Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, Pernambuco, Brazil; Division of Oral Radiology, Department of Dentistry, Federal University of Sergipe (UFS), Aracaju-SE, Brazil.
J Endod. 2021 Jul;47(7):1132-1137. doi: 10.1016/j.joen.2021.04.001. Epub 2021 Apr 20.
The purpose of this preliminary study was to evaluate the diagnostic accuracy of the combined use of 2 cone-beam computed tomographic (CBCT) volumes obtained with the tooth of interest positioned at different orientations in the detection of vertical root fracture (VRF).
Thirty single-rooted teeth were divided into 2 main groups (n = 15): control and with VRF. The teeth were individually placed in a phantom composed of a human skull and mandible, which was CBCT scanned in 2 spatial orientations: conventional (with the Frankfurt plane parallel to the floor) and angled acquisition (tilted 90° backward). Also, each tooth was scanned with gutta-percha, a metal post, and without any intracanal material. Three oral radiologists individually evaluated the images resulting from conventional acquisition and verified the presence or absence of VRF (conventional CBCT assessment), setting a score on a 5-point scale. Subsequently, the observers evaluated both images resulting from the conventional and angled acquisitions (combined CBCT assessment). The diagnostic values of the conventional and combined assessments were compared using 2-way analysis of variance with the post hoc Tukey test. The significance level was set at 5% (α = 0.05).
The combined CBCT assessment showed higher accuracy and sensitivity in the VRF diagnosis of teeth filled with gutta-percha (P < .05). In teeth with a metal post, all diagnostic values were higher in the combined CBCT assessment (P < .05).
This preliminary study suggests that the CBCT-based diagnosis of VRF in teeth with intracanal material was improved when the assessment combines images obtained at 2 orientations.
本初步研究旨在评估在检测垂直根折（VRF）时，将感兴趣的牙齿置于不同位置的两个锥形束计算机断层扫描（CBCT）容积的联合使用的诊断准确性。
将 30 颗单根牙分为 2 个主要组（n=15）：对照组和 VRF 组。将每颗牙单独放置在由人头骨和下颌骨组成的体模中，体模分别以两种空间方向进行 CBCT 扫描：常规（法兰克福平面与地面平行）和倾斜采集（向后倾斜 90°）。此外，每颗牙均用牙胶、金属桩和无任何根管内材料进行扫描。三位口腔放射科医生分别评估常规采集产生的图像，并通过 5 分制评分来验证 VRF 的存在或不存在（常规 CBCT 评估）。然后，观察者评估常规和倾斜采集产生的两幅图像（联合 CBCT 评估）。使用双向方差分析和事后 Tukey 检验比较常规和联合评估的诊断价值。显著水平设定为 5%（α=0.05）。
联合 CBCT 评估在填充牙胶的牙齿的 VRF 诊断中具有更高的准确性和敏感性（P<0.05）。在有金属桩的牙齿中，联合 CBCT 评估的所有诊断值均较高（P<0.05）。
本初步研究表明，在评估时结合两种方向获取的图像，可提高有根管材料的牙齿的 VRF 的 CBCT 诊断。
