Saberi Eshaghali, Mollashahi Narges F, Movasagh Zeinab, Moghaddam Alireza A, Mohammadi Abbas
Department of Endodontics, Faculty of Dentistry, Oral and Dental Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
Department of Endodontics, Faculty of Dentistry, Oral and Dental Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran -
Minerva Stomatol. 2017 Apr;66(2):69-74. doi: 10.23736/S0026-4970.17.03972-3.
Vertical root fracture (VRF) is a diagnostic challenge for dentists. Cone-beam computed tomography (CBCT) scans provide accurate three-dimensional images of teeth enabling detection of VRFs. This in-vivo study compared the accuracy of CBCT and exploratory surgery for detection of VRFs in endodontically-treated teeth.
Forty endodontically-treated teeth of 40 patients with clinical signs and symptoms of VRFs were evaluated. No fracture line was detectable on periapical radiographs. The CBCT scans with limited FOV were obtained of the teeth and inspected separately by a radiologist and two endodontists. Exploratory surgery was performed for all patients as part of their treatment to ensure the presence/absence of VRF (gold standard).
The kappa coefficient was 0.71 (95% CI: 0.59 to 0.84). The CBCT scans had 93% sensitivity, 78% specificity and 88% accuracy for detection of VRFs.
The results showed low specificity of CBCT imaging in detecting VRFs in endodontically-treated teeth.
垂直根折（VRF）对牙医来说是一项诊断挑战。锥形束计算机断层扫描（CBCT）能够提供牙齿的精确三维图像，有助于检测垂直根折。这项体内研究比较了CBCT和探查性手术在检测根管治疗后牙齿垂直根折方面的准确性。
对40例有垂直根折临床症状和体征的患者的40颗根管治疗后的牙齿进行评估。根尖片上未检测到骨折线。对这些牙齿进行了有限视野的CBCT扫描，并由一名放射科医生和两名牙髓病医生分别进行检查。作为治疗的一部分，对所有患者进行了探查性手术，以确定是否存在垂直根折（金标准）。
kappa系数为0.71（95%CI：0.59至0.84）。CBCT扫描检测垂直根折的灵敏度为93%，特异度为78%，准确度为88%。
结果显示CBCT成像在检测根管治疗后牙齿垂直根折方面的特异度较低。
