Oral and maxillofacial radiology
Use of cone-beam volumetric tomography in the diagnosis of root fractures

https://doi.org/10.1016/j.tripleo.2009.01.017Get rights and content

Objectives

The diagnosis of root fractures by conventional radiographs is still difficult because of limitations of 2D images. Cone-beam volumetric tomography improves the diagnosis capacity in dentistry, such as increased radiation dose to the patient and presence of artifacts on the image.

Study design

This study compared the images obtained on conventional periapical radiographs and 3D scans (Accuitomo 3DX) for the diagnosis of root fractures. Twenty patients with suspected root fractures were submitted to examination by periapical radiography and CBCT. Two professionals, unaware of the symptomatology, examined these radiographs and CBCT images according to pre-established scores, which were later checked against the signs and symptoms.

Results

The results revealed statistical difference for cone-beam volumetric tomography compared with conventional radiographs in the diagnosis of root fractures.

Conclusion

It could be concluded that cone-beam volumetric tomography was better than conventional radiography in the diagnosis of root fractures, thereby constituting an excellent alternative for diagnosis in general practice.

Section snippets

Material and Methods

Before onset, the study was revised and approved by the Institutional Review Board of Bauru Dental School, University of São Paulo. All patients were informed on the study objectives and signed an informed consent form.

The study was conducted on 20 patients with endodontically treated teeth. Some patients had suspected root fracture and reported slight discomfort, yet presented teeth with no or few specific signs and symptoms, such as extensive radiolucent images, pain on percussion or

Results

Table I presents the scores assigned by examiners to root fractures observed on conventional radiographs and 3D tomographs, as well as the comparison checked against the symptomatology.

These data were statistically analyzed by the Wilcoxon test for comparison between radiographic methods, as presented in Table II. The results revealed statistically significant difference between conventional radiography compared with 3D computerized tomography in the diagnosis of root fracture.

Analysis between

Discussion

The results revealed that examiners could detect fractures on conventional radiographs in 8 and 6 cases, respectively; images were clearly observed in 2 cases and confirmed by the professional aware of the symptomatology, which was enhanced because these patients exhibited horizontal fractures and reported pain on mastication. In 6 cases with poor definition, enlarged periodontal space was observed on periapical radiographs (Table I). In 18 cases, CBCT clearly revealed the fracture, which was

Conclusion

The CBCT provides enhanced and accurate information for the diagnosis of root fractures, thereby constituting an excellent alternative for diagnosis in the dental practice. However, clinical signs and symptoms are fundamental and very important for the diagnosis of fractures, besides auxiliary resources as the CBCT.

References (35)

  • T.P. Cotton et al.

    Endodontic applications of cone-beam volumetric tomography

    J Endod

    (2007)
  • A. Katsumata et al.

    Image artifact in dental cone-beam CT

    Oral Surg Oral Med Oral Pathol Oral Radiol Endod

    (2006)
  • S. Lofthag-Hansen et al.

    Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology

    Oral Surg Oral Med Oral Pathol Oral Radiol Endod

    (2007)
  • M.K. Nair et al.

    Digital and advanced imaging in endodontics: a review

    J Endod

    (2007)
  • A. Friedrich

    Pasler Heiko VisserRadiologia odontológica. Texto e Atlas

  • A.J. Moule et al.

    Diagnosis and management of teeth with vertical fractures

    Aust Dent J

    (1999)
  • J.K.T. Lee et al.

    Tomografia Computadorizada do Corpo em Correlação com Ressonância Magnética

    (2001)

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