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Diagnostic accuracy of cone-beam computed tomography using different voxel sizes versus digital intraoral radiography in detection of vertical root fractures of teeth with metallic post

Islam Shawky Mohamed Shaker, Nashwa S Mohamed, Ahmed M Abdelsamad


Background: Conventional radiographs are not an efficient diagnostic method to detect vertical root fracture (VRF). Cone-beam computed tomography (CBCT) overcomes the limitations of conventional radiography in the detection of VRF. In CBCT, metallic structures can cause artifacts in the images. Aim: This study aimed to determine the diagnostic accuracy of CBCT using different voxels in the detection of VRFs of teeth with metallic posts compared to digital intraoral radiography. Materials and Methods: A total of 120 single-rooted extracted human teeth were obtained and endodontically treated, then placed in an acrylic block and metallic posts were inserted. After post insertion, the teeth roots were divided into two groups one with induced VRFs and the other having intact roots with the posts inserted. Then, each tooth was coded and imaged 3 times using CBCT and digital periapical radiography (DPR). Results: DPR showed statistically significantly lower diagnostic accuracy than CBCT, and changing the voxel did not improve the diagnostic accuracy. Conclusion: In case of suspicious VRFs, CBCT is recommended to detect the presence of fractures. Clinical Significance: Since most teeth suspected to have VRFs are endodontically treated and have a metallic post in the root canal, fracture detection may pose a challenge CBCT resolves this issue.


Cone-beam computed tomography in vertical root fractures; vertical root fractures cone-beam computed tomography; vertical root fractures detection; vertical root fractures periapical radiography

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