Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil.
Department of Clinical Dentistry, Faculty of Dentistry, Federal University of Espírito Santo, Vitória, Brazil.
Int Endod J. 2015 Sep;48(9):864-71. doi: 10.1111/iej.12382. Epub 2014 Oct 20.
To evaluate (i) the accuracy of three intra-oral digital systems in detecting vertical root fractures (VRFs); and (ii) the influence of different intracanal conditions (without filling, filled with Gutta-percha and metal or fibreglass post).
Forty single-rooted human teeth were decoronated and the root canals prepared. VRFs were induced using a universal testing machine on 20 teeth. Radiographic images were obtained using the paralleling technique with three different horizontal angulations on conventional E/F film, two storage phosphor plates (Digora Optime and VistaScan) and one sensor system (SnapShot). All teeth were radiographed with all intracanal conditions tested. All images were evaluated by five examiners. After 30 days, 25% of the images were reviewed. Areas under ROC curves, sensitivity, specificity, accuracy, positive predictive and negative predictive values were compared by anova.
The weighted kappa values for intra- and interobserver reproducibility were 0.48-0.74 and 0.57-0.66, respectively. The sensitivity revealed a significant difference between imaging modalities, with higher values for SnapShot (0.53) and VistaScan (0.46), followed by the film (0.41) and Digora (0.38). The area under the ROC curve for SnapShot (0.82) was greater than for the other systems in the teeth with a fibreglass post (VistaScan: 0.70; Digora: 0.64; film: 0.60).
All systems gave a similar performance for detecting VRFs; all gave a good performance in the absence of intracanal materials, but performed less well in the presence of a metal post or Gutta-percha. In teeth with a fibreglass post, digital systems with higher resolution should be used.
（i）评估三种口腔内数字系统检测垂直根折（VRF）的准确性；（ii）评估不同根管内条件（无填充、填充牙胶和金属或玻璃纤维桩）的影响。
将 40 颗单根人牙去冠并预备根管。使用万能试验机在 20 颗牙上诱导 VRF。使用平行技术在常规 E/F 胶片、两种存储磷光板（Digora Optime 和 VistaScan）和一种传感器系统（SnapShot）上获得放射影像。所有牙齿均在所有测试的根管内条件下进行放射照相。所有图像均由五名检查者进行评估。30 天后，对 25%的图像进行了复查。通过方差分析比较了 ROC 曲线下面积、敏感性、特异性、准确性、阳性预测值和阴性预测值。
观察者内和观察者间的加权 kappa 值分别为 0.48-0.74 和 0.57-0.66。成像方式之间的敏感性有显著差异，SnapShot（0.53）和 VistaScan（0.46）的敏感性较高，其次是胶片（0.41）和 Digora（0.38）。SnapShot 的 ROC 曲线下面积（0.82）大于其他系统，在有玻璃纤维桩的牙齿中（VistaScan：0.70；Digora：0.64；胶片：0.60）。
所有系统在检测 VRF 方面表现相似；所有系统在无根管材料的情况下表现良好，但在存在金属桩或牙胶的情况下表现较差。在有玻璃纤维桩的牙齿中，应使用分辨率更高的数字系统。
