Diagnostic ability of a cone-beam computed tomography scan to assess longitudinal root fractures in prosthetically treated teeth.
BACKGROUND
This study evaluated the influence of cast-gold posts on the diagnostic ability of a cone beam computed tomography (CBCT) system in assessing longitudinal root fractures. In addition, the influence of gutta-percha and variations in voxel resolution were assessed.


METHODS
One hundred eighty endodontically prepared teeth were divided into 3 experimental and 3 control groups and placed in a dry human skull. The teeth in the experimental groups were artificially fractured. Certain experimental and control groups were filled with gutta-percha cones. Other experimental and control groups were filled with cast-gold posts. All the teeth were viewed by using a tomography scan with 2 voxel resolution protocols (0.3-mm and 0.2-mm). A calibrated examiner, blinded to the protocol, assessed the images by using the nominated scan software.


RESULTS
The kappa values obtained for intraobserver reproducibility were 0.84 and 0.93 for 0.3-mm and 0.2-mm voxel resolution, respectively. The presence of gutta-percha or posts reduced the overall sensitivity and specificity in both voxel resolutions, but with no significant association. The CBCT specificity values were similar and did not depend on the voxel resolution adopted. In contrast, the sensitivity values were significantly higher for 0.2-mm voxel resolution in nonfilled (P < .05), gutta-percha (P < .001), and overall (P < .001) groups.


CONCLUSIONS
The CBCT diagnostic ability was not influenced by the presence of posts or gutta-percha, and the 0.3-mm voxel resolution images were demonstrated not to be a reliable protocol for the investigation of longitudinal root fractures.
Department of Dentomaxillofacial Radiology, School of Dentistry, University of Campinas, São Paulo, SP, Brazil. slsmelo@uol.com.br
Saulo Leonardo Sousa
SL
Melo
Eduardo Antunes
EA
Bortoluzzi
Murillo
M
Abreu
Letícia Ruhland
LR
Corrêa
Marcio
M
Corrêa
D054893:Cone-Beam Computed Tomography / Q000592:standards*; D018772:Dental Marginal Adaptation; D005188:False Negative Reactions; D005189:False Positive Reactions; D006047:Gold Alloys / Q000737:chemistry*; D006171:Gutta-Percha / Q000737:chemistry; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000592:standards; D008953:Models, Anatomic; D015588:Observer Variation; D011176:Post and Core Technique; D011856:Radiographic Image Enhancement / Q000592:standards; D016300:Radiography, Bitewing; D015203:Reproducibility of Results; D012387:Root Canal Filling Materials / Q000737:chemistry; D012390:Root Canal Therapy; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D014082:Tooth Fractures / Q000000981:diagnostic imaging*; D014092:Tooth Root / Q000293:injuries*; D019553:Tooth, Nonvital / Q000000981:diagnostic imaging
D006047:Gold Alloys; D012387:Root Canal Filling Materials; D006171:Gutta-Percha