Ezzodini Ardakani Fatemeh, Razavi Seyed Hossein, Tabrizizadeh Mehdi
Department of Oral and Maxillofacial Radiology, Dental Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Iran;
Department of Endodontics, Dental Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Iran Endod J. 2015;10(2):122-6. Epub 2015 Mar 18.
Vertical root fracture (VRF) is the longitudinal fracture of the root in endodontically treated teeth. Considering the limitations of two-dimensional radiographic images in detection of VRF and introduction of cone-beam computed tomography (CBCT), this study was designed to find the sensitivity, specificity and accuracy of CBCT and periapical (PA) radiography in detection of VRFs.
This was a cross-sectional in vitro study on 80 extracted human single canal teeth including 40 maxillary and 40 mandibular teeth. After standardized endodontic treatment of the roots, VRF was induced in half of the teeth in each group, and other half were left without fracture. Teeth were inserted in dry maxillary and mandibular alveoli. PA radiographs and CBCT images were taken from the specimens. Data were analyzed with SPSS software. The McNemar test was used to evaluate the sensitivity, specificity and accuracy of images, and kappa coefficient was used to assess the degree of agreement between the observers. The level of significance was set at 0.05.
Sensitivity and specificity values of CBCT were 97.5% and 95%, respectively. However, for PA radiography the sensitivity and specificity were 67.5% and 92.5%, in order of appearance. Accuracy of CBCT (96.25%) and PA radiography (80%) in both jaws were significantly different (P=0.022). Two methods were not significantly different when testing specificity (P=0.298).
This study showed that the sensitivity and accuracy of CBCT in detection of vertical root fracture are higher than periapical radiography. CBCT can be recommended to be used in detection of vertical root fractures.
垂直根折（VRF）是指经过牙髓治疗的牙齿根部发生的纵向骨折。考虑到二维放射影像在检测垂直根折方面的局限性以及锥形束计算机断层扫描（CBCT）的引入，本研究旨在探讨CBCT和根尖片（PA）在检测垂直根折方面的敏感性、特异性和准确性。
这是一项横断面体外研究，对80颗拔除的人类单根管牙齿进行研究，其中上颌牙40颗，下颌牙40颗。对牙根进行标准化牙髓治疗后，每组半数牙齿诱导形成垂直根折，另一半不进行骨折处理。将牙齿植入干燥的上颌和下颌牙槽窝。从标本上拍摄根尖片和CBCT图像。使用SPSS软件进行数据分析。采用McNemar检验评估图像的敏感性、特异性和准确性，kappa系数用于评估观察者之间的一致性程度。显著性水平设定为0.05。
CBCT的敏感性和特异性值分别为97.5%和95%。然而，根尖片的敏感性和特异性依次为67.5%和92.5%。CBCT（96.25%）和根尖片（80%）在上颌和下颌的准确性均有显著差异（P = 0.022）。在检测特异性时，两种方法无显著差异（P = 0.298）。
本研究表明，CBCT在检测垂直根折方面的敏感性和准确性高于根尖片。推荐使用CBCT检测垂直根折。
