Value of cone beam CT in detection of dental root fractures

The primary objective of this investigation was to evaluate the detection of root fracture using cone beam CT (CBCT) images and compare these findings with real samples of extracted teeth. A second aim was to determine the importance of reconstructed images in the diagnosis of root fracture.

Conventional periapical radiographs and CBCT images of 10 cases, each with a suspected diagnosis of root fracture, were evaluated in accordance with a pre-established scoring system by a maxillofacial radiologist who was unaware of the clinical symptoms of the patients. Then, the radiologist and an endodontist, aware of patient symptomatology, performed a second evaluation by cross-comparison of these images with clinical findings. Final patient results were based on direct visualization of each extracted tooth and its colourization.

CBCT shows good potential for use in the detection of root fracture as it ensures a high level of diagnostic score accuracy. Reconstructed axial views were more effective in confirming specific diagnoses than other reconstructed views. Combining the clinical and radiographic findings further improved the results.

CBCT can be an ideal alternative in the diagnosis of root fracture in the field of endodontics. This option may also increase assurance of dentists and oral surgeons obtaining an accurate diagnosis of their patients' problems and help decrease the potential failure of treatment and/or the prescription of unwarranted dental procedures.