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Exploring Diagnostic Reliability of CBCT for Vertical Root Fractures: A Systematic Review and Meta-Analytical Approach

  • 0Department of Diagnosis and Oral Health, Division of Endodontics, School of Dentistry, University of Louisville, Louisville, Kentucky, USA.
International Journal of Dentistry +

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July 29, 2025

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July 29, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Cone-beam computed tomography (CBCT) effectively diagnoses complete vertical root fractures (VRFs). However, metal posts reduce accuracy, while smaller voxel sizes improve detection in laboratory settings.

Area Of Science

  • Dentistry
  • Oral and Maxillofacial Radiology

Background

  • Vertical root fractures (VRFs) are a significant cause of tooth loss.
  • Accurate diagnosis of VRFs is crucial for appropriate treatment planning.
  • Cone-beam computed tomography (CBCT) is increasingly used for endodontic diagnostics.

Purpose Of The Study

  • To systematically review factors influencing the diagnostic accuracy of CBCT for VRFs in vitro.
  • To evaluate the impact of fracture type, intracanal materials, and imaging parameters on CBCT performance.

Main Methods

  • Systematic literature search of major databases up to May 2025.
  • Inclusion of in vitro studies assessing CBCT diagnostic accuracy for laboratory-induced VRFs.
  • Quality assessment using QUADAS-2 and meta-analysis with bivariate random-effects models.
  • Meta-regression to investigate confounding factors and GRADE for evidence quality.

Main Results

  • CBCT demonstrated higher sensitivity for complete VRFs than incomplete fractures.
  • Metal posts significantly reduced both sensitivity and specificity.
  • Smaller voxel sizes improved VRF detection in teeth with metal posts.
  • Fracture pattern, intracanal materials, and voxel size were key factors affecting diagnostic accuracy.

Conclusions

  • CBCT is a valuable tool for diagnosing VRFs, particularly complete fractures.
  • The presence of metal posts and the chosen voxel size are critical considerations for optimizing diagnostic accuracy.
  • Further research should focus on standardizing imaging protocols to enhance VRF detection.

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