Effect of Artifact Reduction on the Diagnosis of Vertical Root Fracture in Teeth with Posts Using CBCT

Background: In the absence of clear clinical and radiographic signs, detection of vertical root fractures in teeth receiving root treatment is an important clinical challenge. Restoration with posts form artifacts on the image and reduce the quality of conebeam computed tomography (CBCT) images. Objectives: The present study was conducted to assess the detection accuracy of CBCT system in normalmodecompared to “Artifact Reduction” option. Materials and Methods: A total of 62 human premolars (31 teeth with vertical root fracture and 31 teeth without fracture) that had been extracted for orthodontic, and periodontal treatments were used. Teeth received root canal treatment in the usual way and prefabricated posts were placed in them. Fracture was created by an Instron machine in one group, and the other group was considered as control. CBCT was prepared from all samples both with and without artifact reduction option. Three observers assessed the images for vertical root fracture based on the scales of 5. Sensitivity, specificity, positive and negative predictive values were measured, and compared using Mann-Whitney test at a significant value of P < 0.05. Results: Full diagnostic sensitivity, and specificity was higher in the group without artifact reduction option compared to the group with it. No significant differences were found between groups in any diagnostic indices, including full and absolute sensitivity and specificity, and positive and negative predictive values (P > 0.05). Conclusion: The artifact reduction option creates no CBCT diagnostic difference in the presence of a post, and does not provide better diagnosis of vertical root fractures.