Digital subtraction radiography in detection of vertical root fractures: accuracy evaluation for root canal filling, fra
- PDF / 1,295,878 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 65 Downloads / 192 Views
ORIGINAL ARTICLE
Digital subtraction radiography in detection of vertical root fractures: accuracy evaluation for root canal filling, fracture orientation and width variables. An ex-vivo study Vasileios Kapralos 1 & Andreas Koutroulis 1 & Eleni Irinakis 1 & Pantelis Kouros 2 & Kleoniki Lyroudia 1 & Ioannis Pitas 3 & Georgios Mikrogeorgis 1 Received: 15 July 2019 / Accepted: 29 January 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective Ex-vivo evaluation of the detectability of vertical root fractures (VRFs) using digital subtraction radiography (DSR) and conventional digital periapical radiography (CDPR); investigation of the effect of root canal filling, x-ray angulation, and thickness of the VRF in the diagnostic accuracy. Materials and methods Sixty root canals were mechanically prepared and radiographed either with a gutta-percha root canal filling or without, at 0o and ± 10o. VRFs were introduced with a universal testing machine. The width and angulation of the fracture line with the radiographic beam were calculated. DSR was performed comparing radiographs obtained prior to and after the VRF induction. Five examiners evaluated the resultant images and analysis was performed using receiver operator characteristic (ROC) statistics and binary logistic regression tests. Results No significant differences in sensitivity, specificity, and the areas under the ROC curves (AUC) between the CDPR and DSR were detected (p > 0.05), except for root canal filled teeth where the AUC for DSR was higher (p < 0.05). Using DSR, a VRF was 1.3 times more likely to be diagnosed [95% confidence intervals (CI): 1.045–1.59; p = 0.018]. A correct diagnosis was 2.399 times more likely to occur in non-filled teeth regardless of the radiographic technique (95% CI 1.940–2.965; p = 0). The regression coefficients were positive for width and negative for angle. Conclusions DSR showed a better diagnostic accuracy of VRFs compared with CDPR, in single root canal filled teeth. The angulation, the width, and the presence of a root canal filling affected the diagnostic potential. Clinical relevance DSR is a cost- and time-effective imaging technique that could contribute in early diagnosis of VRFs. Keywords Dental digital radiography . Diagnostic imaging . Digital subtraction radiography . Endodontics . Vertical root fracture
Introduction
* Vasileios Kapralos [email protected] 1
Department of Endodontology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Dentistry Building, Aristotle University of Thessaloniki Campus, 54124 Thessaloniki, Greece
2
Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
3
Artificial Intelligence and Information Analysis Laboratory, School of Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
Vertical root fracture (VRF) is the most severe among the five definitive classifications of the tooth crack types [1, 2]. VRFs usually are buccally linguall
Data Loading...
