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Cone-beam Computed Tomography for Detecting Vertical Root Fractures in Endodontically Treated Teeth: A Systematic
Edwin Chang1, Ernest Lam1, Prakesh Shah2
1Discipline of Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
Journal of Endodontics
|December 4, 2015
Summary
Cone-beam computed tomography (CBCT) shows limited reliability for detecting vertical root fractures (VRFs) in endodontically treated teeth. Current evidence is insufficient due to imprecise estimates and study biases.
Area of Science:
- Endodontics
- Dental Imaging
- Diagnostic Accuracy
Background:
- Vertical root fractures (VRFs) are common in endodontically treated teeth, posing diagnostic challenges.
- Image artifacts from root-filling materials can impede VRF detection using Cone-beam computed tomography (CBCT).
Purpose of the Study:
- To systematically review the diagnostic performance of CBCT for detecting VRFs in endodontically treated teeth.
Main Methods:
- Systematic review of in vivo clinical diagnostic accuracy studies.
- Searches conducted in December 2014 and updated in August 2015.
- Methodological quality assessed using the modified Quality Assessment of Diagnostic Accuracy Studies tool.
Main Results:
- Four studies with 130 patients were included.
- Wide ranges reported for VRF prevalence (40%-90%) and diagnostic values (sensitivity, specificity, PPV, NPV).
- All included studies exhibited high risk or unclear risk of bias.
Conclusions:
- Significant imprecision in diagnostic estimates and observed biases limit current evidence.
- CBCT is not currently considered a reliable test for detecting VRFs in endodontically treated teeth.
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