Ayatollahi Fatemeh, Tabrizizadeh Mahdi, Razavi Hossein, Mowji Mana
Department of Endodontics, Dental School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Department of Oral Radiology, Dental School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Iran Endod J. 2019 Winter;14(1):14-17. doi: 10.22037/iej.v14i1.22590.
File Fracture is one of the most common problems during root canal treatment which can affect treatment procedure and prognosis, so it is important to diagnose and prevent it. The aim of this study was to evaluate and compare the diagnostic value of cone-beam computed tomography (CBCT) and digital periapical radiography for detection of separated instrument retained inside the canal.
Ninety single-rooted extracted human teeth were selected and randomly divided into 3 groups (=30). Group 1, separated file #10 at the 2-mm apical third of the root canal; group 2, separated file #35 at the 2-mm apical third of the root canal; and group 3, without a broken file (control group). The teeth were instrumented to size #30 and were shaped to size #55 and then the canals were obturated up to separated instrument, or the working length for the teeth without a separated instrument, with lateral condensation technique. After that all teeth were placed in dry skull, digital radiography and CBCT was taken. After data collection, data was analyzed using SPSS software by means of sensitivity, specificity, positive and negative predictive values, and frequency tables.
Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of digital periapical radiography in detection of a fractured file #10 in the canal was 96.7% and 63.3%, 76.7%, 73.1%, 67.6%, 70%, for CBCT, respectively. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of digital periapical radiography in detection of a fracture file #35 in the canal was 93.3%, 96.7%, 96.6%, 93.5% and 95%, and 36.7%, 76.7%, 61.1%, 54.8%, 56.66%, for CBCT, respectively.
Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of digital periapical radiography was better than the CBCT technique in both sizes of broken files.
根管锉折断是根管治疗中最常见的问题之一，会影响治疗过程和预后，因此对其进行诊断和预防很重要。本研究的目的是评估和比较锥形束计算机断层扫描（CBCT）和数字化根尖片对检测根管内折断器械的诊断价值。
选取90颗单根拔除的人牙，随机分为3组（每组n = 30）。第1组，在根管根尖三分之一处2mm处折断#10锉；第2组，在根管根尖三分之一处2mm处折断#35锉；第3组，无折断锉（对照组）。将牙齿预备至30号，并成形至55号，然后采用侧向加压技术将根管充填至折断器械处，或充填至无折断器械牙齿的工作长度。之后将所有牙齿置于干燥头颅中，拍摄数字化根尖片和CBCT。数据收集后，使用SPSS软件通过灵敏度、特异度、阳性和阴性预测值以及频率表进行数据分析。
数字化根尖片检测根管内折断#10锉的灵敏度、特异度、阳性预测值、阴性预测值和诊断准确性分别为96.7%、63.3%、76.7%、73.1%、67.6%，CBCT分别为70%。数字化根尖片检测根管内折断#35锉的灵敏度、特异度、阳性预测值、阴性预测值和诊断准确性分别为93.3%、96.7%、96.6%、93.5%、95%，CBCT分别为36.7%、76.7%、61.1%、54.8%、56.66%。
在两种折断锉尺寸中，数字化根尖片的灵敏度、特异度、阳性预测值、阴性预测值和诊断准确性均优于CBCT技术。
