Skip to main content
Top
Published in: BMC Oral Health 1/2016

Open Access 01-12-2016 | Research article

Detection of vertical root fractures in endodontically treated teeth in the absence and in the presence of metal post by cone-beam computed tomography

Published in: BMC Oral Health | Issue 1/2016

Login to get access

Abstract

Background

Aim of this study was to investigate the influence of gutta-percha and metallic posts on the efficiency of Cone Beam Computed Tomography (CBCT) in diagnosing Vertical Root Fracture (VRF).

Methods

Forty-eight teeth were divided into 3 experimental and 3 control groups. The teeth of the first experimental group and the first control group received neither gutta-percha nor metal posts. The teeth of the second experimental group and the second control group were filled with gutta-percha, and the teeth of the third experimental group and the third control group were filled with the metal posts. The teeth of the experimental groups were artificially fractured. The teeth were evaluated through images taken by a Prexion scanner with a 0.1 mm resolution. Fisher’s exact test was used to measure the following values: sensitivity, false negative, specificity, false positive and accuracy for the VRF detection through the scanner. Three observers calibrated and blinded to the protocol evaluated the images.

Results

The inter-observer Kappa coefficient was 0.83. The presence of posts and gutta-percha reduced the sensitivity and the accuracy in detecting the VRF. Regarding to the sensitivity (p = 0.837, p = 0.304, p = 0.837 for evaluator 1, 2 and 3, respectively) and specificity (p = 0.162, p = 0.056, p = 0.062 for evaluator 1, 2 and 3, respectively), Fisher’s exact test showed no statistically significant difference among the evaluated groups. However, a significant difference was observed in relation to the accuracy in the results of evaluator 2 (p = 0.03), which showed a much lower accuracy for the post group (50 %) than for the Nonfilled group (93.8 %).

