Background: Vertical root fracture (VRF) is a diagnostic challenge for dentists. Cone-beam computed tomography (CBCT) scans provide accurate three-dimensional images of teeth enabling detection of VRFs. This in-vivo study compared the accuracy of CBCT and exploratory surgery for detection of VRFs in endodontically-treated teeth.
Methods: Forty endodontically-treated teeth of 40 patients with clinical signs and symptoms of VRFs were evaluated. No fracture line was detectable on periapical radiographs. The CBCT scans with limited FOV were obtained of the teeth and inspected separately by a radiologist and two endodontists. Exploratory surgery was performed for all patients as part of their treatment to ensure the presence/absence of VRF (gold standard).
Results: The kappa coefficient was 0.71 (95% CI: 0.59 to 0.84). The CBCT scans had 93% sensitivity, 78% specificity and 88% accuracy for detection of VRFs.
Conclusions: The results showed low specificity of CBCT imaging in detecting VRFs in endodontically-treated teeth.