title: Impact of root fillings and posts on the diagnostic ability of three intra-oral digital radiographic systems in detecting vertical root fractures.
abstract: OBJECTIVE
  To evaluate (i) the accuracy of three intra-oral digital systems in detecting vertical root fractures (VRFs); and (ii) the influence of different intracanal conditions (without filling, filled with Gutta-percha and metal or fibreglass post).
  
  
  METHODS
  Forty single-rooted human teeth were decoronated and the root canals prepared. VRFs were induced using a universal testing machine on 20 teeth. Radiographic images were obtained using the paralleling technique with three different horizontal angulations on conventional E/F film, two storage phosphor plates (Digora Optime and VistaScan) and one sensor system (SnapShot). All teeth were radiographed with all intracanal conditions tested. All images were evaluated by five examiners. After 30 days, 25% of the images were reviewed. Areas under ROC curves, sensitivity, specificity, accuracy, positive predictive and negative predictive values were compared by anova.
  
  
  RESULTS
  The weighted kappa values for intra- and interobserver reproducibility were 0.48-0.74 and 0.57-0.66, respectively. The sensitivity revealed a significant difference between imaging modalities, with higher values for SnapShot (0.53) and VistaScan (0.46), followed by the film (0.41) and Digora (0.38). The area under the ROC curve for SnapShot (0.82) was greater than for the other systems in the teeth with a fibreglass post (VistaScan: 0.70; Digora: 0.64; film: 0.60).
  
  
  CONCLUSIONS
  All systems gave a similar performance for detecting VRFs; all gave a good performance in the absence of intracanal materials, but performed less well in the presence of a metal post or Gutta-percha. In teeth with a fibreglass post, digital systems with higher resolution should be used.
authors.affiliation: Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil.
authors.forename: H A R
authors.initials: HA
authors.lastname: Nascimento
authors.affiliation: Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil.
authors.forename: F S
authors.initials: FS
authors.lastname: Neves
authors.affiliation: Department of Clinical Dentistry, Faculty of Dentistry, Federal University of Espírito Santo, Vitória, Brazil.
authors.forename: S L
authors.initials: SL
authors.lastname: de-Azevedo-Vaz
authors.affiliation: Division of Endodontics, Department of Clinical Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil.
authors.forename: T M
authors.initials: TM
authors.lastname: Duque
authors.affiliation: Division of Bioestatistcs, Department of Community Dentistry, Dental School of Piracicaba, State University of Campinas, Piracicaba, Brazil.
authors.forename: G M B
authors.initials: GM
authors.lastname: Ambrosano
authors.affiliation: Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil.
authors.forename: D Q
authors.initials: DQ
authors.lastname: Freitas
mesh_terms: D005898:Glass; D006171:Gutta-Percha / Q000627:therapeutic use; D006801:Humans; D011176:Post and Core Technique; D019252:Radiography, Dental, Digital; D015203:Reproducibility of Results; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D012389:Root Canal Obturation / Q000379:methods; D014082:Tooth Fractures / Q000000981:diagnostic imaging*; D014092:Tooth Root / Q000000981:diagnostic imaging* / Q000293:injuries*; D019553:Tooth, Nonvital / Q000000981:diagnostic imaging
chemical_list: D012387:Root Canal Filling Materials; C009753:fiberglass; D006171:Gutta-Percha
keywords: diagnostic imaging; digital radiography; root canal filling materials; tooth fractures