Associate Professor, Department of Prosthodontics, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran.
Associate Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
BMC Med Imaging. 2023 Jun 1;23(1):68. doi: 10.1186/s12880-023-01024-3.
Vertical root fractures (VRFs) sometimes occur in endodontically treated teeth. They have a difficult diagnosis and a dismal result. The objective of this review was to evaluate the diagnostic performance of cone-beam computed tomography (CBCT) for detecting VRFs in teeth that had undergone endodontic treatment.
Literature was reviewed from Web of Science, PubMed, Cochrane Review, SCOPUS, and Embase databases between 2000 and 2022. The searched keywords included "endodontically treated teeth," "cone-beam computed tomography," "CBCT," "tooth fracture," "vertical root fracture," "VRF," "accuracy," "sensitivity," and "specificity." Only articles in the English language were included. The final analysis included 20 papers that satisfied the eligibility requirements.
The overall mean ± SD values (%) for the diagnostic sensitivity and specificity of CBCT for detection of VRFs in endodontically treated teeth in the presence of root-filling materials without an intracanal post were 71.50 ± 22.19 and 75.64 ± 19.41, respectively. The overall mean (SD) value (%) for the sensitivity of CBCT for the detection of VRFs in the presence of root-filling materials and intracanal posts was 72.76 (18.73), while the mean (SD) specificity was 75.44 (18.26). The accuracy of CBCT (mean ± SD) was 78.47 ± 17.19% and 74.02 ± 10.64%, respectively, for teeth without intracanal posts and those with posts.
Further clinical research is needed to validate the optimum efficiency of CBCT as a diagnostic technique for detecting VRFs in teeth that have had endodontic treatment, given the low sensitivity, significant heterogeneity of studies, and lack of in-vivo studies on the subject.
垂直根折（VRF）有时发生在根管治疗的牙齿中。它们的诊断具有一定难度，预后较差。本综述的目的是评估锥形束 CT（CBCT）检测根管治疗后牙齿 VRF 的诊断性能。
在 2000 年至 2022 年间，我们在 Web of Science、PubMed、Cochrane 综述、SCOPUS 和 Embase 数据库中对文献进行了检索。检索的关键词包括“根管治疗牙”、“锥形束 CT”、“CBCT”、“牙折”、“垂直根折”、“VRF”、“准确性”、“敏感性”和“特异性”。仅纳入英语文献。最终分析纳入了 20 篇符合入选标准的文献。
在没有根管内桩的根充材料存在的情况下，CBCT 对根管治疗牙 VRF 的总体诊断敏感性和特异性的平均值（±标准差）分别为 71.50（±22.19）%和 75.64（±19.41）%。在有根充材料和根管内桩的情况下，CBCT 检测 VRF 的总体平均（标准差）值（%）为 72.76（18.73），而平均（标准差）特异性为 75.44（18.26）%。CBCT 的准确性（平均值±标准差）分别为无根管内桩的牙齿和有桩的牙齿的 78.47（±17.19）%和 74.02（±10.64）%。
鉴于 CBCT 检测根管治疗后牙齿 VRF 的敏感性低、研究间异质性大以及缺乏该主题的体内研究，需要进一步的临床研究来验证 CBCT 作为一种诊断技术检测 VRF 的最佳效率。
