Assessment of the Influence of Different Intracanal Materials on the Detection of Root Fracture in Birooted Teeth by Cone-beam Computed Tomography

Luiz Eduardo Marinho Vieira; Elisa Diniz de Lima; Larissa Rangel Peixoto; Martina Gerlane Oliveira Pinto; Saulo L Sousa Melo; Matheus Lima Oliveira; Karla Rovaris Silva; Patrícia Meira Bento; Daniela Pita de Melo

doi:10.1016/j.joen.2019.10.028

Assessment of the Influence of Different Intracanal Materials on the Detection of Root Fracture in Birooted Teeth by Cone-beam Computed Tomography

J Endod. 2020 Feb;46(2):264-270. doi: 10.1016/j.joen.2019.10.028. Epub 2019 Dec 5.

Authors

Luiz Eduardo Marinho Vieira¹, Elisa Diniz de Lima¹, Larissa Rangel Peixoto¹, Martina Gerlane Oliveira Pinto¹, Saulo L Sousa Melo², Matheus Lima Oliveira³, Karla Rovaris Silva⁴, Patrícia Meira Bento¹, Daniela Pita de Melo⁵

Affiliations

¹ Department of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil.
² Department of Integrative Biomedical and Diagnostic Sciences School of Dentistry, Oregon Health and Science University, Portland, Oregon.
³ Department of Oral Diagnosis, University of Campinas, Piracicaba, São Paulo, Brazil.
⁴ Department of Dentistry, Federal University of Piauí, Teresina, Piauí, Brazil.
⁵ Department of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil. Electronic address: danipita@gmail.com.

PMID: 31812360
DOI: 10.1016/j.joen.2019.10.028

Abstract

Introduction: The aim of this study was to assess 2 cone-beam computed tomographic systems on the detection of artificially induced vertical root fractures (VRFs) and artifact intensity using birooted teeth restored with different intracanal materials.

Methods: The sample consisted of 20 extracted birooted premolars. Root fracture was induced in half of the sample. Seven intracanal material combinations were used in each tooth, 1 at a time: unrestored, gutta-percha, a buccal root with gutta-percha and a lingual root with a fiberglass post, a buccal root with gutta-percha and a lingual root with a metal core fiberglass post, fiberglass posts, metal core fiberglass posts, and NiCr posts. Cone-beam computed tomographic scans were acquired using CS 9000 3D (Carestream Dental Rochester, NY) and OP300 (Instrumentarium Dental Inc, Tuusula, Finland) units. Exposure parameters were fixed at 90 kV and 8 mA. The voxel size and field of view were set at 0.085 mm and 5 × 5 cm for OP300 and 0.076 mm and 5 × 3.75 cm for CS 9000, respectively. Two observers assessed all images using a 5-point confidence scale for VRF detection and a 4-point score for artifact interference. The sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve were compared using 2-way analysis of variance and the Tukey test (α = 0.05). Artifact interference was evaluated by descriptive statistics and the chi-square test.

Results: There were significant differences between scanners (P > .05) and among the different intracanal material groups (OP300) (P < .05) for specificity. When a metal post was present in both roots, severe artifact interference was observed in all images.

Conclusions: CS 9000 3D presented better performance than OP300 on VRF detection of endodontically treated teeth. Unrestored teeth and teeth filled with fiberglass posts were considered the groups with the lowest artifact interference and the highest VRF detection results.

Keywords: Artifact; bicuspid; cone-beam computed tomography; diagnostic imaging; tooth root.

MeSH terms

Cone-Beam Computed Tomography*
Finland
Gutta-Percha
Humans
Tooth Fractures* / diagnostic imaging
Tooth Root / diagnostic imaging
Tooth, Nonvital* / diagnostic imaging

Substances

Gutta-Percha