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Habibzadeh S, Ghoncheh Z, Kabiri P, Mosaddad SA. Diagnostic efficacy of cone-beam computed tomography for detection of vertical root fractures in endodontically treated teeth: a systematic review. BMC Med Imaging 2023; 23:68. [PMID: 37264339 DOI: 10.1186/s12880-023-01024-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/23/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Vertical root fractures (VRFs) sometimes occur in endodontically treated teeth. They have a difficult diagnosis and a dismal result. The objective of this review was to evaluate the diagnostic performance of cone-beam computed tomography (CBCT) for detecting VRFs in teeth that had undergone endodontic treatment. METHODS Literature was reviewed from Web of Science, PubMed, Cochrane Review, SCOPUS, and Embase databases between 2000 and 2022. The searched keywords included "endodontically treated teeth," "cone-beam computed tomography," "CBCT," "tooth fracture," "vertical root fracture," "VRF," "accuracy," "sensitivity," and "specificity." Only articles in the English language were included. The final analysis included 20 papers that satisfied the eligibility requirements. RESULTS The overall mean ± SD values (%) for the diagnostic sensitivity and specificity of CBCT for detection of VRFs in endodontically treated teeth in the presence of root-filling materials without an intracanal post were 71.50 ± 22.19 and 75.64 ± 19.41, respectively. The overall mean (SD) value (%) for the sensitivity of CBCT for the detection of VRFs in the presence of root-filling materials and intracanal posts was 72.76 (18.73), while the mean (SD) specificity was 75.44 (18.26). The accuracy of CBCT (mean ± SD) was 78.47 ± 17.19% and 74.02 ± 10.64%, respectively, for teeth without intracanal posts and those with posts. CONCLUSIONS Further clinical research is needed to validate the optimum efficiency of CBCT as a diagnostic technique for detecting VRFs in teeth that have had endodontic treatment, given the low sensitivity, significant heterogeneity of studies, and lack of in-vivo studies on the subject.
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Affiliation(s)
- Sareh Habibzadeh
- Associate Professor, Department of Prosthodontics, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
- Associate Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Ghoncheh
- Associate Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Associate Professor, Department of Oral & Maxillofacial Radiology, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Pedram Kabiri
- Dentist, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
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de Lima KL, Silva LR, de Paiva Prado TB, Silva MAG, de Freitas Silva BS, Yamamoto-Silva FP. Influence of the technical parameters of CBCT image acquisition on vertical root fracture diagnosis: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:433-474. [PMID: 36700991 DOI: 10.1007/s00784-022-04797-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 11/14/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To evaluate the influence of image acquisition parameters (voxel, FOV, kVp, mA) on the accuracy of cone-beam computed tomography (CBCT) in detecting vertical root fracture (VRF). MATERIAL AND METHODS Searches were performed in 6 main databases and the gray literature, without restrictions of language or date. Observational clinical studies (OCS) and in vitro-extracted teeth (IV) studies were considered eligible for inclusion when investigating the accuracy (sensitivity, specificity) of CBCT in detecting VRF in human teeth. The risk of bias was assessed using QUADAS-2, and a meta-analysis was performed using Review Manager v5.4 software and Jamovi software v1.6. RESULTS A total of 60 out of 132 articles was included after fulfilling the eligibility criteria. Of these, 54 were IV studies while 6 were OCS. In the IV studies, it was seen that smaller FOV sizes tended to present higher accuracy values. The meta-analysis of the 6 OCS showed that the overall sensitivity and specificity values for 0.08 mm and 0.1 mm voxels were greater (0.84 and 0.79, respectively) than the sensitivity and specificity values for 0.125 mm and 0.2 mm voxels (0.70 and 0.55, respectively). CONCLUSIONS Despite the uncertain risk of bias found for the IV and OCS studies, smaller voxel and FOV sizes seem to provide more accurate VRF detection values when using CBCT. CLINICAL RELEVANCE This information is crucial for supporting the clinician when prescribing CBCT in cases of a clinical suspicion of VRF, and contributes to the personalization of the CBCT prescription, thereby ensuring greater accuracy in the VRF diagnosis. Registration This protocol was registered at the PROSPERO database (International Prospective Register of Systematic Review) under registration number CRD42020210118.
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Affiliation(s)
- Kaique Leite de Lima
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Lorena Rosa Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | | | - Maria Alves Garcia Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Brunno Santos de Freitas Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil. .,University of Anápolis, Anápolis, GO, Brazil.
| | - Fernanda Paula Yamamoto-Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil.,University of Anápolis, Anápolis, GO, Brazil
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Yang P, Guo X, Mu C, Qi S, Li G. Detection of vertical root fractures by cone-beam computed tomography based on deep learning. Dentomaxillofac Radiol 2023; 52:20220345. [PMID: 36802858 PMCID: PMC9944014 DOI: 10.1259/dmfr.20220345] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVES This study aims to evaluate the performance of ResNet models in the detection of in vitro and in vivo vertical root fractures (VRF) in Cone-beam Computed Tomography (CBCT) images. METHODS A CBCT image dataset consisting of 28 teeth (14 intact and 14 teeth with VRF, 1641 slices) from 14 patients, and another dataset containing 60 teeth (30 intact and 30 teeth with VRF, 3665 slices) from an in vitro model were used for the establishment of VRFconvolutional neural network (CNN) models. The most popular CNN architecture ResNet with different layers was fine-tuned for the detection of VRF. Sensitivity, specificity, accuracy, PPV (positive predictive value), NPV (negative predictive value), and AUC (the area under the receiver operating characteristic curve) of the VRF slices classified by the CNN in the test set were compared. Two oral and maxillofacial radiologists independently reviewed all the CBCT images of the test set, and intraclass correlation coefficients (ICCs) were calculated to assess the interobserver agreement for the oral maxillofacial radiologists. RESULTS The AUC of the models on the patient data were: 0.827(ResNet-18), 0.929(ResNet-50), and 0.882(ResNet-101). The AUC of the models on the mixed data get improved as:0.927(ResNet-18), 0.936(ResNet-50), and 0.893(ResNet-101). The maximum AUC were: 0.929 (0.908-0.950, 95% CI) and 0.936 (0.924-0.948, 95% CI) for the patient data and mixed data from ResNet-50, which is comparable to the AUC (0.937 and 0.950) for patient data and (0.915 and 0.935) for the mixed data obtained from the two oral and maxillofacial radiologists, respectively. CONCLUSIONS Deep-learning models showed high accuracy in the detection of VRF using CBCT images. The data obtained from the in vitro VRF model increases the data scale, which is beneficial to the training of deep-learning models.
