In vitro assessment of local computed tomography for the detection of longitudinal tooth fractures

ObjectiveTo test the accuracy of local computed tomography (LCT) in detecting longitudinal fractures in comparison with conventional periapical radiographs.Study designLongitudinal fractures were induced in 30 of 60 teeth. The teeth were placed in a dry dentate mandible with soft tissue simulation. A laboratory LCT unit was used to acquire 180 basis projections with 1° separation along a 180° arc. Conventional radiographs served as the control modality. Correlated axial, coronal, and sagittal views were presented to 10 observers. The observers determined the presence of a root fracture by using a 5-point receiver operating characteristic confidence scale.ResultsThe mean Az for LCT was 0.91 (SD = 0.07). The mean Az for conventional radiography was 0.70 (SD = 0.07). The difference between the modalities was statistically significant (analysis of variance: P < .0002), whereas the differences between the observers was not (analysis of variance: P = .319).ConclusionLocal CT significantly improves the detection of longitudinal fractures in vitro compared with conventional periapical radiography.