Objective: Detecting vertical root fractures (VRFs) can be challenging in dentistry due to their subtle and often concealed nature. This study aimed to assess the impact of varying resolutions and delayed scanning times of photostimulable phosphor plates on the diagnosis of VRFs. Can different resolutions and/or delayed scan times enhance the diagnosis of VRFs? Material and Methods: In this in vitro study, forty extracted single-rooted premolar teeth were utilized. The crowns of all teeth were removed, and root canals were prepared. The teeth were divided into 2 groups: 20 study teeth with VRFs and 20 teeth without VRFs. VRFs were created using an Instron machine. All tooth roots were positioned in the premolar region of a dry human mandible and fixed with wax. Subsequently, periapical radiographs were taken using a parallel technique. Radiographs were scanned at 4 different times post-exposure: immediately, 30 minutes later, 2 hours later, and 4 hours later, and at three different resolutions: high speed, high resolution, and super high resolution. Statistical analyses were conducted using IBM SPSS statistics 26.0. Results: Intra- and interobserver agreement exhibited substantial to almost perfect ranges of agreement. Statistically significant differences were not observed in the diagnosis of VRFs when comparing different resolutions and scanning times. Conclusion: Varying resolutions and/or delayed scan times did not improve the diagnosis of VRFs. In clinical practice, a comprehensive detection of VRFs might necessitate a combination of different imaging techniques, immediately scanning, optimizing resolution settings, and clinical assessment.
Keywords: Diagnostic imaging; root canal preparation; in vitro study
Amaç: Diş hekimliğinde, dikey kök kırıklarının (DKK) teşhisi, kırıkların belirgin olmayan ve genellikle net olarak görüntülenemeyen niteliklerinden dolayı zor olabilir. Bu çalışma, fotostimüle edilebilir plakaların farklı çözünürlüklerinin ve gecikmeli tarama zamanlarının DKK'lerin teşhisi üzerindeki etkisini değerlendirmeyi amaçlamaktadır. Farklı çözünürlükler ve/veya gecikmeli tarama zamanları, DKK'lerin teşhisini kolaylaştırabilir mi? Gereç ve Yöntemler: Bu in vitro çalışmada, 40 çekilmiş tek köklü premolar diş kullanıldı. Tüm dişlerin kronları minesement sınırından kesilerek, uzaklaştırıldı ve kök kanal preparasyonları yapıldı. Dişler, 20 DKK'li çalışma grubu ve 20 DKK'siz kontrol grubu olmak üzere 2 gruba ayrıldı. DKK'leri, bir Instron makinesi kullanılarak oluşturuldu. Tüm diş kökleri, kuru bir insan mandibulasının premolar bölgesine yerleştirildi, mum ile sabitlendi. Ardından, paralel teknik kullanılarak periapikal radyograflar çekildi. Radyograflar, ışınlamadan hemen sonra, 30 dk sonra, 2 saat sonra ve 4 saat sonra olmak üzere 4 farklı zaman diliminde ve yüksek hız, yüksek çözünürlük ve süper yüksek çözünürlük olmak üzere 3 farklı çözünürlükte tarandı. İstatistiksel analizler IBM SPSS statistics 26.0 kullanılarak gerçekleştirildi. Bulgular: Gözlemci içi uyum, önemli derecede yüksek; gözlemciler arası uyum neredeyse mükemmel olarak gözlendi. Farklı çözünürlüklerde ve farklı tarama zamanlarında, DKK teşhisinde istatistiksel olarak anlamlı farklılıklar gözlemlenmedi. Sonuç: Farklı çözünürlükler ve/veya gecikmeli tarama zamanları, DKK'lerin teşhisini iyileştirmedi. Klinik uygulamada, DKK'lerin kapsamlı bir şekilde teşhisi, farklı görüntüleme tekniklerinin kombinasyonunu, ışınlamadan hemen sonra taramayı, çözünürlük ayarlarını optimize etmeyi ve klinik değerlendirmeyi gerektirebilir.
