Yamamoto-Silva Fernanda Paula, de Oliveira Siqueira Claudeir Felipe, Silva Maria Alves Garcia Santos, Fonseca Rodrigo Borges, Santos Ananda Amaral, Estrela Carlos, de Freitas Silva Brunno Santos
Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Brazil.
Department of Oral Rehabilitation, Dental School, Federal University of Goiás, Goiânia, Brazil.
Imaging Sci Dent. 2018 Sep;48(3):177-184. doi: 10.5624/isd.2018.48.3.177. Epub 2018 Sep 18.
This study was performed to evaluate the influence of voxel size and the accuracy of 2 cone-beam computed tomography (CBCT) systems in the detection of vertical root fracture (VRF) in the presence of intracanal metallic posts.
Thirty uniradicular extracted human teeth were selected and randomly divided into 2 groups (VRF group, n=15; and control group, n=15). The VRFs were induced by an Instron machine, and metallic posts were placed in both groups. The scans were acquired by CBCT with 4 different voxel sizes: 0.1 mm and 0.16 mm (for the Eagle 3D V-Beam system) and 0.125 mm and 0.2 mm (for the i-CAT system) (protocols 1, 2, 3, and 4, respectively). Interobserver and intraobserver agreement was assessed using the Cohen kappa test. Sensitivity and specificity were evaluated and receiver operating characteristic analysis was performed.
The intraobserver coefficients indicated good (0.71) to very good (0.83) agreement, and the interobserver coefficients indicated moderate (0.57) to very good (0.80) agreement. In respect to the relationship between sensitivity and specificity, a statistically significant difference was found between protocols 1 (positive predictive value: 0.710, negative predictive value: 0.724) and 3 (positive predictive value: 0.727, negative predictive value: 0.632) (<.05). The least interference due to artifact formation was observed using protocol 2.
Protocols with a smaller voxel size and field of view seemed to favor the detection of VRF in teeth with intracanal metallic posts.
本研究旨在评估体素大小和两种锥形束计算机断层扫描（CBCT）系统在检测存在根管内金属桩时垂直根折（VRF）的准确性方面的影响。
选取30颗单根拔除的人牙，随机分为两组（VRF组，n = 15；对照组，n = 15）。通过英斯特朗试验机诱导形成VRF，并在两组中均放置金属桩。使用CBCT以4种不同体素大小进行扫描：0.1 mm和0.16 mm（用于Eagle 3D V-Beam系统）以及0.125 mm和0.2 mm（用于i-CAT系统）（分别为方案1、2、3和4）。使用Cohen卡方检验评估观察者间和观察者内的一致性。评估敏感性和特异性，并进行受试者工作特征分析。
观察者内系数显示出良好（0.71）至非常好（0.83）的一致性，观察者间系数显示出中等（0.57）至非常好（0.80）的一致性。关于敏感性和特异性之间的关系，在方案1（阳性预测值：0.710，阴性预测值：0.724）和方案3（阳性预测值：0.727，阴性预测值：0.632）之间发现了统计学上的显著差异（<.05）。使用方案2观察到由于伪影形成造成的干扰最小。
具有较小体素大小和视野的方案似乎有利于检测存在根管内金属桩的牙齿中的VRF。