Conclusions

The Prexion tomograph was precise in detecting vertical root fractures and the CBCT diagnostic ability was not influenced by the presence of posts or gutta-percha.
Literature
1.
go back to reference Tamse A. Iatrogenic vertical root fractures in endodontically treated teeth. Endod Dent Traumatol. 1988;4:190–6.CrossRefPubMed Tamse A. Iatrogenic vertical root fractures in endodontically treated teeth. Endod Dent Traumatol. 1988;4:190–6.CrossRefPubMed
2.
go back to reference Walton RE, Michelich RJ, Smith GN. The histopathogenesis of vertical root fractures. J Endod. 1984;10:48–56.CrossRefPubMed Walton RE, Michelich RJ, Smith GN. The histopathogenesis of vertical root fractures. J Endod. 1984;10:48–56.CrossRefPubMed
3.
go back to reference Cohen S, Blanco L, Berman L. Vertical root fractures: clinical e radiographic diagnosis. J Am Dent Assoc. 2003;134:434–41.CrossRefPubMed Cohen S, Blanco L, Berman L. Vertical root fractures: clinical e radiographic diagnosis. J Am Dent Assoc. 2003;134:434–41.CrossRefPubMed
4.
go back to reference Tamse A. Vertical root fractures in endodontically treated teeth: diagnostic signs and clinical management. Endod Topics. 2006;13:84–94.CrossRef Tamse A. Vertical root fractures in endodontically treated teeth: diagnostic signs and clinical management. Endod Topics. 2006;13:84–94.CrossRef
5.
go back to reference Andreasen JO. Traumatic injuries of the teeth. 2nd ed. Philadelphia: WB Saunders; 1981. Andreasen JO. Traumatic injuries of the teeth. 2nd ed. Philadelphia: WB Saunders; 1981.
6.
go back to reference Mora MA, Mol A, Tyndall DA, Rivera EM. In vitro assessment of local computed tomography for the detection of longitudinal tooth fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103:825–9.CrossRefPubMed Mora MA, Mol A, Tyndall DA, Rivera EM. In vitro assessment of local computed tomography for the detection of longitudinal tooth fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103:825–9.CrossRefPubMed
7.
go back to reference Hassan B, Metska ME, Ozok AR, Stelt PVD, Wesselink PR. Detection of vertical root fractures in endodontically treated teeth by a cone beam computed tomography scan. J Endod. 2009;35:719–22.CrossRefPubMed Hassan B, Metska ME, Ozok AR, Stelt PVD, Wesselink PR. Detection of vertical root fractures in endodontically treated teeth by a cone beam computed tomography scan. J Endod. 2009;35:719–22.CrossRefPubMed
8.
go back to reference Ilguy D, Ilguy M, Fisekcioglu E, Bayirli G. Detection of jaw and root fractures using cone beam computed tomography: a case report. Dentomaxillofac Radiol. 2009;38:169–73.CrossRefPubMed Ilguy D, Ilguy M, Fisekcioglu E, Bayirli G. Detection of jaw and root fractures using cone beam computed tomography: a case report. Dentomaxillofac Radiol. 2009;38:169–73.CrossRefPubMed
9.
go back to reference Wenzel A, Haitter Neto F, Frydenberg M, Kirkevang LL. Variable-resolution cone-beam computerized tomography with enhancement filtration compared with intraoral photostimulable phosphor radiography in detection of transverse root fractures in an in vitro model. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:939–45.CrossRefPubMed Wenzel A, Haitter Neto F, Frydenberg M, Kirkevang LL. Variable-resolution cone-beam computerized tomography with enhancement filtration compared with intraoral photostimulable phosphor radiography in detection of transverse root fractures in an in vitro model. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:939–45.CrossRefPubMed
10.
go back to reference Kamburoglu K, Murat S, Yuksel SP, Cebeci AR, Horasan S. Detection of vertical root fracture using cone-beam computerized tomography: an in vitro assessment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:74–81.CrossRef Kamburoglu K, Murat S, Yuksel SP, Cebeci AR, Horasan S. Detection of vertical root fracture using cone-beam computerized tomography: an in vitro assessment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:74–81.CrossRef
11.
go back to reference Estrela C, Bueno MR, Azevedo B, Azevedo JR, Pecora JD. A new periapical index based on cone beam computed tomography. J Endod. 2008;34:1325–31.CrossRefPubMed Estrela C, Bueno MR, Azevedo B, Azevedo JR, Pecora JD. A new periapical index based on cone beam computed tomography. J Endod. 2008;34:1325–31.CrossRefPubMed
12.
go back to reference Venskutonis T, Plotino G, Juodzbalys G, Mickeviciene L. The importance of Cone-beam Computed Tomography in the Management of Endodontic Problems: A Review of the Literature. J Endod. 2014;40:1895–901.CrossRefPubMed Venskutonis T, Plotino G, Juodzbalys G, Mickeviciene L. The importance of Cone-beam Computed Tomography in the Management of Endodontic Problems: A Review of the Literature. J Endod. 2014;40:1895–901.CrossRefPubMed
13.
go back to reference Bornstein MM, Hanssen ABW, Sendi P, Arx TV. Comparasion of intraoral radiography and limited cone beam computed tomography for the assessment of root-fractured permanent teeth. Dent Traumatol. 2009;25:571–7.CrossRefPubMed Bornstein MM, Hanssen ABW, Sendi P, Arx TV. Comparasion of intraoral radiography and limited cone beam computed tomography for the assessment of root-fractured permanent teeth. Dent Traumatol. 2009;25:571–7.CrossRefPubMed