Anahtar Kelimeler: Tanısal görüntüleme; kök kanalı şekillendirmesi; in vitro çalışma
- Khasnis SA, Kidiyoor KH, Patil AB, Kenganal SB. Vertical root fractures and their management. J Conserv Dent. 2014;17(2):103-10. [Crossref] [PubMed] [PMC]
- Patel S, Brady E, Wilson R, Brown J, Mannocci F. The detection of vertical root fractures in root filled teeth with periapical radiographs and CBCT scans. Int Endod J. 2013;46(12):1140-52. [Crossref] [PubMed]
- García-Guerrero C, Parra-Junco C, Quijano-Guauque S, Molano N, Pineda GA, Marín-Zuluaga DJ. Vertical root fractures in endodontically-treated teeth: A retrospective analysis of possible risk factors. J Investig Clin Dent. 2018;9(1). [Crossref] [PubMed]
- Nascimento HA, Ramos AC, Neves FS, de-Azevedo-Vaz SL, Freitas DQ. The 'Sharpen' filter improves the radiographic detection of vertical root fractures. Int Endod J. 2015;48(5):428-34. [Crossref] [PubMed]
- Nascimento HA, Visconti MA, Ferreira LM, Suarez MA, Haiter Neto F, Freitas DQ. Effect of delayed scanning on imaging and on the diagnostic accuracy of vertical root fractures in two photostimulable phosphor plates digital systems. Int Endod J. 2016;49(10):973-9. [Crossref] [PubMed]
- Akdeniz BG, Gröndahl HG, Kose T. Effect of delayed scanning of storage phosphor plates. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99(5):603-7. [Crossref] [PubMed]
- Martins MG, Whaites EJ, Ambrosano GM, Haiter Neto F. What happens if you delay scanning Digora phosphor storage plates (PSPs) for up to 4 hours? Dentomaxillofac Radiol. 2006;35(3):143-6. [Crossref] [PubMed]
- Li G, Berkhout WE, Sanderink GC, Martins M, van der Stelt PF. Detection of in vitro proximal caries in storage phosphor plate radiographs scanned with different resolutions. Dentomaxillofac Radiol. 2008;37(6):325-9. [Crossref] [PubMed]
- Junqueira RB, Verner FS, Campos CN, Devito KL, do Carmo AM. Detection of vertical root fractures in the presence of intracanal metallic post: a comparison between periapical radiography and cone-beam computed tomography. J Endod. 2013;39(12):1620-4. [Crossref] [PubMed]
- Chang E, Lam E, Shah P, Azarpazhooh A. Cone-beam Computed Tomography for Detecting Vertical Root Fractures in Endodontically Treated Teeth: A Systematic Review. J Endod. 2016;42(2):177-85. [Crossref] [PubMed]
- Edlund M, Nair MK, Nair UP. Detection of vertical root fractures by using cone-beam computed tomography: a clinical study. J Endod. 2011;37(6):768-72. [Crossref] [PubMed]
- Neves FS, Freitas DQ, Campos PS, Ekestubbe A, Lofthag-Hansen S. Evaluation of cone-beam computed tomography in the diagnosis of vertical root fractures: the influence of imaging modes and root canal materials. J Endod. 2014;40(10):1530-6. [Crossref] [PubMed]
- Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159-74. [Crossref] [PubMed]
- Ezzodini Ardakani F, Razavi SH, Tabrizizadeh M. Diagnostic value of cone-beam computed tomography and periapical radiography in detection of vertical root fracture. Iran Endod J. 2015;10(2):122-6. [PubMed] [PMC]
- Valizadeh S, Khosravi M, Azizi Z. Diagnostic accuracy of conventional, digital and Cone Beam CT in vertical root fracture detection. IEJ Iranian Endodontic Journal 2011;6(1):15-20. [Link]
- Varshosaz M, Tavakoli MA, Mostafavi M, Baghban AA. Comparison of conventional radiography with cone beam computed tomography for detection of vertical root fractures: an in vitro study. J Oral Sci. 2010;52(4):593-7. [Crossref] [PubMed]
- Wenzel A, Haiter-Neto F, Frydenberg M, Kirkevang LL. Variable-resolution cone-beam computerized tomography with enhancement filtration compared with intraoral photostimulable phosphor radiography in detection of transverse root fractures in an in vitro model. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(6):939-45. [Crossref] [PubMed]
- Wenzel A, Kirkevang LL. High resolution charge-coupled device sensor vs. medium resolution photostimulable phosphor plate digital receptors for detection of root fractures in vitro. Dent Traumatol. 2005;21(1):32-6. [Crossref] [PubMed]
- De Martin E Silva D, Campos CN, Pires Carvalho AC, Devito KL. Diagnosis of mesiodistal vertical root fractures in teeth with metal posts: influence of applying filters in cone-beam computed tomography images at different resolutions. J Endod. 2018;44(3):470-4. [Crossref] [PubMed]
- Sogur E, Baksi BG, Mert A. The effect of delayed scanning of storage phosphor plates on occlusal caries detection. Dentomaxillofac Radiol. 2012;41(4):309-15. [Crossref] [PubMed] [PMC]
.: Process List