Detection of Vertical Root Fractures Using Cone-Beam Computed Tomography in the Presence and Absence of Gutta-Percha

Background. Vertical root fractures (VRFs) can significantly reduce dental prognosis. Cone-beam computed tomography (CBCT) offers better visualization of VRF than conventional radiography. However, gutta-percha creates artifacts in cone-beam CT (CBCT) images and reduces the diagnosis quality. The pu...

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Main Authors: Ehsan Hekmatian, Mitra Karbasi kheir, Hossein Fathollahzade, Mahnaz Sheikhi
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1155/2018/1920946
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author Ehsan Hekmatian
Mitra Karbasi kheir
Hossein Fathollahzade
Mahnaz Sheikhi
author_facet Ehsan Hekmatian
Mitra Karbasi kheir
Hossein Fathollahzade
Mahnaz Sheikhi
author_sort Ehsan Hekmatian
collection DOAJ
description Background. Vertical root fractures (VRFs) can significantly reduce dental prognosis. Cone-beam computed tomography (CBCT) offers better visualization of VRF than conventional radiography. However, gutta-percha creates artifacts in cone-beam CT (CBCT) images and reduces the diagnosis quality. The purpose of this study was to evaluate the accuracy of CBCT in detection of VRF in presence and absence of gutta-percha in canals. Materials and Methods. In this cross-sectional study, 50 extracted mandibular premolars were selected. After preparing the access cavity, canals were instrumented using step-back method, and gutta-percha #40 was placed afterwards. The fractures were created using electromechanical universal testing machine on 25 teeth. The teeth were randomly placed in dry mandibular dental sockets, and the first CBCTs were taken. Then the gutta-percha was removed, and the second CBCTs were taken. Results. The results of Kappa coefficient between two observers in roots with and without gutta-percha were 0.644 and 0.830, respectively (p value ≤ 0.001). The sensitivity and specificity of VRF diagnosis in assessing gutta-percha filled canals were 32% and 68% for the first observer, respectively (Kappa < 0.000, p value = 1.000), and 40% and 68% for the second observer, respectively (Kappa = 0.080, p value = 0.556). The sensitivity and specificity of VRF diagnosis in assessing the empty canals (without gutta-percha) were 72% and 96% for the first observer, respectively (Kappa = 0.680, p value ≤ 0/001), and 72% and 96% for the second observer, respectively (Kappa = 0.680, p value ≤ 0/001). Conclusion. The intracanal filling materials such as gutta-percha reduce the diagnostic ability of vertical root fractures. Hence, it is recommended to remove those materials from root canals before imaging to improve the diagnostic potential of CBCT.
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spelling doaj-art-cb319b22a3fb44b5a92cc098daa2736e2025-02-03T07:23:33ZengWileyThe Scientific World Journal2356-61401537-744X2018-01-01201810.1155/2018/19209461920946Detection of Vertical Root Fractures Using Cone-Beam Computed Tomography in the Presence and Absence of Gutta-PerchaEhsan Hekmatian0Mitra Karbasi kheir1Hossein Fathollahzade2Mahnaz Sheikhi3Dental Implant Research Center, Department of Oral and Maxillofacial Radiology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Oral and Maxillofacial Radiology, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, IranDepartment of Oral and Maxillofacial Radiology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, IranTorabinejad Research Center, Department of Oral and Maxillofacial Radiology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, IranBackground. Vertical root fractures (VRFs) can significantly reduce dental prognosis. Cone-beam computed tomography (CBCT) offers better visualization of VRF than conventional radiography. However, gutta-percha creates artifacts in cone-beam CT (CBCT) images and reduces the diagnosis quality. The purpose of this study was to evaluate the accuracy of CBCT in detection of VRF in presence and absence of gutta-percha in canals. Materials and Methods. In this cross-sectional study, 50 extracted mandibular premolars were selected. After preparing the access cavity, canals were instrumented using step-back method, and gutta-percha #40 was placed afterwards. The fractures were created using electromechanical universal testing machine on 25 teeth. The teeth were randomly placed in dry mandibular dental sockets, and the first CBCTs were taken. Then the gutta-percha was removed, and the second CBCTs were taken. Results. The results of Kappa coefficient between two observers in roots with and without gutta-percha were 0.644 and 0.830, respectively (p value ≤ 0.001). The sensitivity and specificity of VRF diagnosis in assessing gutta-percha filled canals were 32% and 68% for the first observer, respectively (Kappa < 0.000, p value = 1.000), and 40% and 68% for the second observer, respectively (Kappa = 0.080, p value = 0.556). The sensitivity and specificity of VRF diagnosis in assessing the empty canals (without gutta-percha) were 72% and 96% for the first observer, respectively (Kappa = 0.680, p value ≤ 0/001), and 72% and 96% for the second observer, respectively (Kappa = 0.680, p value ≤ 0/001). Conclusion. The intracanal filling materials such as gutta-percha reduce the diagnostic ability of vertical root fractures. Hence, it is recommended to remove those materials from root canals before imaging to improve the diagnostic potential of CBCT.http://dx.doi.org/10.1155/2018/1920946
spellingShingle Ehsan Hekmatian
Mitra Karbasi kheir
Hossein Fathollahzade
Mahnaz Sheikhi
Detection of Vertical Root Fractures Using Cone-Beam Computed Tomography in the Presence and Absence of Gutta-Percha
The Scientific World Journal
title Detection of Vertical Root Fractures Using Cone-Beam Computed Tomography in the Presence and Absence of Gutta-Percha
title_full Detection of Vertical Root Fractures Using Cone-Beam Computed Tomography in the Presence and Absence of Gutta-Percha
title_fullStr Detection of Vertical Root Fractures Using Cone-Beam Computed Tomography in the Presence and Absence of Gutta-Percha
title_full_unstemmed Detection of Vertical Root Fractures Using Cone-Beam Computed Tomography in the Presence and Absence of Gutta-Percha
title_short Detection of Vertical Root Fractures Using Cone-Beam Computed Tomography in the Presence and Absence of Gutta-Percha
title_sort detection of vertical root fractures using cone beam computed tomography in the presence and absence of gutta percha
url http://dx.doi.org/10.1155/2018/1920946
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AT hosseinfathollahzade detectionofverticalrootfracturesusingconebeamcomputedtomographyinthepresenceandabsenceofguttapercha
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