digitally enhanced images: reverse-contrast and colorization. Dent Traumatol 2012; 28: 478-482.
Arai Y, Tammisalo E, Iwai K, Hashimoto K, Shinoda K. Development of a compact computed tomographic apparatus for dental use. Dentomaxillofac Radiol 1999; 28: 245-248.
Bornstein MM, Wölner-Hanssen AB, Sendi P, von Arx T. Comparison of intraoral radiography and limited cone beam computed tomography for the assessment of root-fractured permanent teeth. Dent Traumatol 2009; 25: 571-577.
Hassan B, Metska ME, Ozok AR, van der Stelt P, Wesselink PR. Detection of vertical root fractures in endodontically treated teeth by a cone beam computed tomography scan. J Endod 2009; 35:719- 722.
Valizadeh S, Khosravi M, Azizi Z. Diagnostic accuracy of conventional,digital and cone beam computed tomography in vertical root fracture detection. IEJ 2011; 6: 15-20.
Edlund M, Nair MK, Nair UP. Detection of vertical root fractures by using cone-beam computed tomography: a clinical study. J Endod 2011; 37: 768-772.
Costa FF, Gaia BF, Umetsubo OS, Cavalcanti MG. Detection of horizontal root fracture with small- volume cone-beam computed tomography in the presence and absence of intracanal metallic post. J Endod 2011; 37: 1456-1459.
Costa FF1, Gaia BF, Umetsubo OS, Pinheiro LR, Tortamano IP, Cavalcanti MG Use of large-volume cone-beam computed tomography in identification and localization of horizontal root fracture in the presence and absence of intracanal metallic post. J Endod 2012; 38: 856-859.
Ozer SY. Detection of vertical root fractures by using cone beam computed tomography with variable voxel sizes in an in vitro model. J Endod 2011; 37: 75-79.
Wang P, Yan XB, Lui DG, Zhang WL, Zhang Z, Ma XC. Detection of dental root fractures by using cone-beam computed tomography. Dentomaxillofac Radiol 2011; 40: 290-298.
Moudi E, Haghanifar S, Madani Z, Alhavaz A, Bijani A, Bagheri M.. Assessment of vertical root fracture using cone-beam computed tomography. Imaging Sci Dent 2014; 44: 37-41.
Ezzodini Ardakani F, Razavi SH, Tabrizizadeh M. Diagnostic value of cone-beam computed tomography and periapical radiography in detection of vertical root fracture. Iran Endod J 2015; 10: 122-126.
Patel S,Durack C, Abella F,Shemesh H, Roig M, Lemberg K.Cone beam computed tomography in Endodontics- a review. Int Endod J 2015; 48: 3-15.
Hassan B1, Metska ME, Ozok AR, van der Stelt P, Wesselink PR.Comparison of five cone beam computed tomography systems for the detection of vertical root fractures. J Endod 2010; 36: 126- 129.
Metska ME, Aartman IH, Wesselink PR, Özok AR. Detection of vertical root fractures in vivo in endodontically treated teeth by cone-beam computed tomography scans. J Endod 2012; 38: 1344- 1347.
Estrela C,Bueno, MR,Silva, JA,Porto, OC,Leles, CR,Azevedo, BC.Effect of intracanal posts on dimensions of cone beam computed tomography images of endodontically treated teeth. Dental Press Endod 2011; 1: 28-36.
Patel S, Brady E, Wilson R, Brown J, Mannocci F. The detection of vertical root fractures in root filled teeth with periapical radiographs and CBCT scans. Int Endod J 2013; 46: 1140-1152.
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