Vertical Root Fracture Detection Using Limited-FOV Cone-Beam Computed Tomography
Abstract
Introduction: Vertical root fractures (VRF) often occur in endodontically treated teeth and are difficult to definitively diagnose. Limited-field of view (FOV) cone beam computed tomography (CBCT) might be promising in the identification of VRFs. Methods: Fifty-two single rooted teeth with single canals were used. The experimental group consisted of teeth with naturally existing and artificially induced fractures. Twenty-six non-fractured teeth served as the control group. Specimens were instrumented and imaged with a limited-FOV CBCT and 2 periapical radiographs. Two board certified endodontists and one oral and maxillofacial radiologist evaluated the presence or absence of VRFs. Kappa values comparing the true nature of the specimen with examiner interpretation of the images were determined. Sensitivities and specificities, and inter-examiner reliability were calculated. Results: Low kappa values indicated examiners inability to accurately detect VRFs. Poor agreement among examiners indicated low precision in detecting VRFs with CBCT and PAs. The average sensitivity and specificity for the detection of VRFs using CBCT and PAs was 0.42 and 0.27, respectively. The sensitivities in detecting VRFs with the CBCT of complete versus incomplete fractures were 0.83 and 0.32, respectively. Conclusion: Examiners were neither accurate nor precise in detecting VRFs with CBCT scans and PAs. VRFs could not be predictably identified with current limited-FOV CBCT technology unless there was a visible separation of tooth segments.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 01, 2012
- Accession Number
- AD1013139
Entities
People
- Geoffrey Mcmurray
Organizations
- Uniformed Services University of the Health Sciences