In vitro Comparison of Diagnostic Accuracy of Cone Beam Computed Tomography with Periapical Direct Digital Radiography in Detection of Horizontal Root Fracture in Single Root Teeth

Between 0.5 to 7 percent of injuries in permanent teeth include root fractures. If it is left without diagnosis, tooth will become nonvital and subsequent necrotic pulp leads to loss of the tooth. Diagnosis is based on radiography (a radiolucent line /lines) and mobility of coronal segment of tooth. In this study accuracy of cone beam computed tomography(CBCT) was compared with periapical direct digital radiography (CCD) in evaluation of horizontal root fracture in single root teeth.

Method and material :

This in vitro study was performed on 90 recently extracted single root teeth. In study group horizontal fractures(45 teeth) were done by applying mechanical force of hammer and the each two broken segment were stuck together by glue and then imaging performed by CCD and CBCT . The images were evaluated by two radiologists as a single blind study. Results were analyzed by SPSS software ver. 22. To comparing sensitivity, specificity, positive and negative predictive value using Wilcoxon and MC Nemar analysis and Spearman’s correlation coefficient were calculated.

Sensitivity, specificity, positive and negative predictive value in CBCT were 97.8%, 95.6%, 93% 92% respectively and CCD were 86.7%, 66.7%, 80% and 85% respectively. Accuracy of CBCT was 93% and that of CCD was 60%.

The results for CBCT for both observers and gold standard were not significantly statistically different, but for CCD for one of the observers a significant difference was observed.