title: Evaluation of cone-beam computed tomography in the diagnosis of vertical root fractures: the influence of imaging modes and root canal materials.
abstract: BACKGROUND
  The purpose of this study was to evaluate the influence of cone-beam computed tomography (CBCT) imaging modes in the diagnosis of vertical root fractures with different intracanal materials.
  
  
  METHODS
  The sample consisted of 30 single-rooted teeth divided into 3 groups (n = 10), control and complete and incomplete root fracture. In each tooth, different materials were used (gutta-percha, metal post, and fiber post) as well as no filling material. Each tooth/root was scanned in a 3D Accuitomo 170 CBCT device by using 4 different imaging modes (high-resolution, high-fidelity, high-speed, and standard). In addition, the dose-area product was calculated for each CBCT imaging mode. The images were randomly evaluated by 5 dentomaxillofacial radiologists.
  
  
  RESULTS
  Complete root fractures were visualized more easily than incomplete fractures. The presence of metal post and gutta-percha negatively influenced the diagnosis of root fracture. Regarding the CBCT imaging modes, there was no influence for complete root fracture diagnosis. In cases of incomplete root fractures, high-fidelity, high-resolution, and standard had a higher diagnostic accuracy, especially in the fiber post and no filling groups.
  
  
  CONCLUSIONS
  The CBCT imaging modes had little influence in the diagnosis of complete and incomplete root fractures, whereas the presence of intracanal material had greater impact on the diagnostic ability, demonstrating that CBCT is not beneficial for the diagnosis of root fractures when metal posts are present.
authors.affiliation: Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil. Electronic address: fredsampaio@yahoo.com.br.
authors.forename: Frederico Sampaio
authors.initials: FS
authors.lastname: Neves
authors.affiliation: Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
authors.forename: Deborah Queiroz
authors.initials: DQ
authors.lastname: Freitas
authors.affiliation: Division of Oral Radiology, Department of Oral Radiology, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil.
authors.forename: Paulo Sérgio Flores
authors.initials: PS
authors.lastname: Campos
authors.affiliation: Department of Oral and Maxillofacial Radiology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
authors.forename: Annika
authors.initials: A
authors.lastname: Ekestubbe
authors.affiliation: Clinic of Oral and Maxillofacial Radiology, Public Dental Health, Göteborg, Sweden.
authors.forename: Sara
authors.initials: S
authors.lastname: Lofthag-Hansen
mesh_terms: D019540:Area Under Curve; D016477:Artifacts; D002858:Chromium Alloys / Q000737:chemistry; D054893:Cone-Beam Computed Tomography / Q000379:methods / Q000592:standards*; D003764:Dental Materials / Q000737:chemistry; D017267:Dental Prosthesis Design; D003786:Dental Pulp Cavity / Q000000981:diagnostic imaging; D006171:Gutta-Percha / Q000737:chemistry; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000592:standards; D015588:Observer Variation; D011176:Post and Core Technique / Q000295:instrumentation; D012372:ROC Curve; D011829:Radiation Dosage; D011897:Random Allocation; D015203:Reproducibility of Results; D012387:Root Canal Filling Materials / Q000737:chemistry*; D012680:Sensitivity and Specificity; D014082:Tooth Fractures / Q000000981:diagnostic imaging*; D014092:Tooth Root / Q000000981:diagnostic imaging / Q000293:injuries*; D019553:Tooth, Nonvital / Q000000981:diagnostic imaging*
chemical_list: D002858:Chromium Alloys; D003764:Dental Materials; D012387:Root Canal Filling Materials; D006171:Gutta-Percha
keywords: Beam hardening artifacts; cone beam computed tomography; diagnosis; endodontics; vertical root fracture