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Affiliation(s)
| | | | | | - Senrong Qi
- Department of Oral and Maxillofacial Radiology, Beijing Stomatology Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Gang Li
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
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Mizuhashi F, Watarai Y, Ogura I. Diagnosis of Vertical Root Fractures in Endodontically Treated Teeth by Cone-Beam Computed Tomography. J Imaging 2022; 8:jimaging8030051. [PMID: 35324606 PMCID: PMC8949458 DOI: 10.3390/jimaging8030051] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 02/01/2023] Open
Abstract
The purpose of this study was to investigate the characteristics and the detection ability of vertical root fractures in endodontically treated teeth by intraoral radiography and cone-beam computed tomography (CBCT). CBCT images of 50 patients with root fractures in endodontically treated teeth were reviewed, and 36 vertical root fractures were taken in this study. The cause of fracture, core construction, kind of teeth, and fracture direction (bucco-lingual and mesio-distal fractures) were investigated. Detection ability of vertical root fractures by intraoral radiography and CBCT was also examined. Statistical analyses concerning the characteristics were performed by χ2 test, and the detection ability was analyzed by cross-tabulation. All of the fractured teeth were nontraumatized teeth. The vertical root fracture occurrence was not differed by core construction. The vertical root fracture number was largest at the premolar teeth (p = 0.005), and the number of the bucco-lingual fracture was larger than the mesio-distal fracture (p = 0.046). Vertical root fractures were detectable using CBCT, while undetectable by intraoral radiography (p < 0.001). Vertical root fractures occurred easily in premolar teeth with bucco-lingual direction, and CBCT is an adequate radiographic method to diagnose vertical root fracture.
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Affiliation(s)
- Fumi Mizuhashi
- Department of Removable Prosthodontics, The Nippon Dental University School of Life Dentistry at Niigata, Niigata 951-8580, Japan;
- Correspondence: ; Tel.: +81-25-267-1500
| | - Yuko Watarai
- Department of Removable Prosthodontics, The Nippon Dental University School of Life Dentistry at Niigata, Niigata 951-8580, Japan;
| | - Ichiro Ogura
- Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata 951-8580, Japan;
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Arriola-Guillén L, de Lima Moreno J, Boessio Vizzotto M, da Silveira Tiecher P, Assein Arús N, Dias da Silveira H. Impact of intracanal post-material on vertical root fractures diagnosis: A high-resolution cone-beam computed tomography study. J Int Oral Health 2022. [DOI: 10.4103/jioh.jioh_209_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Paz JLC, Borges JS, Rodrigues JF, Fagundes DM, Barbosa GLDR, Soares CJ, Soares PBF. Dental undergraduate students' ability in the diagnosis of root fractures: Comparative analysis of different imaging methods. J Dent Educ 2021; 86:136-143. [PMID: 34599517 DOI: 10.1002/jdd.12798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/05/2021] [Accepted: 09/03/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the diagnostic ability of dental undergraduate students to detect horizontal and oblique root fractures (ORFs) using different imaging techniques. MATERIALS AND METHODS Nine teeth were selected and randomly divided in three groups in order to create a fracture line without fragments separation: control (without fracture), horizontal root fracture (HRF), and ORF. The root fracture was created using perpendicular force and was confirmed by transillumination. A model with two adjacent teeth was created, and different imaging techniques were performed: conventional periapical radiograph; mesially and distally shifted periapical radiographs; cone-beam computer tomography (CBCT). Twenty students that had participation on dental trauma clinic at the year of 2019 were invited to identify root fractures by a five-point scale: (i) fracture definitely not present, (ii) fracture probably not present, (iii) uncertain whether fracture is present or not, (iv) fracture probably present, and (v) fracture definitely present. Data were analyzed by Kappa test for agreement evaluation. RESULTS Comparing each student to the gold standard, there was a variation in reproducibility and performance from poor to substantial (0.042-0.667). Reproducibility values ranged from poor to good for all periapical radiographs both in the diagnosis of ORF (-0.33-0.667) and in HRF (0-1). CONCLUSIONS In CBCT images, the students' ability was lower in HRF detection in comparison with the oblique ones. The students showed limited capacity to diagnose root fractures; however when CBCT was used, the performance was more satisfactory than when periapical radiographs were used.
