Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, 22 Zhongguancun Nandajie, Haidian District, Beijing, 100081, China.
Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, Sai Ying Pun, Hong Kong, SAR, China.
Clin Oral Investig. 2019 Dec;23(12):4433-4439. doi: 10.1007/s00784-019-02905-0. Epub 2019 Apr 13.
This study aimed to investigate the effect of fracture orientation on the detection accuracy of vertical root fractures (VRFs) in non-endodontically treated teeth using four different cone beam computed tomography (CBCT) units.
Thirty eight out of 148 extracted human permanent teeth were chosen randomly, and VRFs were artificially induced to result in 20 mesiodistally and 18 buccolingually oriented root fractures. The fracture width was subsequently measured. All the teeth were scanned with four CBCT units. CBCT images were evaluated independently by two observers. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated for each observer and fracture orientation. The AUC between the two fracture orientations was compared using Z test.
The mean fracture width was 140 μm (standard deviation 26.8 μm). A statistically significant difference was found between the mesiodistal and buccolingual VRFs for the AUC from the CBCT unit 3D Accuitomo 170 (p = 0.02). There were no statistically significant differences between the mesiodistal and buccolingual VRFs for AUCs from the CBCT units NewTom VGi (p = 0.21), ProMax 3D Mid (p = 0.23), and i-CAT FLX (p = 0.21).
Fracture orientations of teeth with VRFs in non-endodontically treated teeth may play a role in the detection accuracy of CBCT images, but this effect seems to be dependent on the CBCT unit used.
Although for most of the CBCT units tested, the fracture orientation of VRF in non-endodontically treated teeth seems not to play a role for the diagnosis, clinical data is needed to further assess the impact of different devices on VRF detection.
本研究旨在探讨四种不同锥形束计算机断层扫描（CBCT）设备对非根管治疗牙中垂直根折（VRF）检测准确性的影响。
随机选择 148 颗离体人恒牙中的 38 颗，人为诱导 VRF 导致 20 颗近远中向和 18 颗颊舌向根折。随后测量骨折宽度。所有牙齿均用 4 个 CBCT 单位进行扫描。由两位观察者独立评估 CBCT 图像。计算每个观察者和骨折方向的曲线下面积（AUC）、敏感度和特异度。使用 Z 检验比较两种骨折方向之间的 AUC。
平均骨折宽度为 140 μm（标准差 26.8 μm）。CBCT 单元 3D Accuitomo 170 的 AUC 在近远中向和颊舌向 VRF 之间存在统计学差异（p=0.02）。CBCT 单元 NewTom VGi（p=0.21）、ProMax 3D Mid（p=0.23）和 i-CAT FLX（p=0.21）的 AUC 在近远中向和颊舌向 VRF 之间无统计学差异。
非根管治疗牙中 VRF 的骨折方向可能对 CBCT 图像的检测准确性起作用，但这种影响似乎取决于使用的 CBCT 单元。
尽管对于大多数测试的 CBCT 单元，非根管治疗牙中 VRF 的骨折方向似乎对诊断没有作用，但需要临床数据来进一步评估不同设备对 VRF 检测的影响。
