Title of article :
Detection of Vertical Root Fractures Using Cone-Beam Computed Tomography in the Presence and Absence of Gutta-Percha
Author/Authors :
Hekmatian, Ehsan Dental Implant Research Center - Department of Oral and Maxillofacial Radiology - School of Dentistry - Isfahan University of Medical Sciences - Isfahan, Iran , Karbasi kheir, Mitra Department of Oral and Maxillofacial Radiology - School of Dentistry - Islamic Azad University - Isfahan (Khorasgan) Branch - Isfahan, Iran , Fathollahzade, Hossein Department of Oral and Maxillofacial Radiology - School of Dentistry - Isfahan University of Medical Sciences - Isfahan, Iran , Sheikhi, Mahnaz Torabinejad Research Center - Department of Oral and Maxillofacial Radiology - School of Dentistry - Isfahan University of Medical Sciences - Isfahan, Iran
Abstract :
Background. Vertical root fractures (VRFs) can signifcantly reduce dental prognosis. Cone-beam computed tomography (CBCT) ofters better visualization of VRF than conventional radiography. However, gutta-percha creates artifacts in cone-beam CT (CBCT) images and reduces the diagnosis quality. The purpose of this study was to evaluate the accuracy of CBCT in detection of VRF
in presence and absence of gutta-percha in canals. Materials and Methods. In this cross-sectional study, 50 extracted mandibular premolars were selected. After preparing the access cavity, canals were instrumented using step-back method, and gutta-percha #40
was placed aferwards. Te fractures were created using electromechanical universal testing machine on 25 teeth. Te teeth were
randomly placed in dry mandibular dental sockets, and the frst CBCTs were taken. Ten the gutta-percha was removed, and the
second CBCTs were taken. Results. Te results of Kappa coefcient between two observers in roots with and without gutta-percha
were 0.644 and 0.830, respectively (p value ≤ 0.001). Te sensitivity and specifcity of VRF diagnosis in assessing gutta-percha flled
canals were 32% and 68% for the frst observer, respectively (Kappa < 0.000, p value = 1.000), and 40% and 68% for the second
observer, respectively (Kappa = 0.080, p value = 0.556). Te sensitivity and specifcity of VRF diagnosis in assessing the empty
canals (without gutta-percha) were 72% and 96% for the frst observer, respectively (Kappa = 0.680, p value ≤ 0/001), and 72% and
96% for the second observer, respectively (Kappa = 0.680, p value ≤ 0/001). Conclusion. Te intracanal flling materials such as gutta-percha reduce the diagnostic ability of vertical root fractures. Hence, it is recommended to remove those materials from root canals before imaging to improve the diagnostic potential of CBCT.
Keywords :
Detection , Vertical Root Fractures , Cone-Beam Computed Tomography , Presence , Absence , Gutta-Percha , VRFs
Journal title :
The Scientific World Journal