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Affiliation(s)
- João Lucas C Paz
- Department of Periodontology and Implantology, Faculty of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Juliana S Borges
- Department of Periodontology and Implantology, Faculty of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Jessica F Rodrigues
- Faculty of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Daniela M Fagundes
- Department of Dentistry, Faculty of Dentistry, Ceuma University, São Luís, Maranhão, Brazil
| | - Gabriella Lopes de R Barbosa
- Department of Stomatological Diagnosis, Faculty of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Carlos J Soares
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of, Uberlândia, Minas Gerais, Brazil
| | - Priscilla B F Soares
- Department of Periodontology and Implantology, Faculty of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
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Candemil AP, Mangione F, Vasconcelos KF, Oenning AC, Jacobs R, Freitas DQ, Haiter-Neto F, Salmon B, Oliveira ML. Influence of the exomass on the detection of simulated root fracture in cone-beam CT - an ex-vivo study. Dentomaxillofac Radiol 2020; 50:20200450. [PMID: 33237809 DOI: 10.1259/dmfr.20200450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To evaluate the influence of exomass-related metal artefacts on the detection of simulated vertical root fracture (VRF) in cone-beam computed tomography (CBCT). METHODS 20 teeth were endodontically instrumented and VRF was induced in half of them. All teeth were individually placed in an empty socket of a human mandible. Metallic materials were differently arranged in the exomass [zone outside of the field of view (FOV) but between the X-ray source and the receptor] and/or endomass (zone inside of the FOV), and CBCT scans were obtained. Four radiologists evaluated the presence of VRF using a 5-point scale. Sensitivity, specificity, and area under the receiver operating curve (AUC) were compared using ANOVA. Also, the tooth of interest was replaced with a tube filled with a radiopaque solution and all CBCT scans were repeated to analyse the data objectively. Mean grey and noise values were obtained from the tube and compared using ANOVA followed by Tukey's test (α = 0.05). RESULTS Mean grey values were significantly lower and noise was significantly higher when metallic materials were present in the endomass or both the exomass and endomass. Sensitivity, specificity, and AUC were not influenced by the artefacts from the metallic materials irrespective of the arrangement condition. CONCLUSIONS Exomass-related metal artefacts did not influence the diagnosis of simulated VRF in CBCT.
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Affiliation(s)
- Amanda Pelegrin Candemil
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Francesca Mangione
- Orofacial Pathologies, Imaging and Biotherapies Lab, Université de Paris, UR 2496, Montrouge, France.,Dental Medicine Departments, Bretonneau and Henri Mondor University Hospitals, AP-HP, Paris, France
| | - Karla Farias Vasconcelos
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Anne Caroline Oenning
- Orofacial Pathologies, Imaging and Biotherapies Lab, Université de Paris, UR 2496, Montrouge, France.,Dental Medicine Departments, Bretonneau and Henri Mondor University Hospitals, AP-HP, Paris, France.,Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, Sao Paulo, Brazil
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Francisco Haiter-Neto
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Benjamin Salmon
- Orofacial Pathologies, Imaging and Biotherapies Lab, Université de Paris, UR 2496, Montrouge, France.,Dental Medicine Departments, Bretonneau and Henri Mondor University Hospitals, AP-HP, Paris, France
| | - Matheus Lima Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Andraws Yalda F, Clarkson RJ, Davies J, Rout PGJ, Sengupta A, Horner K. Does anthropomorphic model design in ex vivo studies affect diagnostic accuracy for dental root fracture using CBCT? Dentomaxillofac Radiol 2020; 49:20200093. [PMID: 32479121 PMCID: PMC7549528 DOI: 10.1259/dmfr.20200093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/03/2020] [Accepted: 05/21/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The evidence for diagnostic accuracy using cone beam computed tomography (CBCT) for dental applications depends heavily on ex vivo research, but there is little knowledge of whether the model used affects the diagnostic accuracy results. The objective of this study was to determine the impact of different designs of anthropomorphic models on diagnostic accuracy for the specific task of dental root fracture detection. METHODS Horizontal or oblique root fracture was induced in 24 of 48 permanent maxillary incisors. The 48 teeth were scanned by CBCT using standard clinical exposure factors on five occasions, each with a different model design. Scans were viewed by five dental and maxillofacial radiologists, who each made a forced diagnosis of fracture or no fracture in each root and a judgment on root fracture using a five-point confidence scale. Sensitivity (Se), specificity (Sp) and areas under receiver operating characteristic (ROC) curve (Az) were calculated for each observer for each model. RESULTS There were no significant differences between the diagnostic accuracy measurements recorded using different models. There were, however, numerous significant differences between observers using the same anthropomorphic model. CONCLUSIONS Despite the differences in X-ray attenuation between the five model designs, the results suggest that the anthropomorphic model does not affect the results of diagnostic accuracy studies on root fracture using this CBCT machine at standard clinical exposures. This provides some confidence in the previously published evidence. The interobserver diagnosis differences indicate that research using only two observers could provide misleading results.
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Affiliation(s)
| | - Rosalyn J Clarkson
- Department of Radiology, Leeds Dental Institute, Clarendon Way, Leeds LS2 9LU, UK
| | - Jonathan Davies
- Department of Dental Radiological Imaging, Guy's and St Thomas' NHS Foundation Trust, Floor 23, Tower Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
| | - Peter G J Rout
- Birmingham Dental Hospital, Birmingham Community Healthcare Foundation NHS Trust, 5 Mill Pool Way, Birmingham, B5 7EG, UK
| | - Anita Sengupta
- Division of Dentistry, School of Medical Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Oxford Road, Manchester M13 9PL, UK
| | - Keith Horner
- Division of Dentistry, School of Medical Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Oxford Road, Manchester M13 9PL, UK
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Kasahara Y, Iino Y, Ebihara A, Okiji T. Differences in the corono-apical location of sinus tracts and buccal cortical bone defects between vertically root-fractured and non-root-fractured teeth based on periradicular microsurgery. J Oral Sci 2020; 62:327-330. [PMID: 32475865 DOI: 10.2334/josnusd.19-0328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This retrospective study aimed to investigate whether the corono-apical location of sinus tracts differs according to the presence/location of vertical root fracture (VRF) in microsurgically treated root-filled teeth. The cases included were (1) anterior and premolar teeth without a preoperative diagnosis of VRF, (2) those with a periodontal probing depth of ≤3 mm, and (3) those for which preoperative cone-beam computed tomography (CBCT) scans and intraoperative video records were available. VRF was diagnosed intraoperatively. The locations of buccal cortical bone defects and fracture lines were categorized on video images, and the corono-apical sinus tract locations were determined by superimposing video images onto volume-rendered CBCT images. Eleven of the 78 teeth investigated had VRF, and there was no significant difference in the incidence of sinus tracts between vertically fractured and non-fractured teeth (Mann-Whitney U-test, P > 0.05). The location of the sinus tract was significantly more coronal in vertically fractured than in non-fractured teeth (Mann-Whitney U-test, P < 0.0001). The location of sinus tracts was high correlated with cortical bone defects (Spearman's correlation, P < 0.0001). In microsurgically treated anterior and premolar teeth with a normal probing depth, sinus tracts were located more coronally in vertically fractured than in non-fractured teeth, and were highly correlated with the location of cortical bone defects.
