Effect of selecting cone-beam computed tomography for diagnosis of root fractures

Background/Aim The aim of this study was to investigate the diagnosability of root fractures by cone-beam computed tomography (CBCT) compared to intraoral radiography and panoramic radiography for finding the first choice of radiography to diagnose root fracture. Methods We reviewed the CBCT images of 60 patients with root fracture and 60 patients without root fracture. Diagnosability of root fractures by intraoral radiography, panoramic radiography, and CBCT was examined. The influence of metal materials to the diagnosability was also investigated. Sensitivity and specificity of CBCT were calculated. In the group that root fracture was diagnosable; the detection ability of root fractures by inspection was examined. Diagnosability according to vertical root fracture direction was also investigated. Statistical analyses were performed using chi(2) test or cross-tabulation. Results Diagnosability was statistically significantly different by radiography (P < .001), and most of root fracture was diagnosable by CBCT but it was impossible to diagnose by intraoral radiography and panoramic radiography (P < .05). Root fracture tended to be impossible to diagnose by CBCT because of the presence of metal materials around root fracture teeth (P < .05). The number of the root fractures that was diagnosable by intraoral radiography or panoramic radiography was more than root fracture detectable by inspection (P < .01) and bucco-lingual vertical fracture (P < .05). Conclusions These results made it clear that the first choice of radiography to diagnose the root fracture was CBCT especially in the case of suspected of mesio-distal vertical root fracture.