Mohammadpour Mahdis, Bakhshalian Neema, Shahab Shahriar, Sadeghi Shaya, Ataee Mona, Sarikhani Soodeh
Department of Oral and Maxillofacial Radiology, School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran.
Department of Advanced Periodontology, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA.
Imaging Sci Dent. 2014 Jun;44(2):89-94. doi: 10.5624/isd.2014.44.2.89. Epub 2014 Jun 11.
Vertical root fracture (VRF) is a common complication in endodontically treated teeth. Considering the poor prognosis of VRF, a reliable and valid detection method is necessary. Cone beam computed tomography (CBCT) has been reported to be a reliable tool for the detection of VRF; however, the presence of metallic intracanal posts can decrease the diagnostic values of CBCT systems. This study evaluated and compared the effects of intracanal stainless steel or titanium posts on the sensitivity, specificity, and accuracy of VRF detection using a NewTom VG CBCT system.
Eighty extracted single-rooted teeth were selected and sectioned at the cemento-enamel junction. The roots were divided into two groups of 40. Root fracture was induced in the test group by using an Instron machine, while the control group was kept intact. Roots were randomly embedded in acrylic blocks and radiographed with the NewTom VG, both with titanium and stainless steel posts and also without posts. Sensitivity, specificity, and accuracy values were calculated as compared to the gold standard.
The sensitivity, specificity, and accuracy of VRF diagnosis were significantly lower in teeth with stainless steel and titanium posts than in those without posts. Interobserver agreement was the highest in teeth without posts, followed by stainless steel posts, and then titanium posts.
Intracanal posts significantly decreased the VRF diagnostic values of CBCT. The stainless steel posts decreased the diagnostic values more than the titanium posts.
垂直根折是根管治疗后牙齿常见的并发症。鉴于垂直根折预后较差，需要一种可靠且有效的检测方法。锥形束计算机断层扫描（CBCT）已被报道是检测垂直根折的可靠工具；然而，根管内金属桩的存在会降低CBCT系统的诊断价值。本研究评估并比较了根管内不锈钢桩或钛桩对使用NewTom VG CBCT系统检测垂直根折的敏感性、特异性和准确性的影响。
选取80颗拔除的单根牙，在牙骨质-釉质界处进行切片。将牙根分为两组，每组40颗。试验组使用英斯特朗材料试验机诱导牙根折断，而对照组保持完整。将牙根随机嵌入丙烯酸块中，使用NewTom VG进行X线摄影，分别在有钛桩和不锈钢桩以及无桩的情况下进行。与金标准相比，计算敏感性、特异性和准确性值。
有不锈钢桩和钛桩的牙齿垂直根折诊断的敏感性、特异性和准确性显著低于无桩的牙齿。观察者间一致性在无桩牙齿中最高，其次是不锈钢桩，然后是钛桩。
根管内桩显著降低了CBCT对垂直根折的诊断价值。不锈钢桩比钛桩对诊断价值的降低更明显。
