Influence of Width of Fracture Line on Detection of Subtle Vertical Root Fracture in Endodontically Treated Teeth using Cone Beam CT

doi:10.13701/j.cnki.kqyxyj.2020.02.019

Abstract

Abstract: Objective: To explore the influence of width of fracture lines on the detection of subtle vertical root fracture (VRF) in endodontically treated teeth using cone beam CT (CBCT). Methods: Twenty-six patients with incredulous VRFs in endodontically treated teeth were collected from March 2016 to March 2019. All patients were performed CBCT scan and evaluated the presence or absence of fracture line. All teeth were extracted due to diagnosis of VRF or severe bone loss. The position of the fracture line was confirmed and recorded under a microscope, and the teeth were immediately subjected to micro-CT scan in vitro, and the ImageJ was used to measure the width of fracture line on micro-CT images. Results: Of 26 teeth, 24 teeth were confirmed to be VRFs with 49 fracture lines. 11 teeth were diagnosed VRF using CBCT before extraction. The sensitivity, specificity, and accuracy were 45.83%, 100%, and 50%. All 24 teeth that were diagnosed as VRF by micro-CT. the accuracy was 100% for diagnosis of VRF teeth and 95.92% for fracture lines. The width of fracture line was between 15 μm-99 μm in CBCT negative group and 62 μm-288 μm in CBCT positive group. There was a significant difference of the width of the fracture line between two groups (P<0.05). Conclusion: The accuracy of CBCT detection in subtle vertical root fracture in endodontically treated teeth is relatively poor, and the width is an important factor affecting CBCT diagnosis.

Key words: Vertical root fracture, Cone beam CT, Micro-CT, Width

Gvlbira Ahmat, CAO Ya, XIE Sijing, WANG Tiemei, LIANG Jiahao, GAO Antian, WANG Congyue, LIN Zitong. Influence of Width of Fracture Line on Detection of Subtle Vertical Root Fracture in Endodontically Treated Teeth using Cone Beam CT[J]. Journal of Oral Science Research, 2020, 36(2): 172-176.

References

[1] Kahler W. The cracked tooth conundrum: terminology, classification, diagnosis, and management[J]. Am J Dent, 2008, 21(5): 275-282.
[2] Patel S, Brown J, Semper M, et al. European society of endodontology position statement: use of cone beam computed tomography in endodontics: european society of endodontology (ESE) developed by[J].Int Endod J, 2019, 52(12):1675-1678.
[3] 刘澍,童昕,王铁梅,等.基于CBCT的可视化技术在颧种植体导航中的设计研究[J].口腔医学研究,2018,34(10):1093-1097.
[4] Salineiro FCS, Kobayashi-Velasco S, Braga MM, et al. Radiographic diagnosis of root fractures: a systematic review, meta-analyses and sources of heterogeneity[J]. Dentomaxillofac Radiol, 2017, 46(8):20170400.
[5] Chavda R, Mannocci F, Andiappan M, et al. Comparing the in vivo diagnostic accuracy of digital periapical radiography with cone-beam computed tomography for the detection of vertical root fracture[J]. J Endod, 2014, 40(10):1524-1529.
[6] Zhang L, Wang T, Cao Y, et al. In Vivo detection of subtle vertical root fracture in endodontically treated teeth by cone-beam computed tomography[J]. J Endod, 2019, 45(7):856-862.
[7] Eric M, Richard E. Longitudinal tooth fractures: findings that contribute to complex endodontic diagnoses[J]. Endodontic Topics, 2010, 16(1): 82-111.
[8] Bornstein MM, Wölner-Hanssen AB, Sendi P, et al. Comparison of intraoral radiography and limited cone beam computed tomography for the assessment of root-fractured permanent teeth[J]. Dent Traumatol, 2009, 25(6):571-577.
[9] Long H, Zhou Y, Ye N, et al. Diagnostic accuracy of CBCT for tooth fractures: a meta-analysis[J]. J Dent, 2014, 42(3):240-248.
[10] Ma RH, Ge ZP, Li G, et al. Detection accuracy of root fractures in cone-beam computed tomography images: a systematic review and meta-analysis[J].Int Endod J, 2016, 49(7): 646-654.
[11] Talwar S, Utneja S, Nawal RR, et al. Role of cone-beam computed tomography in diagnosis of vertical root fractures: a systematic review and meta-analysis[J]. J Endod, 2016, 42(1):12-24.
[12] Guo XL, Li G, Zheng JQ, et al. Accuracy of detecting vertical root fractures in non-root filled teeth using cone beam computed tomography: effect of voxel size and fracture width[J]. Int Endod J, 2019, 52(6):887-898.
[13] Brady E, Mannocci F, Brown J, et al. A comparison of cone beam computed tomography and periapical radiography for the detection of vertical root fractures in nonendodontically treated teeth[J]. Int Endod J, 2014, 47(8): 735-746.
[14] Ozer SY. Detection of vertical root fractures of different thicknesses in endodontically enlarged teeth by cone beam computed tomography versus digital radiography[J]. J Endod, 2010, 36(7): 1245-1249.
[15] Makeeva IM, Byakova SF, Novozhilova NE, et al. Detection of artificially induced vertical root fractures of different widths by cone beam computed tomography in vitro and in vivo[J]. Int Endod J, 2016, 49(10): 980-989.