Detection of vertical root fractures in the presence of intracanal metallic post: a comparison between periapical radiography and cone-beam computed tomography.
BACKGROUND
This in vitro study compared cone-beam computed tomography (CBCT) exam with different voxel sizes with digital periapical radiography in the detection of vertical root fractures in teeth with and without intracanal metallic posts.


METHODS
Eighteen single-rooted human teeth were endodontically treated, prepared for cast metal posts, and artificially fractured. After positioning the teeth in dry mandibular sockets, the samples were subjected twice (with and without posts) to digital periapical radiography at 3 different angles and to CBCT examinations with 2 voxel sizes, 0.125 and 0.25 mm. The images were evaluated by 3 oral radiologists. Indices of sensitivity, specificity, and positive and negative predictive values, in addition to the areas under the receiver operating characteristic curves (accuracy), were calculated. Comparison of the accuracy of the imaging methods was assessed by using the χ(2) test. Comparison of the accuracy between teeth with and without posts was determined by using the Fisher exact test.


RESULTS
The accuracy of the imaging methods showed no significant differences (P = .08). The comparison between teeth with and without posts in each examination revealed significant differences for CBCT with a voxel of 0.125 mm (P = .04) and for periapical radiography (P = .04).


CONCLUSIONS
No significant differences were observed between CBCT and periapical radiography in the detection of vertical root fractures, except for teeth with metallic posts in images from CBCT with a voxel of 0.125 mm and in digital periapical radiography. Furthermore, voxel size did not significantly influence the diagnosis of vertical root fractures.
School of Dentistry, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
Rafael Binato
RB
Junqueira
Francielle Silvestre
FS
Verner
Celso Neiva
CN
Campos
Karina Lopes
KL
Devito
Antônio Márcio Resende
AM
do Carmo
D019540:Area Under Curve; D016477:Artifacts; D002858:Chromium Alloys / Q000737:chemistry; D054893:Cone-Beam Computed Tomography / Q000706:statistics & numerical data*; D003481:Cuspid / Q000293:injuries; D003722:Dental Alloys / Q000737:chemistry*; D005189:False Positive Reactions; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000706:statistics & numerical data; D007180:Incisor / Q000293:injuries; D015588:Observer Variation; D011176:Post and Core Technique / Q000295:instrumentation*; D011237:Predictive Value of Tests; D012372:ROC Curve; D016300:Radiography, Bitewing / Q000706:statistics & numerical data*; D019252:Radiography, Dental, Digital / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D014082:Tooth Fractures / Q000000981:diagnostic imaging*; D014092:Tooth Root / Q000000981:diagnostic imaging / Q000293:injuries*; D019553:Tooth, Nonvital / Q000000981:diagnostic imaging
D002858:Chromium Alloys; D003722:Dental Alloys
Cone-beam computed tomography; diagnosis; digital periapical radiography; vertical root fracture