The detection of vertical root fractures in post-core restored teeth with cone-beam CT: in vivo and ex vivo

• Published in: Dento-maxillo-facial radiology 2019-09, Vol.48 (6), p.20180327-20180327
• Main Authors: Byakova, Svetlana F, Novozhilova, Nina E, Makeeva, Irina M, Grachev, Vasiliy I, Kasatkina, Inna V
• Format: Article
• Language: English
• Subjects: Cone-Beam Computed Tomography; Humans; Reproducibility of Results; Sensitivity and Specificity; Tooth Fractures - diagnostic imaging; Tooth Root
• ISSN: 0250-832X; 1476-542X
• DOI: 10.1259/dmfr.20180327

To compare the accuracy of cone-beam CT and for the detection of artificially created large and small vertical root fractures in extracted teeth restored with post-core. Individual metal cast post-cores were fixed in the root canals of 50 extracted single-rooted human teeth. In 30 teeth fractures were created by tapping posts with a hammer. The teeth were sterilised in autoclave and embedded into bite-plates made of silicon impression material. Cone-beam CT scanning was performed and . For the scanning, teeth in sterile plastic bags were inserted into the mouths of volunteers. Then the teeth were sectioned with low-speed saw and the widths of the VRFs were measured microscopically. The teeth were distributed into 2 groups in accordance with the measured fractures' widths: large (wider than 180-250 µm) and small (80-150 µm). Five observers assessed the presence of vertical root fractures on axial CBCT slices. Sensitivity, specificity, accuracy and inter examiner agreement were calculated. The accuracy of cone-beam CT for large and small vertical root fractures detection was 0.56 and 0.40 respectively ( = 0.043). The sensitivity values were 0.53 and 0.27 for large and small vertical root fractures, respectively ( = 0.043). The visualisation of fracture lines was impossible in 90 % of cases, because of low image quality. Inter examiner reliability analysis showed κ values ranging from 0.02 to 0.54. Fracture width affected the detectability of vertical root fractures by cone-beam CT in teeth with metal cast post-cores. The detectability of root fractures was decreased because of low image quality, making the assessment of sound tooth tissue impossible.