Cone beam computed tomography image optimization to detect root fractures in endodontically treated teeth: an in vitro (phantom) study

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The aim of this study was to evaluate the effect of an optimization filter (OF) and voxel size on the accuracy of root fracture detection.

Study Design.

Half of 40 endodontically treated roots were fractured, and the other half were left intact. All teeth were randomly placed into 5 bovine ribs. Each rib was scanned with the Planmeca ProMax 3-D using 4 different settings: 75 μm and 100 μm voxel size with and without an OF. Five reviewers reported if a fracture was present by using a 5-point scale. Intra-/interobserver agreement, area under the receiver operative characteristic curve, accuracy, sensitivity, and false-positive rates were analyzed.


High κ-values indicated strong intra-/interobserver agreement. There was no significant difference in fracture detection between any of the evaluated techniques.


Because of the decreased cost, dose area product, and time required, compared with the other imaging modalities studied, the high-resolution mode (100 μm) without an OF is recommended for root fracture detection in endodontically treated teeth.

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