Detection of Vertical Root Fractures of Different Thicknesses in Endodontically Enlarged Teeth by Cone Beam Computed Tomography versus Digital Radiography

Introduction: This study was performed to compare the accuracy of cone beam computed tomography (CBCT) scans and digital radiography (DR) for detecting simulated vertical root fractures (VRFs) with different thicknesses in extracted human teeth. Methods: Eighty teeth were endodontically prepared and divided into 4 groups, 3 experimental and 1 control. The teeth in experimental groups were artificially fractured and fixed together with different thicknesses of 0.2 mm (0.2-mm VRF group), 0.4 mm (0.4-mm VRF group), and smaller than 0.2 mm (crack group). Teeth in control group were kept intact. Three observers evaluated the DR and CBCT images in terms of accuracy for VRF detection. Results: No significant differences in detection rate were noted among the observers (P > .5). The overall accuracy for detecting VRFs was significantly higher for CBCT scans compared with DR (P < .001). CBCT scans were more accurate in detecting 0.2-mm VRFs (70%) and 0.4-mm VRFs (90%) as compared with DR (43.3% and 60%, respectively). Conclusions: The results of this study showed that CBCT scans are effective for detecting VRFs of different thicknesses. (J Endod 2010;36:1245-1249)