14.
go back to reference Ozer SY. Detection of vertical root fractures of different thicknesses in endodontically enlarged teeth by cone beam computed tomography versus digital radiography. J Endod. 2010;36:1245–9.CrossRefPubMed Ozer SY. Detection of vertical root fractures of different thicknesses in endodontically enlarged teeth by cone beam computed tomography versus digital radiography. J Endod. 2010;36:1245–9.CrossRefPubMed
15.
go back to reference Edlund M, Nair MK, Nair UP. Detection of vertical root fractures by using cone-beam computed tomography: a clinical study. J Endod. 2011;37:768–72.CrossRefPubMed Edlund M, Nair MK, Nair UP. Detection of vertical root fractures by using cone-beam computed tomography: a clinical study. J Endod. 2011;37:768–72.CrossRefPubMed
16.
go back to reference Ezzodini-Ardakani F, Razavi SH, Tabrizizadch M. Diagnostic Value of Cone-Beam Computed Tomography and Periapical Radiography in Detection of Vertical Root Fracture. Iran Endod J. 2015;10(2):122–6.PubMedPubMedCentral Ezzodini-Ardakani F, Razavi SH, Tabrizizadch M. Diagnostic Value of Cone-Beam Computed Tomography and Periapical Radiography in Detection of Vertical Root Fracture. Iran Endod J. 2015;10(2):122–6.PubMedPubMedCentral
17.
go back to reference Brady E, Mannocci F, Brown J, Wilson R, Patel S. A comparison of cone beam computed tomography and periapical radiography for the detection of vertical root fractures in nonendodontically treated teeth. Int Endod J. 2014;47:735–46.CrossRefPubMed Brady E, Mannocci F, Brown J, Wilson R, Patel S. A comparison of cone beam computed tomography and periapical radiography for the detection of vertical root fractures in nonendodontically treated teeth. Int Endod J. 2014;47:735–46.CrossRefPubMed
18.
go back to reference Wilcox LR, Roskelley C, Sutton T. The relationship of root canal enlargement to finger-spreader induced vertical root fracture. J Endod. 1997;23:533–4.CrossRefPubMed Wilcox LR, Roskelley C, Sutton T. The relationship of root canal enlargement to finger-spreader induced vertical root fracture. J Endod. 1997;23:533–4.CrossRefPubMed
19.
go back to reference Neves FS, Freitas DQ, Campos PSF, Ekestubbe A, Lofthag-Hansen S. Evaluation of cone-beam computed tomography in the diagnosis of vertical root fractures: the influence of imaging modes and root canal materials. J Endod. 2014;40:1530–6.CrossRefPubMed Neves FS, Freitas DQ, Campos PSF, Ekestubbe A, Lofthag-Hansen S. Evaluation of cone-beam computed tomography in the diagnosis of vertical root fractures: the influence of imaging modes and root canal materials. J Endod. 2014;40:1530–6.CrossRefPubMed
20.
go back to reference Liedke GS, Silveira HED, Silveira HLD, Dutra V, Figueiredo JAP. Influence of voxel size in the diagnostic ability of cone beam tomography to evaluate simulated external root resorption. J Endod. 2009;35:233–5.CrossRefPubMed Liedke GS, Silveira HED, Silveira HLD, Dutra V, Figueiredo JAP. Influence of voxel size in the diagnostic ability of cone beam tomography to evaluate simulated external root resorption. J Endod. 2009;35:233–5.CrossRefPubMed
21.
go back to reference Katsumata A, Hirukawa A, Okumura S, Naitoh M, Fujishita M, Ariji E, et al. Effects of image artifacts on gray-value density in limited-volume cone-beam computerized tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:829–36.CrossRefPubMed Katsumata A, Hirukawa A, Okumura S, Naitoh M, Fujishita M, Ariji E, et al. Effects of image artifacts on gray-value density in limited-volume cone-beam computerized tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:829–36.CrossRefPubMed
22.
go back to reference Shelley AM, Brunton P, Horner K. Subjective image quality assessment of cross sectional imaging methods for the symphyseal region of the mandible prior to dental implant placement. J Dentist. 2011;39:764–70.CrossRef Shelley AM, Brunton P, Horner K. Subjective image quality assessment of cross sectional imaging methods for the symphyseal region of the mandible prior to dental implant placement. J Dentist. 2011;39:764–70.CrossRef
23.
go back to reference Tamse A, Fuss Z, Lustig J, Ganor Y, Kaffe I. Radiographic features of vertically fractured, endodontically treated maxillary premolars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88:348–52.CrossRefPubMed Tamse A, Fuss Z, Lustig J, Ganor Y, Kaffe I. Radiographic features of vertically fractured, endodontically treated maxillary premolars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88:348–52.CrossRefPubMed
24.
go back to reference Chen SC, Chueh LH, Hsiao CK, Wu HP, Chiang CP. First untoward events and reasons for tooth extraction after nonsurgical endodontic treatment in Taiwan. J Endod. 2008;34:671–4.CrossRefPubMed Chen SC, Chueh LH, Hsiao CK, Wu HP, Chiang CP. First untoward events and reasons for tooth extraction after nonsurgical endodontic treatment in Taiwan. J Endod. 2008;34:671–4.CrossRefPubMed
25.
