Detection of Apical Root Cracks Using Spectral Domain and Swept-source Optical Coherence Tomography.

Area of Science:

• Dentistry
• Biomedical Imaging
• Endodontics

Background:

• Apical dentinal microcracks are a clinical concern in endodontics.
• Accurate detection of these microcracks is crucial for successful treatment outcomes.

Purpose of the Study:

• To evaluate the efficacy of two optical coherence tomography (OCT) systems in detecting apical dentinal microcracks.
• To compare the diagnostic performance of spectral domain OCT (SD-OCT) and swept-source OCT (SS-OCT).

Main Methods:

• Twenty extracted human single-rooted mandibular incisors were prepared and analyzed using micro-computed tomography (micro-CT) to identify apical microcracks.
• The apical portions were subsequently imaged using SD-OCT and SS-OCT.
• Three independent examiners evaluated the OCT images for microcrack detection in a blinded manner.

Main Results:

• Micro-CT identified apical microcracks in 60% of the specimens.
• Both OCT systems successfully visualized microcrack lines corresponding to micro-CT findings.
• While SD-OCT showed superior diagnostic performance, no statistically significant difference was found between the two OCT systems (P > .05).
• Inter- and intra-examiner agreement was substantial to almost perfect for both systems.

Conclusions:

• Both SD-OCT and SS-OCT systems demonstrate significant potential as diagnostic tools for apical dentinal microcracks.
• These OCT technologies offer a promising non-invasive approach for identifying root fractures in endodontic practice.