Comparison of cone beam CT scans with enhanced photostimulated phosphor plate images in the detection of root fracture of endodontically treated teeth

B Bechara; C A McMahan; M Noujeim; T Faddoul; W S Moore; F B Teixeira; H Geha

doi:10.1259/dmfr.20120404

$Comparison of cone beam CT scans with enhanced photostimulated phosphor plate images in the detection of root fracture of endodontically treated teeth$

Journal article

Open access

Peer reviewed

Comparison of cone beam CT scans with enhanced photostimulated phosphor plate images in the detection of root fracture of endodontically treated teeth

B Bechara, C A McMahan, M Noujeim, T Faddoul, W S Moore, F B Teixeira and H Geha

Dento-maxillo-facial radiology, Vol.42(7), pp.20120404-20120404

2013

DOI: 10.1259/dmfr.20120404

PMCID: PMC3699972

PMID: 23625067

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Abstract

Two-dimensional intraoral radiography is the most common tool for diagnosing root fractures (RFs). Cone beam CT (CBCT) is widely used to depict RFs in endodontically treated teeth. Beam hardening and other artefacts caused by gutta percha may result in an incorrect diagnosis when using CBCT only. A comparison of two CBCT machines with photostimulated phosphor (PSP) plate images enhanced with the equalization tool was carried out to detect RFs in endodontically treated teeth. 66 roots were collected, decoronated and treated endodontically using the same technique with gutta percha. 33 of these roots were randomly selected and fractured; the 2 root fragments were glued together with 1 layer of methyl methacrylate and placed randomly in 8 prepared beef rib fragments. Large fields of view (FOVs) were acquired with one CBCT unit and small FOVs with the second CBCT unit. Periapical radiographs (using intraoral PSP plates) were also acquired. A contrast enhancement tool was used when evaluating the PSP plate images. Small FOV images had significantly higher accuracy (area under the receiver operating characteristic curve) and sensitivity in detecting RFs than PSP plates and large FOV images. The specificity of the enhanced PSP images was higher than, although not significantly higher than, the small FOV images and was significantly higher than the large FOV images. CBCT small FOVs should be acquired for depicting RFs of endodontically treated teeth. Images obtained using PSP plates had the lowest rate of false-positive results and their use can save the patient a radiation dose.

Tooth, Nonvital - diagnostic imaging

Radiography, Dental, Digital - methods

Tooth Fractures - diagnostic imaging

Area Under Curve

Gutta-Percha - therapeutic use

Humans

Dental Pulp Cavity - diagnostic imaging

Radiography, Bitewing - statistics & numerical data

Radiation Dosage

False Positive Reactions

Root Canal Filling Materials - therapeutic use

Radiographic Image Enhancement - instrumentation

Radiography, Dental, Digital - statistics & numerical data

X-Ray Intensifying Screens

Cone-Beam Computed Tomography - statistics & numerical data

Radiography, Bitewing - instrumentation

Time Factors

Sensitivity and Specificity

ROC Curve

Tooth Root - injuries

Cone-Beam Computed Tomography - methods

Observer Variation

Details

Title: Subtitle: Comparison of cone beam CT scans with enhanced photostimulated phosphor plate images in the detection of root fracture of endodontically treated teeth
Creators: B Bechara - Department of Comprehensive Dentistry, Oral and Maxillofacial Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA. boulosbchara@hotmail.com
C A McMahan
M Noujeim
T Faddoul
W S Moore
F B Teixeira
H Geha
Resource Type: Journal article
Publication Details: Dento-maxillo-facial radiology, Vol.42(7), pp.20120404-20120404
DOI: 10.1259/dmfr.20120404
PMID: 23625067
PMCID: PMC3699972
NLM abbreviation: Dentomaxillofac Radiol
ISSN: 0250-832X
eISSN: 1476-542X
Publisher: England
Language: English
Date published: 2013
Academic Unit: Endodontics
Record Identifier: 9984065701802771

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