RESUMO
Statement of the Problem: The diagnosis of vertical root fracture [VRF] is a challenging task
Purpose: This in vitro study compared cone beam computed tomography [CBCT] imaging with digital periapical radiography [DPR] made by three different horizontal angels [20 degree mesial, 0 degree and 20 degree distal] for accurate diagnosis of VRF
Materials and Method: Among 120 posterior teeth included in this study, 60 were vertically fractured. Fractured and non-fractured teeth were randomly distributed into three groups defined as group 1 with no filling in the root canal, group 2 with gutta-percha in the canal, and group 3 with the intracanal post. All samples were placed in a dry mandible and imaged with CBCT and DPR techniques. Two blind observers investigated the images
Results: CBCT had higher sensitivity but lower specificity compared with DPR, except for the intracanal post group in which the sensitivity of DPR was higher; though the chi-square test showed the differences to be statistically insignificant. The sensitivity, specificity, and accuracy of CBCT and DPR were reduced in the cases that gutta-percha or post were present in the canal. Inter-observer agreement was higher for CBCT. A set of three DPRs with different horizontal angels were significantly more sensitive for VRF recognition than a single orthogonal DPR
Conclusion: Based on our results, there was no significant difference between CBCT and a set of three DPRs with different angulations for VRF detection in posterior teeth. Therefore, it is suggested to consider DPRs with three different horizontal angels [20 degree mesial, 0 degree and 20 degree distal] for radiographic evaluation before CBCT examination