Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Bejing 100081, China.
Dentomaxillofac Radiol. 2011 Jul;40(5):290-8. doi: 10.1259/dmfr/84907460.
The purpose of this study was to compare the diagnostic accuracy of cone beam CT (CBCT) with that of conventional dental radiography in the detection of root fractures and to evaluate the influence of root canal fillings on root fracture detection.
We investigated 128 patients with clinically suspected root fractures in 135 teeth. These patients underwent conventional dental radiography, CBCT and eventually surgical exploration. Among the 135 teeth, 86 were non-endodontically treated teeth and 49 were endodontically treated teeth. Two oral radiologists independently analysed the dental radiographs and CBCT images of each patient and reached a consensus. The CBCT findings of root fractures were set as the detection of a separation of the adjacent root segments on at least two contiguous sections and on at least two of the three-dimensional (3D) planes.
Root fracture was intraoperatively detected in 95 of the 135 teeth. The sensitivity and specificity of root fractures diagnosed on the basis of the consensus between the 2 evaluators were 26.3% and 100%, respectively, for dental radiography and 89.5% and 97.5%, respectively, for CBCT. CBCT was significantly more accurate than dental radiography in detecting root fractures (P < 0.001). The sensitivity of CBCT was reduced in the presence of root canal fillings but its specificity remained unaffected. Both the sensitivity and specificity of dental radiography were not influenced by the presence of root canal fillings.
CBCT appears to be more accurate than conventional dental radiography in the detection of root fractures.
本研究旨在比较锥形束 CT（CBCT）与传统牙科射线照相在检测根折方面的诊断准确性，并评估根管充填对根折检测的影响。
我们调查了 128 例临床疑似根折的患者共 135 颗牙齿。这些患者接受了常规牙科射线照相、CBCT 检查，最终进行了手术探查。在 135 颗牙齿中，86 颗为未经根管治疗的牙齿，49 颗为根管治疗的牙齿。两位口腔放射科医生独立分析每位患者的牙科射线照片和 CBCT 图像，并达成共识。CBCT 根折的发现被设定为至少两个连续节段和至少三个二维（3D）平面上相邻根段的分离。
在 135 颗牙齿中，95 颗牙齿在手术中检测到根折。基于两位评估者之间的共识诊断的根折的敏感性和特异性分别为牙科射线照相的 26.3%和 100%，CBCT 的 89.5%和 97.5%。CBCT 在检测根折方面明显优于牙科射线照相（P<0.001）。根管充填存在时，CBCT 的敏感性降低，但特异性不受影响。根管充填对牙科射线照相的敏感性和特异性均无影响。
CBCT 在检测根折方面似乎比传统牙科射线照相更准确。
