Detection of vertical root fractures: an investigation on the impact of using orthogonal and dissociated radiographs in conventional and digital systems

Lisangela da Silva, Priscila Fernanda da Silveira, Mariana Boessio Vizzotto, Gabriela Salatino Liedke, Heraldo Luis Dias da Silveira, Heloísa Emília Dias da Silveira

Introduction: Intraoral radiographs are an important inves- tigative aid in the detection of endodontic injuries, including vertical root fractures (VRF). Objective: The objective of this study was to assess the capacity of orthogonal and an- gulated conventional as well as digital radiographs to detect VRF in teeth under different root conditions. Methods: Sixty teeth were divided into three groups according to the canal condition: non-filled, filled with gutta-percha and filled with gutta-percha and metallic post. Ten teeth in each group were artificially fractured, whereas teeth in the con- trol group were not fractured. Orthogonal and horizontally angulated conventional film (Kodak) and digital phosphor plate (VistaScan Dürr Dental) were used. Three blinded and calibrated observers carried out evaluations at four differ- ent time intervals. Modal values were used to calculate sen- sibility, specificity and accuracy. The area under the ROC curve (aucROC) and confidence intervals (CI) was used to compare the performance between radiographic systems, as well as the influence of combined angulated images. Re- sults: Angulated radiographs showed larger aucROC for both conventional and digital images. CI revealed statisti- cally significant differences between conventional orthogo- nal and digital angulated radiographs (CI: 0.403 – 0.697 and 0.767 – 0.967, respectively). Moreover, when only orthogo- nal incidences were considered, digital radiographs yielded better results than the conventional ones (CI: 0.403 – 0.697 and 0.622 – 0.878, respectively). Conclusion: The strong inclination towards yielding better diagnostic test results provided by digital radiographs suggests that the digital system using angulated projections is more appropriate to investigate VRF than the conventional one.

Keywords: Diagnosis. Endodontics. Dental radiography.

How to cite: Silva L, Silveira PF, Vizzotto MB, Liedke GS, Silveira HLD, Silveira HED. Detection of vertical root fractures: An investigation on the impact of using orthogonal and dissociated radiographs in conventional and digital systems. Dental Press Endod. 2014 Jan-Apr;4(1):46-50. doi: http://dx.doi.org/10.14436/2178-3713.4.1.046-050.oar

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