Document Type: Original Article

Authors

1 Dental Implants Research Center, Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Torabinejad Dental Research Center, Dept. of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Postgraduate Student, Dept. of Orthodontics, Dental School, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.

Abstract

Statement of the Problem: The diagnosis of vertical root fracture (VRF) is a challenging task.Purpose: This in vitro study compared cone beam computed tomography (CBCT) imaging with digital periapical radiography (DPR) made by three different horizontal angels (20°mesial, 0° and 20° distal) for accurate diagnosis of VRF.Materials and Method: Among 120 posterior teeth included in this study, 60 were vertically fractured. Fractured and non-fractured teeth were randomly distributed into three groups defined as group 1 with no filling in the root canal, group 2 with gutta-percha in the canal, and group 3 with the intracanal post. All samples were placed in a dry mandible and imaged with CBCT and DPR techniques. Two blind observers investigated the images.Results: CBCT had higher sensitivity but lower specificity compared with DPR, except for the intracanal post group in which the sensitivity of DPR was higher; though the chi-square test showed the differences to be statistically insignificant. The sensitivity, specificity, and accuracy of CBCT and DPR were reduced in the cases that gutta-percha or post were present in the canal. Inter-observer agreement was higher for CBCT. A set of three DPRs with different horizontal angels were significantly more sensitive for VRF recognition than a single orthogonal DPR.Conclusion: Based on our results, there was no significant difference between CBCT and a set of three DPRs with different angulations for VRF detection in posterior teeth. Therefore, it is suggested to consider DPRs with three different horizontal angels (20°mesial, 0° and 20° distal) for radiographic evaluation before CBCT examination.Keywords ● Cone-Beam Computerized Tomography  ● Dental Digital Radiography  ● Tooth Fracture  ● Diagnosis