title: Comparison of five cone beam computed tomography systems for the detection of vertical root fractures.
abstract: BACKGROUND
  This study compared the accuracy of cone beam computed tomography (CBCT) scans made by five different systems in detecting vertical root fractures (VRFs). It also assessed the influence of the presence of root canal filling (RCF), CBCT slice orientation selection, and the type of tooth (premolar/molar) on detection accuracy.
  
  
  METHODS
  Eighty endodontically prepared teeth were divided into four groups and placed in dry mandibles. The teeth in groups Fr-F and Fr-NF were artificially fractured; those in groups control-F and control-NF were not. Groups Fr-F and control-F were root filled. CBCT scans were made using five different commercial CBCT systems. Two observers evaluated images in axial, coronal, and sagittal reconstruction planes.
  
  
  RESULTS
  There was a significant difference in detection accuracy among the five systems (p = 0.00001). The presence of RCF did not influence sensitivity (p = 0.16), but it reduced specificity (p = 0.003). Axial slices were significantly more accurate than sagittal and coronal slices (p = 0.0001) in detecting VRF in all systems. Significantly more VRFs were detected among molars than premolars (p = 0.0001).
  
  
  CONCLUSIONS
  RCF presence reduced specificity in all systems (p = 0.003) but did not influence accuracy (p = 0.79) except in one system (p = 0.012). Axial slices were the most accurate in detecting VRFs (p = 0.0001).
authors.affiliation: Department of Oral and Maxillofacial Radiology, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands.
authors.forename: Bassam
authors.initials: B
authors.lastname: Hassan
authors.forename: Maria Elissavet
authors.initials: ME
authors.lastname: Metska
authors.forename: Ahmet Rifat
authors.initials: AR
authors.lastname: Ozok
authors.forename: Paul
authors.initials: P
authors.lastname: van der Stelt
authors.forename: Paul Rudolf
authors.initials: PR
authors.lastname: Wesselink
mesh_terms: D002102:Cadaver; D054893:Cone-Beam Computed Tomography / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D011861:Radiography, Dental / Q000379:methods*; D012389:Root Canal Obturation; D015898:Tomography Scanners, X-Ray Computed; D014082:Tooth Fractures / Q000000981:diagnostic imaging*; D014092:Tooth Root / Q000000981:diagnostic imaging / Q000293:injuries*; D019553:Tooth, Nonvital / Q000000981:diagnostic imaging