The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 18 , ISSUE 2 ( February, 2017 ) > List of Articles

RESEARCH ARTICLE

Evaluation of Root Fracture in endodontically treated Teeth using Cone Beam Computed Tomography

Ricardo Raitz, Mariana Tiepo, Gabriel Magrin, Ana C Kovalik, Belkiss Marmora, Milena F Silva

Citation Information : Raitz R, Tiepo M, Magrin G, Kovalik AC, Marmora B, Silva MF. Evaluation of Root Fracture in endodontically treated Teeth using Cone Beam Computed Tomography. J Contemp Dent Pract 2017; 18 (2):94-99.

DOI: 10.5005/jp-journals-10024-1997

Published Online: 01-02-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

Our objective was to perform an in vitro evaluation of root fracture in endodontically treated teeth using two cone beam computed tomography (CBCT) machines.

Materials and methods

The sample comprised 86 singlerooted human premolars that had been fractured by a universal testing machine. The tomographic images were acquired using an Orthopantomograph OP300® and an Orthophos XG 3D® and evaluated by three examiners, by means of specific software. The teeth were classified into presence or absence of root fracture, then the root third where the fracture occurred, was determined. With regard to the detection of the fracture, the Kappa statistic was used for intra and interexaminer reproducibility at two distinct points in time. Chi-squared test was employed to analyze the sensitivity and specificity of the two tomographs (p < 0.05).

Results

The results showed a good or excellent Kappa index between examiners. As for the absolute frequency, the sensitivity (0.6) of the Orthophos XG 3D® equipment was superior, while specificity (0.91) was higher with the Orthopantomograph OP300®. On the receiver operating characteristics curve, moderate performance was found with an accuracy of 0.73 (OrthopantomographOP300®) and 0.74 (Orthophos XG 3D®) respectively. As far as the location of the root fracture is concerned, moderate agreement was verified using the Kappa statistic (k = 0.56).

Conclusion

Although the regular CBCTs represent the imaging examination of choice for assisting root fracture diagnosis in endodontically treated teeth, their performance in this study demonstrated an imprecise diagnosis of fractures in a good many cases, irrespective of the tomography machine used.

Clinical significance

An early and precise detection of root fractures is of the utmost clinical importance, but the radiopaque and/or metallic filling materials in the CBCT viewing field may generate artifacts, known as the beam-hardening effect, which could compromise root fracture detection.

How to cite this article

Tiepo M, Magrin G, Kovalik AC, Marmora B, Silva MF, Raitz R. Evaluation of Root Fracture in endodontically treated Teeth using Cone Beam Computed Tomography. J Contemp Dent Pract 2017;18(2):94-99.


PDF Share
  1. Resistance to fracture of endodontically treated teeth restored with different post systems. J Prosthet Dent 2002 Apr;87(4):431-437.
  2. Endodontic applications of cone-beam volumetric tomography. J Endod 2007 Sep;33(9):1121-1132.
  3. Vertical root fractures in crowned teeth: a report of 32 cases. Quintessence Int 2012 Jan;43(1):37-43.
  4. Prevalence and reasons for tooth loss in a sample from a dental clinic in Brazil. Int J Dent 2012;2012:719750.
  5. Vertical root fractures in endodontically treated teeth: A clinical survey. Stomatologija 2004;6(3):77-80.
  6. Incomplete tooth fracture – proposal for a new definition. Br Dent J 2001 Apr;190(8):424-428.
  7. Use of cone-beam volumetric tomography in the diagnosis of root fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009 Aug;108(2):270-277.
  8. Detection of vertical root fractures in endodontically treated teeth by a cone beam computed tomography scan. J Endod 2009 May;35(5):719-722.
  9. Root fracture detection on digital images: Effect of the zoom function. Dent Traumatol 2003 Jun;19(3):154-159.
  10. The potential applications of cone beam computed tomography in the management of endodontic problems. Int Endod J 2007 Oct;40(10):818-830.
  11. Application of cone beam volumetric tomography in endodontics. Aust Dent J 2012 Mar;57 (Suppl 1):72-81.
  12. Three-dimensional, non-destructive visualization of vertical root fractures using flat panel volume detector computer tomography: an ex vivo in vitro case report. Int Endod J 2005 Dec;38(12):904-913.
  13. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc 2006 Feb;72(1):75-80.
  14. Influence of dental metallic artifact from multislice CT in the assessment of simulated mandibular lesions. J Appl Oral Sci 2010 Mar-Apr;18(2):149-154.
  15. Analysis of the accuracy of linear measurements obtained by cone beam computed tomography (CBCT-NewTom). Dentomaxillofac Radiol 2004 Sep;33(5):291-294.
  16. Three-dimensional accuracy of measurements made with software on cone-beam computed tomography images. Am J Orthod Dentofacial Orthop 2008 Jul;134(1):112-116.
  17. Assessment of linear and angular measurements on three-dimensional cone-beam computed tomographic images. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009 Sep;108(3):430-436.
  18. Comparison of five cone beam computed tomography systems for the detection of vertical root fractures. J Endod 2010 Jan;36(1):126-129.
  19. Assessment of vertical root fractures using three imaging modalities: cone beam CT, intraoral digital radiography and film. Dentomaxillofac Radiol 2012 Feb;41(2):91-95.
  20. Evaluation of three imaging techniques for the detection of vertical root fractures in the absence and presence of gutta-percha root fillings. Int Endod J 2012 Nov;45(11):1004-1009.
  21. Dental vertical root fractures: value of CT in detection. Radiology 1999 Feb;210(2):545-549.
  22. Accuracy of intraoral radiography, multidetector helical CT, and limited cone-beam CT for the detection of horizontal tooth root fracture. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009 Nov;108(5):e70-e74.
  23. Detection of vertical root fractures in vivo in endodontically treated teeth by cone-beam computed tomography scans. J Endod 2012 Oct;38(10):1344-1347.
  24. Detection of vertical root fracture using cone-beam computerized tomography: an in vitro assessment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010 Feb;109(2):e74-e81.
  25. The detection of vertical root fractures in root filled teeth with periapical radiographs and CBCT scans. Int Endod J 2013 Dec;46(2):1140-1152.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.