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Affiliation(s)
- Yuki Kasahara
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Yoshiko Iino
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Arata Ebihara
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Takashi Okiji
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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Diniz de Lima E, Lira de Farias Freitas AP, Mariz Suassuna FC, Sousa Melo SL, Bento PM, Pita de Melo D. Assessment of Cone-beam Computed Tomographic Artifacts from Different Intracanal Materials on Birooted Teeth. J Endod 2019; 45:209-213.e2. [PMID: 30711180 DOI: 10.1016/j.joen.2018.11.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/12/2018] [Accepted: 11/18/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study quantitatively evaluated the type and amount of image artifacts generated by different intracanal materials in birooted teeth scanned at different exposure parameters. METHODS The sample consisted of 15 birooted premolars. Seven different intracanal material combinations were used in each tooth one at a time: (1) roots without intracanal materials, (2) roots with gutta-percha, (3) a buccal root with gutta-percha and a lingual root with a fiberglass post, (4) a buccal root with gutta-percha and a lingual root with a metal core fiberglass post, (5) buccal and lingual roots with fiberglass posts, (6) buccal and lingual roots with metal core fiberglass posts, and (7) buccal and lingual roots with NiCr metal posts. Cone-beam computed tomographic scans were acquired using a CS 9000 unit (Carestream Dental, Atlanta, GA). An image of each tooth was captured under 5 exposure parameters: 2.5, 4, 6.3, 8, and 12 mA. The voxel size, field of view, and tube voltage were fixed at 0.076 mm, 5 × 3.75 cm, and 75 kV. We assessed each artifact quantitatively using ImageJ's threshold tool (National Institutes of Health, Bethesda, MD) to determine the hypodense and hyperdense artifact areas within 8-bit images extracted from the scans. All analyses were conducted with a 95% confidence level (α <0.05). RESULTS The inferential analysis showed that roots filled with metal posts presented the highest amount of hypodense and hyperdense artifacts, whereas fiberglass post in both roots presented fewer artifacts. All materials presented more hypodense than hyperdense artifact formation. Overall, the low-exposure settings presented fewer artifacts and higher values of preserved dental images. CONCLUSIONS Low-exposure protocols and fiberglass posts presented fewer image artifacts in CBCT scans.
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Affiliation(s)
- Elisa Diniz de Lima
- Department of Dentistry, State University of Paraíba, Campina Grande, Paraiba, Brazil
| | | | | | - Saulo L Sousa Melo
- Department of Oral Pathology, Radiology and Medicine, The University of Iowa, Iowa City, Iowa
| | - Patricia Meira Bento
- Department of Dentistry, State University of Paraíba, Campina Grande, Paraiba, Brazil
| | - Daniela Pita de Melo
- Department of Dentistry, State University of Paraíba, Campina Grande, Paraiba, Brazil.
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11
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Byakova SF, Novozhilova NE, Makeeva IM, Grachev VI, Kasatkina IV. The detection of vertical root fractures in post-core restored teeth with cone-beam CT: in vivo and ex vivo. Dentomaxillofac Radiol 2019; 48:20180327. [PMID: 31095425 DOI: 10.1259/dmfr.20180327] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To compare the accuracy of cone-beam CT ex vivo and in vivo for the detection of artificially created large and small vertical root fractures in extracted teeth restored with post-core. METHODS 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 ex vivo and in vivo . For the in vivo 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. RESULTS The accuracy of cone-beam CT in vitro for large and small vertical root fractures detection was 0.56 and 0.40 respectively (p = 0.043). The sensitivity values were 0.53 and 0.27 for large and small vertical root fractures, respectively (p = 0.043). The visualisation of fracture lines in vivo 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. CONCLUSIONS Fracture width affected the in vitro detectability of vertical root fractures by cone-beam CT in teeth with metal cast post-cores. The detectability of root fractures in vivo was decreased because of low image quality, making the assessment of sound tooth tissue impossible.
