Comparison of the Diagnostic Accuracy of Digital Intraoral Radiography with PSP and CBCT in the Detection of Horizontal and Vertical Dental Root Fractures

Clinical and radiographic diagnoses of dental root fractures have always been difficult and require high accuracy in dental care and treatment. The aim of this study was to compare the diagnostic accuracy of intraoral digital radiography (PSP) and CBCT in the detection of horizontal and vertical root fractures (HRF and VRF). For this experimental study, 60 human mandibular teeth (30 anterior and 30 posterior multi-rooted teeth) were selected. Thirty randomly-selected teeth were fractured horizontally while the next 30 randomly-selected teeth were fractured vertically by use of a hammer and then the pieces were glued back together and were placed in a sheep mandible. Radiographic images of all the teeth were taken using intraoral digital radiography (PSP) and CBCT methods. Afterwards, two oral and maxillofacial radiologists assessed the images separately. The data were subjected to diagnostic analytic tests. There were significant differences in specificity, sensitivity, positive predictive value and negative predictive value between digital intraoral radiography (PSP) and CBCT in the detection of HRF and VRF. Kappa value for inter-observer and intra-observer agreement in VRF equaled 73.3% for CBCT and 54.2% for PSP, while in HRF it equaled 63.3% for CBCT and 55.4% for PSP. CBCT method has higher specificity and sensitivity in the detection of HRF and VRF compared with intraoral digital radiography.