go back to reference Melo SL, Bortoluzzi EA, Abreu Jr M, Corrêa LR, Corrêa M. Diagnostic ability of a cone-beam computed tomography scan to assess longitudinal root fractures in prosthetically treated teeth. J Endod. 2010;36:1879–82.CrossRefPubMed Melo SL, Bortoluzzi EA, Abreu Jr M, Corrêa LR, Corrêa M. Diagnostic ability of a cone-beam computed tomography scan to assess longitudinal root fractures in prosthetically treated teeth. J Endod. 2010;36:1879–82.CrossRefPubMed
26.
go back to reference Metska ME, Aartman IH, Wesselink P, Ozok A. Detection of vertical root fractures in vivo in endodontically treated by cone-beam computed tomography scans. J Endod. 2012;38:1344–47.CrossRefPubMed Metska ME, Aartman IH, Wesselink P, Ozok A. Detection of vertical root fractures in vivo in endodontically treated by cone-beam computed tomography scans. J Endod. 2012;38:1344–47.CrossRefPubMed
27.
go back to reference Ozer SY. Detection of vertical root fractures by using cone beam computed tomography with variable voxel sizes in an in vitro model. J Endod. 2011;37:75–9.CrossRefPubMed Ozer SY. Detection of vertical root fractures by using cone beam computed tomography with variable voxel sizes in an in vitro model. J Endod. 2011;37:75–9.CrossRefPubMed
28.
go back to reference Khedmat S, Rouhi N, Drage N, Shokouhinejad N, Nekoofar MH. Evaluation of Three imaging techniques for the detection of vertical root fractures in the absence and presence of gutta-percha root fillings. Int Endod J. 2012;45:1004–9.CrossRefPubMed Khedmat S, Rouhi N, Drage N, Shokouhinejad N, Nekoofar MH. Evaluation of Three imaging techniques for the detection of vertical root fractures in the absence and presence of gutta-percha root fillings. Int Endod J. 2012;45:1004–9.CrossRefPubMed
29.
go back to reference Vizzotto MB, Silveira PF, Araús NA, Montagner F, Gomes BP, da Silveira HE. CBCT for the assessment of second mesiobuccal (MB2) canals in maxillary molar teeth: effect of voxel size and presence of root filling. Int Endod J. 2013;46:870–6.CrossRefPubMed Vizzotto MB, Silveira PF, Araús NA, Montagner F, Gomes BP, da Silveira HE. CBCT for the assessment of second mesiobuccal (MB2) canals in maxillary molar teeth: effect of voxel size and presence of root filling. Int Endod J. 2013;46:870–6.CrossRefPubMed
30.
go back to reference Patel S, Brady E, Wilson R, Brown J, Mannocci F. The detection of vertical root fractures in root filled teeth with periapical radiographs and CBCT scans. Int Endod J. 2013;46:1140–52.CrossRefPubMed Patel S, Brady E, Wilson R, Brown J, Mannocci F. The detection of vertical root fractures in root filled teeth with periapical radiographs and CBCT scans. Int Endod J. 2013;46:1140–52.CrossRefPubMed
31.
go back to reference Bechara B, Alex McMahan C, Moore WS, Noujeim M, Teixeira FB, Geha H. Cone beam CT scans with and without artefact reduction in root fracture detection of endodontically treated teeth. Dentomaxillofac Radiol. 2013;42(5):20120245.CrossRefPubMedPubMedCentral Bechara B, Alex McMahan C, Moore WS, Noujeim M, Teixeira FB, Geha H. Cone beam CT scans with and without artefact reduction in root fracture detection of endodontically treated teeth. Dentomaxillofac Radiol. 2013;42(5):20120245.CrossRefPubMedPubMedCentral
32.
go back to reference Costa FF, Gaia BF, Umetsubo OS, Pinheiro LR, Tortamano IP, Cavalcanti MG. Use of large-volume cone-beam computed tomography in identification and localization of horizontal root fracture in the presence and absence of intracanal metallic post. J Endod. 2012;38:856–9.CrossRefPubMed Costa FF, Gaia BF, Umetsubo OS, Pinheiro LR, Tortamano IP, Cavalcanti MG. Use of large-volume cone-beam computed tomography in identification and localization of horizontal root fracture in the presence and absence of intracanal metallic post. J Endod. 2012;38:856–9.CrossRefPubMed
33.
go back to reference da Silveira PF, Vizzoto MB, Liedke GS, da Silveira HL, Montagner F, da Silveira HE. Detection of vertical root fractures by conventional radiographic examination and cone beam computed tomography: an in vitro analysis. Dent Traumatol. 2013;29:41–6.CrossRefPubMed da Silveira PF, Vizzoto MB, Liedke GS, da Silveira HL, Montagner F, da Silveira HE. Detection of vertical root fractures by conventional radiographic examination and cone beam computed tomography: an in vitro analysis. Dent Traumatol. 2013;29:41–6.CrossRefPubMed
34.
go back to reference Kositbowornchai S, Nuansakul R, Sikram S, Sinahawattana S, Saengmontri S. Root fracture detection: a comparison of direct digital radiography with conventional radiography. Dentomaxillofac Radiol. 2001;30:106–9.CrossRefPubMed Kositbowornchai S, Nuansakul R, Sikram S, Sinahawattana S, Saengmontri S. Root fracture detection: a comparison of direct digital radiography with conventional radiography. Dentomaxillofac Radiol. 2001;30:106–9.CrossRefPubMed
Metadata
Title
Detection of vertical root fractures in endodontically treated teeth in the absence and in the presence of metal post by cone-beam computed tomography
Publication date
01-12-2016
Published in
BMC Oral Health / Issue 1/2016
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-016-0207-y

Other articles of this Issue 1/2016

BMC Oral Health 1/2016 Go to the issue