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Affiliation(s)
- Svetlana F Byakova
- Department of Therapeutic Dentistry, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Nina E Novozhilova
- Department of Therapeutic Dentistry, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Irina M Makeeva
- Department of Therapeutic Dentistry, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Vasiliy I Grachev
- Independent X-ray Diagnostic Laboratory, "3D Lab", Bolshaya Andronievskaya, Moscow, Russia
| | - Inna V Kasatkina
- A.N. Frumkin Institute of Physical Chemistry and Electrochemistry RAS, Moscow, Russia
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12
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Guo XL, Li G, Yin S, Ma RH, Guo YJ, Bornstein MM. Effect of fracture orientation on detection accuracy of vertical root fractures in non-endodontically treated teeth using cone beam computed tomography. Clin Oral Investig 2019; 23:4433-4439. [DOI: 10.1007/s00784-019-02905-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 04/04/2019] [Indexed: 11/25/2022]
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13
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Guo XL, Li G, Zheng JQ, Ma RH, Liu FC, Yuan FS, Lyu PJ, Guo YJ, Yin S. Accuracy of detecting vertical root fractures in non‐root filled teeth using cone beam computed tomography: effect of voxel size and fracture width. Int Endod J 2019; 52:887-898. [PMID: 30661246 DOI: 10.1111/iej.13076] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 01/15/2019] [Indexed: 01/16/2023]
Affiliation(s)
- X. L. Guo
- Department of Oral and Maxillofacial Radiology Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology Beijing China
| | - G. Li
- Department of Oral and Maxillofacial Radiology Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology Beijing China
| | - J. Q. Zheng
- Center of Digital Dentistry & Department of Prosthodontics Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology Beijing China
| | - R. H. Ma
- Department of Oral and Maxillofacial Radiology Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology Beijing China
| | - F. C. Liu
- Department of Epidemiology and Biostatistics School of Public Health Peking University Beijing China
| | - F. S. Yuan
- Center of Digital Dentistry & Department of Prosthodontics Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology Beijing China
| | - P. J. Lyu
- Center of Digital Dentistry & Department of Prosthodontics Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology Beijing China
| | - Y. J. Guo
- Department of Stomatology Beijing Children's Hospital Capital Medical University Beijing China
| | - S. Yin
- Department of Oral and Maxillofacial Radiology Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology Beijing China
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Yamamoto-Silva FP, de Oliveira Siqueira CF, Silva MAGS, Fonseca RB, Santos AA, Estrela C, de Freitas Silva BS. Influence of voxel size on cone-beam computed tomography-based detection of vertical root fractures in the presence of intracanal metallic posts. Imaging Sci Dent 2018; 48:177-184. [PMID: 30276154 PMCID: PMC6148034 DOI: 10.5624/isd.2018.48.3.177] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/17/2018] [Accepted: 07/31/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose This study was performed to evaluate the influence of voxel size and the accuracy of 2 cone-beam computed tomography (CBCT) systems in the detection of vertical root fracture (VRF) in the presence of intracanal metallic posts. Materials and Methods Thirty uniradicular extracted human teeth were selected and randomly divided into 2 groups (VRF group, n=15; and control group, n=15). The VRFs were induced by an Instron machine, and metallic posts were placed in both groups. The scans were acquired by CBCT with 4 different voxel sizes: 0.1 mm and 0.16 mm (for the Eagle 3D V-Beam system) and 0.125 mm and 0.2 mm (for the i-CAT system) (protocols 1, 2, 3, and 4, respectively). Interobserver and intraobserver agreement was assessed using the Cohen kappa test. Sensitivity and specificity were evaluated and receiver operating characteristic analysis was performed. Results The intraobserver coefficients indicated good (0.71) to very good (0.83) agreement, and the interobserver coefficients indicated moderate (0.57) to very good (0.80) agreement. In respect to the relationship between sensitivity and specificity, a statistically significant difference was found between protocols 1 (positive predictive value: 0.710, negative predictive value: 0.724) and 3 (positive predictive value: 0.727, negative predictive value: 0.632) (P<.05). The least interference due to artifact formation was observed using protocol 2. Conclusion Protocols with a smaller voxel size and field of view seemed to favor the detection of VRF in teeth with intracanal metallic posts.
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Affiliation(s)
| | | | | | - Rodrigo Borges Fonseca
- Department of Oral Rehabilitation, Dental School, Federal University of Goiás, Goiânia, Brazil
| | - Ananda Amaral Santos
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Brazil
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Lira de Farias Freitas AP, Cavalcanti YW, Costa FCM, Peixoto LR, Maia AMA, Rovaris K, Bento PM, Melo DP. Assessment of artefacts produced by metal posts on CBCT images. Int Endod J 2018; 52:223-236. [PMID: 30107037 DOI: 10.1111/iej.12999] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 08/12/2018] [Indexed: 01/27/2023]
Abstract
AIM To evaluate artefact intensity in cone beam computed tomography (CBCT) images of two alloys used in metal posts scanned using different exposure parameters. METHODOLOGY The sample consisted of 20 single-rooted teeth divided into two groups for use with either a NiCr post or AgPd post. All teeth were scanned with and without their corresponding metal posts and with and without the presence of an extra restored tooth in the arch. The samples were scanned using CS 9000 3D scanner with two exposure protocols: 85 kV 6.3 mA and 85 kV 10 mA. Voxel size and FOV were fixed at 0.100 mm and 5 cm × 3.75 cm. The presence of artefacts was assessed qualitatively by two calibrated observers using the CBCT volume and paired 2D images, and quantitatively by one trained observer, using ImageJ software. Wilcoxon's signed rank, Mann-Whitney, kappa and chi-square tests were used for qualitative analyses. Two-way anova and Tukey's tests were used for quantitative analyses. All analyses were conducted considering the 95% confidence level (α < 0.05). RESULTS For the CBCT volume qualitative analysis, significant differences were observed between the metal alloys in the presence of an extra restored tooth, with higher artefact intensity for AgPd when assessing hypodense halos and lines (P = 0.006). Images with two restored teeth had significantly more hypodense and hyperdense lines (P = 0.033). When evaluating exposure parameters and number of restored teeth, the paired image quality analysis revealed significant disagreement between observers for diagnostic image quality (P = 0.001). Quantitative artefact analysis revealed higher artefact intensity for the AgPd posts in the presence of two restored teeth. CONCLUSION Although the exposure parameters tested did not interfere with artefact intensity, post alloys with a higher atomic number and the presence of another metal structure in the arch increased artefact intensity and impaired the diagnostic quality of CBCT images.
