title: Diagnostic accuracy of CBCT for tooth fractures: a meta-analysis.
abstract: OBJECTIVE
  The objective of this meta-analysis was to determine the diagnostic accuracy of cone-beam computed tomography (CBCT) for tooth fractures in vivo.
  
  
  METHODS
  PubMed, Embase, Web of Science, ProQuest Dissertations & Theses, CNKI and SIGLE were searched from January 1990 to April 2013 for eligible studies. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was employed to assess the quality of the included studies. Meta-analyses were performed in MetaDisc 1.4, Stata 12.1 and StatsDirect 2.7.9.
  
  
  RESULTS
  Finally, 12 studies were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and summary receiver operating characteristic were 0.92 (95% CI=0.89-0.94), 0.85 (95% CI=0.75-0.92), 5.68 (95% CI=3.42-9.45), 0.13 (95% CI=0.09-0.18) and 0.94 (95% CI=0.90-0.98), respectively. The pooled prevalence of tooth fractures in patients with clinically-suspected but periapical-radiography-undetected tooth fractures was 91% (95% CI=83%-97%). Positive and negative predictive values were 0.98 and 0.43 (subgroup analysis: 0.98 and 0.28 for endodontically-treated teeth; 0.99 and 0.77 for non-endodontically-treated teeth).
  
  
  CONCLUSIONS
  We suggest that CBCT has a high diagnostic accuracy for tooth fractures and could be used in clinical settings. We can be very confident with positive test results but should be very cautious with negative test results, especially for endodontically treated teeth.
authors: Department of Orthodontics, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
authors: Hu
authors: H
authors: Long
authors: Department of Orthodontics, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
authors: Yang
authors: Y
authors: Zhou
authors: Department of Orthodontics, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
authors: Niansong
authors: N
authors: Ye
authors: Department of Orthodontics, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
authors: Lina
authors: L
authors: Liao
authors: Department of Orthodontics, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
authors: Fan
authors: F
authors: Jian
authors: Department of Orthodontics, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
authors: Yan
authors: Y
authors: Wang
authors: Department of Orthodontics, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China. Electronic address: wenlilai@hotmail.com.
authors: Wenli
authors: W
authors: Lai
mesh_terms: D054893:Cone-Beam Computed Tomography / Q000706:statistics & numerical data*; D006801:Humans; D011237:Predictive Value of Tests; D012372:ROC Curve; D016300:Radiography, Bitewing / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D014082:Tooth Fractures / Q000000981:diagnostic imaging*; D019553:Tooth, Nonvital / Q000000981:diagnostic imaging
keywords: Cone-beam computed tomography; Diagnostic accuracy; Meta-analysis; Root fracture; Systematic review; Tooth fracture