Influence of Cone-beam Computed Tomographic Scan Mode for Detection of Horizontal Root Fracture

IntroductionThe purpose of the present study was (1) to test the accuracy of a small-volume cone-beam computed tomographic (CBCT) device in detecting horizontal root fractures (HRFs) in teeth with and without an intracanal metallic post (IMP) and (2) to investigate the use of 2 different acquisition protocols of a CBCT device for HRF diagnosis.MethodsForty endodontically treated teeth with and without an IMP were examined using PreXion 3D CBCT scanner (Terarecon, San Mateo, CA) with a 5-cm high and 5-cm diameter cylinder at 0.10-mm voxel reconstruction. Two observers analyzed the samples to determine the presence and location of HRFs.ResultsSensitivity values ranged from 0.40–0.80. The most favorable results were found for the samples with no IMP observed using the protocol of a higher number of x-ray projections (0.70–0.80). Accuracy in the groups with an IMP ranged from 75%–90% in the 1024 x-ray projection protocol (HI-HI group) versus 70%–85% for the same samples examined in the 512 x-ray projection protocol (HI-STD group). Intraobserver agreement ranged from relevant to perfect concordance for both protocols (HI-HI = Kappa: 0.60–1.00 and HI-STD = Kappa: 0.55–0.89). Interobserver agreement ranged from moderate to perfect concordance for both protocols (HI-HI = Kappa: 0.79–0.89 and HI-STD = Kappa: 0.42–0.76).ConclusionsEven though there are statistically significant differences for the protocol with the higher number of x-ray projections, we found high accuracy, sensitivity, sensibility, and intra- and interobserver agreement in detecting HRFs for both Prexion 3D protocols.