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Affiliation(s)
| | - Y W Cavalcanti
- Department of Clinical and Social Dentistry, Federal University of Paraíba, João Pessoa, Brazil
| | - F C M Costa
- Department of Dentistry, State University of Paraíba, Campina Grande, PB, Brazil
| | - L R Peixoto
- Department of Dentistry, State University of Paraíba, Campina Grande, PB, Brazil
| | - A M A Maia
- Department of Dentistry, State University of Paraíba, Campina Grande, PB, Brazil
| | - K Rovaris
- Department of Dentistry, State University of Paraíba, Campina Grande, PB, Brazil
| | - P M Bento
- Department of Dentistry, State University of Paraíba, Campina Grande, PB, Brazil
| | - D P Melo
- Department of Dentistry, State University of Paraíba, Campina Grande, PB, Brazil
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16
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De Martin e Silva D, Campos CN, Pires Carvalho AC, Devito KL. Diagnosis of Mesiodistal Vertical Root Fractures in Teeth with Metal Posts: Influence of Applying Filters in Cone-beam Computed Tomography Images at Different Resolutions. J Endod 2018; 44:470-474. [DOI: 10.1016/j.joen.2017.08.030] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 08/10/2017] [Accepted: 08/26/2017] [Indexed: 12/14/2022]
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17
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Salineiro FCS, Kobayashi-Velasco S, Braga MM, Cavalcanti MGP. Radiographic diagnosis of root fractures: a systematic review, meta-analyses and sources of heterogeneity. Dentomaxillofac Radiol 2017; 46:20170400. [PMID: 28749700 DOI: 10.1259/dmfr.20170400] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Many studies to evaluate the accuracy of root fracture diagnosis have been conducted. However, there is a scarcity of studies to assess the quality and the sources of heterogeneity in the literature. For this reason, the aim of this study was to conduct systematic reviews and meta-analyses to summarize the available evidence on detection of root fractures by cone beam CT (CBCT) and periapical radiograph (PR) images and the interference of artefact by investigating possible sources of heterogeneity. METHODS Studies reporting root fracture detection, from January 2010 to February 2016, were selected. All selected studies were subjected to selection criteria and then, comparative and qualitative analyses by using the quality assessment of diagnostic accuracy studies (QUADAS-2) tool were performed. Pooled sensitivity, specificity and diagnostic odds ratios were calculated. Also, receiver operator characteristics (ROC) curves were built to summarize the results. SROC curve analyses were performed to investigate the heterogeneity among studies. RESULTS Initially, 799 articles were selected. After screening titles and abstracts, 743 articles were excluded. After reading the remaining 56 full-texts, 47 relevant articles were included in this study. Diagnostic odds ratio values revealed a wide range of results across the studies and determined a higher heterogeneity for PR compared with CBCT. The analyses of the SROC curves compared CBCT imaging versus PR in the diagnosis of root fracture, favouring CBCT modality. CONCLUSIONS CBCT was the imaging exam that rendered a higher diagnostic accuracy for root fractures.
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Affiliation(s)
| | | | - Mariana Minatel Braga
- 2 Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
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18
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Kobayashi-Velasco S, Salineiro FCS, Gialain IO, Cavalcanti MGP. Diagnosis of alveolar and root fractures in macerated canine maxillae: a comparison between two different CBCT protocols. Dentomaxillofac Radiol 2017; 46:20170037. [PMID: 28613920 DOI: 10.1259/dmfr.20170037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To compare two small-field-of-view (FOV) CBCT protocols with different voxel sizes and number of frames for the diagnosis of root and alveolar fractures in macerated canine maxillae. METHODS 80 incisor teeth from the canine species were inserted in 80 anterior alveolar sockets of 20 canine maxillae. An operator randomly divided each maxilla site (80 sites in total) into 4 equal groups of 20 sites: 1 (sound tooth and non-fractured alveolar socket); 2 (sound tooth and fractured alveolar socket); 3 (fractured root and non-fractured alveolar socket); and 4 (fractured root and fractured alveolar socket). The CBCT images were obtained using two different protocols: normal (N) (voxel 0.20 mm, 400 frames and radiation exposure 5.6 mGy) and high definition (HD) (voxel 0.15 mm, 500 frames and radiation exposure 7.0 mGy). RESULTS Sensitivity numbers for alveolar fractures were lower than specificity, resulting in comparable areas under the receiver operating characteristic curves (AUC) for both protocols. Sensitivity, specificity and AUC for N and HD protocols were very similar for root fractures. When comparing AUC for both N and HD protocols by submitting them to Student's t-test, the comparison among the curves produced statistically non-significant results for alveolar fractures and root fractures likewise. CONCLUSIONS Our findings demonstrated that the elected protocol for the diagnosis of root and alveolar fractures was N. This protocol allowed similar diagnosis results than HD protocol; however, with a lower amount of radiation exposure for the patient (5.6 mGy for N vs 7.0 mGy for HD).
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Affiliation(s)
| | - Fernanda C S Salineiro
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ivan O Gialain
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marcelo G P Cavalcanti
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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19
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Baageel TM, Allah EH, Bakalka GT, Jadu F, Yamany I, Jan AM, Bogari DF, Alhazzazi TY. Vertical root fracture: Biological effects and accuracy of diagnostic imaging methods. J Int Soc Prev Community Dent 2016; 6:S93-S104. [PMID: 27652254 PMCID: PMC5022399 DOI: 10.4103/2231-0762.189735] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This review assessed the most up-to-date literature on the accuracy of detecting vertical root fractures (VRFs] using the currently available diagnostic imaging methods. In addition, an overview of the biological and clinical aspects of VRFs will also be discussed. A systematic review of the literature was initiated in December of 2015 and then updated in May of 2016. The electronic databases searched included PubMed, Emabse, Ovid, and Google Scholar. An assessment of the methodological quality was performed using a modified version of the quality assessment of diagnostic accuracy studies tool. Twenty-two studies were included in this systematic review after applying specific inclusion and exclusion criteria. Of those, 12 favored using cone beam computed tomography (CBCT) for detecting VRF as compared to periapical radiographs, whereas 5 reported no differences between the two methods. The remaining 5 studies confirmed the advantages associated with using CBCT when diagnosing VRF and described the parameters and limitations associated with this method, but they were not comparative studies. In conclusion, overwhelming evidence suggests that the use of CBCT is a preferred method for detecting VRFs. Nevertheless, additional well controlled and high quality studies are needed to produce solid evidence and guidelines to support the routine use of CBCT in the diagnosis of VRFs as a standard of care.
