Analysis of the width of vertical root fracture in endodontically treated teeth by 2 micro-computed tomography systems

J Endod. 2014 May;40(5):698-702. doi: 10.1016/j.joen.2013.12.015. Epub 2014 Feb 15.

Abstract

Introduction: Early detection of vertical root fracture (VRF) is important for clinical endodontic practice. The purpose of this study was to measure the fracture width (distance between 2 sides of the fracture) of VRF teeth in vitro by using 2 micro-computed tomography (μ-CT) systems with different spatial resolution and voxel size.

Methods: Thirty-seven endodontically treated teeth with VRF were scanned by 80-μm pixel size μ-CT. Fifteen teeth with no obvious fracture line, blurred image, or fracture space less than 100 μm were scanned by 9-μm pixel size μ-CT.

Results: Presence of 2 VRF lines was more common in premolars (82%) than in molars (53%). In 7 premolars (32%) and 9 molars (60%), the VRF lines extended to within the apical 3 mm of the root. All fracture lines were detected by 9-μm pixel size μ-CT, but only 22 of 37 VRF teeth had vertical fracture identified by 80-μm μ-CT. From μ-CT examination, none of the fracture lines showed consistent and uniform fracture space. If 2 fracture lines were present, they were typically in opposite (not linear) directions. There was a significant correlation between 2 fracture lines or fracture lines extending within the 3 mm of the apex and fracture width greater than 100 μm.

Conclusions: Application of 9-μm μ-CT can be accurately used for early detection of VRF. Fracture characteristics (eg, number of fracture lines, extension of fracture line) may affect the fracture width. Appropriate use of μ-CT technology can be helpful for early diagnosis of VRF.

Keywords: Cone-beam computed tomography (CBCT); endodontically treated teeth; micro-computed tomography (μ-CT); vertical root fracture (VRF).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bicuspid / diagnostic imaging
  • Bicuspid / injuries
  • Early Diagnosis
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Molar / diagnostic imaging
  • Molar / injuries
  • Tooth Apex / diagnostic imaging
  • Tooth Apex / injuries
  • Tooth Fractures / diagnostic imaging*
  • Tooth Root / diagnostic imaging
  • Tooth Root / injuries*
  • Tooth, Nonvital / diagnostic imaging*
  • X-Ray Microtomography / methods*