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Assessment of the quality of root canal fillings-an ex vivo comparison of CBCT scans, conventional intraoral sensors, and a novel photon-counting sensor
Journal article   Peer reviewed

Assessment of the quality of root canal fillings-an ex vivo comparison of CBCT scans, conventional intraoral sensors, and a novel photon-counting sensor

Matt Jervis, Erin Waid, Juliana B. Melo da Fonte, Daniela Pita de Melo, Karan J. Replogle, Saulo L. Sousa Melo and Juliana Batista Melo da Fonte
Dento-maxillo-facial radiology, Vol.54(3), pp.173-179
03/01/2025
DOI: 10.1093/dmfr/twaf005
PMID: 39821003

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Abstract

Objectives: To compare a novel photon-counting sensor, 2 CBCT protocols and 2 CMOS sensors on the detection of gaps between a gutta-percha cone and root canal walls. Methods: Twenty-five mandibular incisors were prepared to 45/0.04 (size/taper) at working length. Teeth were placed in a partially dentate mandible and single gutta-percha cones of 7 sizes were placed at length, one at a time, for image acquisition with a photon-counting sensor, 2 CBCT protocols (90 mu m(3), 120 mu m(3)) and 2 CMOS sensors. Three calibrated observers assessed images for gap presence. Sensitivity, specificity, accuracy, AUC, and agreement with gold standard were determined using ANOVA and Tukey test (P <= .05). Results: Photon-counting sensor showed superior sensitivity and accuracy (88.47%, 81.57%), significantly higher than the CBCT protocols (50.70%-56.33%, 45.87%-53.17%). Contrarily, the photon-counting sensor showed the lowest specificity (40.27%), significantly lower than the CBCT protocols (90.27%, 97.23%). CMOS sensors showed sensitivity, specificity, and accuracy between 72.23%-74.53%, not differing from other modalities. All intraoral sensors showed AUC around 82.87%-84.03%, significantly higher than CBCT protocol 120 mu m(3) (74.07%). The file size was inversely related to gap size and percentual agreement with gold standard. Conclusions: CMOS sensors showed consistent results, while the photon-counting sensor had the highest sensitivity but lacked specificity. CBCT protocols excelled in specificity but had lower sensitivity. Advances in knowledge: Novel photon-counting sensors and CBCT imaging provided no significant advantage over conventional sensors in assessing gaps as an indicator of quality of root canal filling. Furthermore, smaller gaps were more difficult to detect, regardless of the imaging technique used.
 Dentistry, Oral Surgery & Medicine Life Sciences & Biomedicine Radiology, Nuclear Medicine & Medical Imaging Science & Technology

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