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Affiliation(s)
- Turki M Baageel
- Interns Training Program, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Emad Habib Allah
- Interns Training Program, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ghaida T Bakalka
- Department of Dental, King Abdulaziz Medical City, National Guard Hospital, Jeddah, Saudi Arabia
| | - Fatima Jadu
- Department of Diagnostic Oral Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ibrahim Yamany
- Department of Diagnostic Oral Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed M Jan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Dania F Bogari
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Turki Y Alhazzazi
- Department of Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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20
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Pinto MGO, Rabelo KA, Sousa Melo SL, Campos PSF, Oliveira LSAF, Bento PM, Melo DP. Influence of exposure parameters on the detection of simulated root fractures in the presence of various intracanal materials. Int Endod J 2016; 50:586-594. [DOI: 10.1111/iej.12655] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 04/27/2016] [Indexed: 11/28/2022]
Affiliation(s)
- M. G. O. Pinto
- Department of Oral Diagnosis; Paraíba State University; Campina Grande Brazil
| | - K. A. Rabelo
- Department of Oral Diagnosis; Paraíba State University; Campina Grande Brazil
| | - S. L. Sousa Melo
- Department of Oral Pathology, Radiology & Medicine; The University of Iowa; Iowa City IA USA
| | - P. S. F. Campos
- Department of Oral Diagnosis; Federal University of Bahia; Salvador Brazil
| | - L. S. A. F. Oliveira
- Division of Radiology; Department of Health Technology and Biology; Federal Institute of Bahia; Salvador Brazil
| | - P. M. Bento
- Department of Oral Diagnosis; Paraíba State University; Campina Grande Brazil
| | - D. P. Melo
- Department of Oral Diagnosis; Paraíba State University; Campina Grande Brazil
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21
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Valizadeh S, Vasegh Z, Rezapanah S, Safi Y, Khaeazifard MJ. Effect of Object Position in Cone Beam Computed Tomography Field of View for Detection of Root Fractures in Teeth with Intra-Canal Posts. IRANIAN JOURNAL OF RADIOLOGY 2015; 12:e25272. [PMID: 26793289 PMCID: PMC4711188 DOI: 10.5812/iranjradiol.25272] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 07/13/2015] [Accepted: 08/15/2015] [Indexed: 12/29/2022]
Abstract
Background: Vertical root fracture (VRF) is a common problem in endodontically treated teeth. Due to its poor prognosis, a reliable technique must be used to make an accurate diagnosis. Cone beam computed tomography (CBCT) has been recently introduced for maxillofacial imaging. Despite the high diagnostic value of this method, metal artifacts resulting from intra-canal posts still make the detection of VRFs challenging. Objectives: This study aimed to assess the effect of object position in the field of view (FOV) of CBCT on detection of VRFs in teeth with intra-canal posts. Materials and Methods: The crowns of 60 extracted premolar teeth were cut at the level of cementoenamel junction (CEJ). Root canals were filled with gutta-percha and filling of the coronal 2/3 of the root canals was subsequently removed to fabricate intra-canal cast posts. The teeth were randomly divided into two groups of 30. Fracture was induced in group one using an Instron machine. Group two was considered as the control group with no fracture. All teeth were then randomly positioned and scanned in five different positions starting at the center of the FOV as well as right, left anterior and posterior relative to the center (3, 9, 12, and 6 O’clock) via the New Tom VGI CBCT unit. Two observers evaluated images for VRFs. Sensitivity and specificity of fracture diagnosis in each position was calculated in comparison with the gold standard. Wilcoxon test was used for data analysis. Results: Considering deterministic and probabilistic diagnostic parameters, probabilistic sensitivity was similar in all positions; but probabilistic specificity of the center position (65.1%) was significantly higher than that of 6 and 12 O’clock positions. Considering the deterministic diagnostic parameters, the overall sensitivity and specificity values decreased in all positions in FOV, but sensitivity of the center position of FOV was significantly higher than that of other positions; specificity was significantly higher at the 3 O’clock position (58.5%). Conclusion: Concerning the positions in FOV, the center position is suitable for detection of VRF in teeth with intra-canal posts due to significantly higher sensitivity at this position. The 3 O’clock position would be suitable for assessment of intact teeth without fractures due to significantly higher specificity at this position.
