Development of a predictive model for identifying previously undetected vertical root fractures

Aust Endod J. 2023 Aug;49(2):302-310. doi: 10.1111/aej.12667. Epub 2022 Jul 21.

Abstract

This study aimed to develop a predictive model to screen for undetected vertical root fractures (VRFs) in root canal treated teeth. We included 95 root canal treated teeth with suspected VRFs; 77 for training and 18 for validation. Following clinical and cone-beam CT parameters were recorded: sex, tooth type, coronal restoration, time interval from completion of endodontic treatment to definitive diagnosis (TI), type of bone loss (BL), apical extent of root filling (AR) and the ratio of root filling diameter to the actual diameter in the coronal (1/3TA) and middle (2/3TA) root thirds. A predictive model p = 1/(1 - e-x ) was generated, where x = -7.433 + 1.977BL + 1.479 (2/3TA) + 1.102 AR; the sensitivity and specificity were 0.852 and 0.875 for training and 0.917 and 0.833 for validation. VRF teeth were more likely to have vertical bone loss and overfilled root canals. This model had a high diagnostic efficacy for VRFs.

Keywords: apical extent of root filling; bone loss; logistic regression model; root canal diameter; undetected vertical root fracture.

MeSH terms

  • Bone Diseases, Metabolic*
  • Cone-Beam Computed Tomography
  • Fractures, Bone*
  • Humans
  • Root Canal Therapy
  • Sensitivity and Specificity
  • Tooth Fractures* / diagnostic imaging
  • Tooth Fractures* / therapy
  • Tooth Root / diagnostic imaging
  • Tooth, Nonvital*