Detection of Incomplete Root Fractures in Endodontically Treated Teeth Using Different High-resolution Cone-beam Computed Tomographic Imaging Protocols.

INTRODUCTION: The purpose of this study was to compare different high-resolution cone-beam computed tomographic (CBCT) imaging protocols in the diagnosis of incomplete root fractures of endodontically treated teeth. METHODS: Twenty single-rooted human teeth were endodontically treated, and an incomplete root fracture was induced. The teeth were scanned with the CBCT unit PreXion 3D (Teracom, San Mateo, CA) operating at 2 different protocols: high resolution/standard (HI-STD) (19 seconds and 512 basis images) and high resolution/high density (HI-HI) (37 seconds and 1024 basis images). Three oral radiologists evaluated all images using multiplanar reconstructions. The diagnostic tests and the receiver operating characteristic (ROC) curve were calculated. RESULTS: The HI-STD and HI-HI protocols presented an accuracy of 0.90 and 0.93, respectively, and both protocols had a sensitivity of 0.97. The HI-HI protocol showed a higher positive predictive value and slightly higher areas under the ROC curve. CONCLUSIONS: Both high-resolution imaging protocols presented high accuracy in the detection of incomplete root fracture of endodontically teeth. Thus, the HI-STD protocol should be indicated this reduces the radiation dose.

Maxillary canine morphology: comparative and descriptive analysis from periapical radiographs and cone beam computed tomography.

The anatomical characteristics of permanent maxillary canines were evaluated through visual examination, periapical radiography, and cone beam computed tomography (CBCT), and measurements obtained from the images and directly on the teeth were compared. Fifty extracted human maxillary canines were classified according to the side of the mouth. The direction of root curvature and location of the apical foramen were also verified. Periapical radiographs and CBCTs of the specimens were obtained. The number of root canals was verified. Tooth length and the mesiodistal and buccopalatal widths of the root were measured directly on the specimens as well as on the radiographs and CBCTs. Data were analyzed by chi-square testing and analysis of variance (α = 0.05). All teeth-26 (52%) from the right side of the dental arch and 24 (48%) from the left-had only 1 main canal each. The apical foramen was located exactly in the root apex in 34 teeth (68%). Root curvature toward the distal side was observed in the apical third in 23 teeth (46%). There were no statistically significant differences between the canines' arch side and either the foramen location (P = 0.104) or the root curvature (P = 0.215). No statistically significant differences were found in measurements of tooth length (P = 0.669), mesiodistal root width (P = 0.517), or buccopalatal root width (P = 0.672) obtained from specimens and images. Both CBCTs and periapical radiographs were reliable for determining the tooth length, mesiodistal root width, and buccopalatal root width of maxillary canines and produced statistically similar measurements.

Comparative analysis of mandibular anatomical variations between panoramic radiography and cone beam computed tomography.

PURPOSE: The objective of this study is to compare the ability of panoramic radiography and cone beam computed tomography (CBCT) in detecting anatomical variations of the mandibular canal and mental foramen. METHODS: One hundred twenty-seven preoperative panoramic and CBCT images were evaluated. Two oral and maxillofacial radiologists investigated the presence of bifid mandibular canals and/or additional mental foramina on the right, left, or both sides of the mandible. Intra- and interobserver reliability was determined using Cohen's kappa coefficient. McNemar's test compared the prevalence of mandibular anatomical variations between panoramic radiography and CBCT. The significance level was set at 0.05. RESULTS: Additional mental foramen and bifid mandibular canal were detected in 1.2 and 7.4 % of the panoramic radiographs and 7.4 and 9.8 % of the CBCT images, respectively. The incidence of anatomical variations on the mandibular canal was not significantly different between both imaging modalities (P > 0.05). CONCLUSIONS: Although CBCT provides better viewing of anatomical structures, including location, shape, and relationship with the surrounding area, panoramic radiography is a conventional imaging modality that can be used in the study of the bifid mandibular canals.