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Affiliation(s)
- Solmaz Valizadeh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Vasegh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding author: Zahra Vasegh, Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: +98-2188773550, Fax: +98-2188773550, E-mail:
| | - Samin Rezapanah
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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22
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Huang CC, Lee BS. Diagnosis of vertical root fracture in endodontically treated teeth using computed tomography. J Dent Sci 2015. [DOI: 10.1016/j.jds.2015.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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23
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Ma RH, Ge ZP, Li G. Detection accuracy of root fractures in cone-beam computed tomography images: a systematic review and meta-analysis. Int Endod J 2015; 49:646-54. [PMID: 26102215 DOI: 10.1111/iej.12490] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 06/19/2015] [Indexed: 11/30/2022]
Affiliation(s)
- R. H. Ma
- Department of Oral and Maxillofacial Radiology; Peking University School and Hospital of Stomatology; Beijing China
| | - Z. P. Ge
- Department of Oral and Maxillofacial Radiology; Peking University School and Hospital of Stomatology; Beijing China
| | - G. Li
- Department of Oral and Maxillofacial Radiology; Peking University School and Hospital of Stomatology; Beijing China
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24
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Corbella S, Del Fabbro M, Tamse A, Rosen E, Tsesis I, Taschieri S. Cone beam computed tomography for the diagnosis of vertical root fractures: a systematic review of the literature and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:593-602. [DOI: 10.1016/j.oooo.2014.07.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 06/24/2014] [Accepted: 07/29/2014] [Indexed: 11/29/2022]
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Komatsu K, Abe Y, Yoshioka T, Ishimura H, Ebihara A, Suda H. Differential diagnosis of vertical root fractures using reconstructed three-dimensional models of bone defects. Dentomaxillofac Radiol 2014; 43:20140256. [PMID: 25245201 DOI: 10.1259/dmfr.20140256] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate the accuracy of diagnosing vertical root fractures (VRFs) by comparing the volume of bone defects in VRFs with those in non-VRFs on reconstructed three-dimensional (3D) models (TDMs) using CBCT. METHODS 32 maxillary pre-molars and anterior teeth with radiolucent areas were evaluated on pre-operative CBCT images. Of the 32 teeth, 16 had a fractured root (VRF group) and 16 had a non-fractured root (non-VRF group). The radiolucent area of each tooth was traced in each dimension [mesiodistal, buccolingual and horizontal (the apicoincisal aspect)] by two observers, and 3D images were reconstructed with the Amira(®) software (Visage Imaging Inc., Richmond, Australia). The volume, V, of the TDM was divided into the coronal side and the periapical side at the horizontal slice through the apical foramen, and v was defined as the volume of the coronal side. The values of v/V were calculated for all cases. The Mann-Whitney U test was used to compare values between the VRF group and the non-VRF group (p < 0.05). A receiver operating characteristic (ROC) curve was constructed to select the optimal cut-point. RESULTS There was a statistically significant difference in the value of v/V between the two groups (p < 0.05). With a cut-point derived from the ROC curve, and the sensitivity, specificity and accuracy of predicting the VRFs were 1.00, 0.75 and 0.88, respectively. CONCLUSIONS Lesions resulting from VRFs can be distinguished from those of non-VRFs on 3D CBCT images with a high degree of accuracy, based on their different 3D shapes.
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Affiliation(s)
- K Komatsu
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Medical and Dental Sciences Track, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Mao T, Neelakantan P. Three-dimensional imaging modalities in endodontics. Imaging Sci Dent 2014; 44:177-83. [PMID: 25279337 PMCID: PMC4182351 DOI: 10.5624/isd.2014.44.3.177] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 12/16/2013] [Accepted: 12/21/2013] [Indexed: 11/24/2022] Open
Abstract
Recent research in endodontics has highlighted the need for three-dimensional imaging in the clinical arena as well as in research. Three-dimensional imaging using computed tomography (CT) has been used in endodontics over the past decade. Three types of CT scans have been studied in endodontics, namely cone-beam CT, spiral CT, and peripheral quantitative CT. Contemporary endodontics places an emphasis on the use of cone-beam CT for an accurate diagnosis of parameters that cannot be visualized on a two-dimensional image. This review discusses the role of CT in endodontics, pertaining to its importance in the diagnosis of root canal anatomy, detection of peri-radicular lesions, diagnosis of trauma and resorption, presurgical assessment, and evaluation of the treatment outcome.
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Affiliation(s)
- Teresa Mao
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha University, Chennai, India
| | - Prasanna Neelakantan
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha University, Chennai, India
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27
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Mohammadpour M, Bakhshalian N, Shahab S, Sadeghi S, Ataee M, Sarikhani S. Effect of titanium and stainless steel posts in detection of vertical root fractures using NewTom VG cone beam computed tomography system. Imaging Sci Dent 2014; 44:89-94. [PMID: 24944957 PMCID: PMC4061304 DOI: 10.5624/isd.2014.44.2.89] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 02/17/2014] [Accepted: 03/07/2014] [Indexed: 01/23/2023] Open
Abstract
PURPOSE Vertical root fracture (VRF) is a common complication in endodontically treated teeth. Considering the poor prognosis of VRF, a reliable and valid detection method is necessary. Cone beam computed tomography (CBCT) has been reported to be a reliable tool for the detection of VRF; however, the presence of metallic intracanal posts can decrease the diagnostic values of CBCT systems. This study evaluated and compared the effects of intracanal stainless steel or titanium posts on the sensitivity, specificity, and accuracy of VRF detection using a NewTom VG CBCT system. MATERIALS AND METHODS Eighty extracted single-rooted teeth were selected and sectioned at the cemento-enamel junction. The roots were divided into two groups of 40. Root fracture was induced in the test group by using an Instron machine, while the control group was kept intact. Roots were randomly embedded in acrylic blocks and radiographed with the NewTom VG, both with titanium and stainless steel posts and also without posts. Sensitivity, specificity, and accuracy values were calculated as compared to the gold standard. RESULTS The sensitivity, specificity, and accuracy of VRF diagnosis were significantly lower in teeth with stainless steel and titanium posts than in those without posts. Interobserver agreement was the highest in teeth without posts, followed by stainless steel posts, and then titanium posts. CONCLUSION Intracanal posts significantly decreased the VRF diagnostic values of CBCT. The stainless steel posts decreased the diagnostic values more than the titanium posts.
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Affiliation(s)
- Mahdis Mohammadpour
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Neema Bakhshalian
- Department of Advanced Periodontology, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Shahriar Shahab
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahed University, Tehran, Iran
| | - Shaya Sadeghi
- Radmehr Oral and Maxillofacial Radiology Clinic, Ghazvin, Iran
| | - Mona Ataee
- Radmehr Oral and Maxillofacial Radiology Clinic, Ghazvin, Iran
| | - Soodeh Sarikhani
- Department of Oral and Maxillofacial Radiology, School of Dentistry, University of Golestan, Gorgan, Iran
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