Faculty of Dentistry, Department of Oral Radiology, Qazvin University of Medical Sciences, Qazvin, Iran.
Dent Traumatol. 2011 Apr;27(2):143-6. doi: 10.1111/j.1600-9657.2010.00973.x. Epub 2011 Feb 1.
Vertical root fractures (VRFs) can only be detected by radiography. In recent years, direct digital dental radiography (DDR) has become a substitute to film-based radiography. Purpose of this study was to compare accuracy and reliability of charge couple device (CCD)-based direct digital radiography with conventional radiography (CR) in VRF diagnosis.
In this in vitro study, 230 extracted single-rooted human teeth were endodontically instrumented. VRFs were performed experimentally in half of the samples. Each tooth was imaged using the paralleling technique with E-speed film and a CCD-based digital image receptor. Two oral radiologists interpreted the images and repeated the procedure a month later with half of the samples. The accuracy, sensitivity, and specificity of each technique were determined. The reliability and degree of agreement were also determined by the means of Cohen's Kappa analysis. χ² test was used to compare two observers' diagnosis, considering the location of fracture line.
The accuracy of CR and DDR was 65% and 70% retrospectively. The sensitivity was 60% for CR, 61% for DDR and the specificity was 70% for CR, 78% for DDR, but the differences were not significant. The interobserver reliability was moderate for CR (K = 0.366, 95% CI) and fair for DDR (K = 0.538, 95% CI).
No significant difference was seen between the two techniques. The specificity of DDR was slightly better than CR, and their accuracy and sensitivity showed small differences.
垂直根折（VRF）只能通过射线照相检测。近年来，直接数字牙科射线照相（DDR）已成为胶片射线照相的替代品。本研究的目的是比较基于电荷耦合器件（CCD）的直接数字射线照相与传统射线照相（CR）在 VRF 诊断中的准确性和可靠性。
在这项体外研究中，对 230 颗根管治疗后的单根人牙进行了实验性 VRF 操作。使用平行技术对每个牙齿进行 E 速度胶片和基于 CCD 的数字图像接收器成像。两名口腔放射科医生对图像进行解释，并在一个月后对一半样本重复该程序。确定每种技术的准确性、敏感性和特异性。还通过 Cohen 的 Kappa 分析确定可靠性和一致性程度。使用 χ²检验比较两位观察者的诊断，考虑骨折线的位置。
CR 和 DDR 的准确性分别为 65%和 70%（回顾性）。CR 的敏感性为 60%，DDR 为 61%，特异性为 70%，DDR 为 78%，但差异无统计学意义。CR 的观察者间可靠性为中度（K=0.366，95%CI），DDR 为适度（K=0.538，95%CI）。
两种技术之间未见显著差异。DDR 的特异性略优于 CR，其准确性和敏感性显示出微小差异。
