Vol. 10, Issue 3, Part C (2024)

Background: Vertical root fractures (VRFs) are longitudinal fractures originating from the apical end of the root and propagating coronally, posing diagnostic challenges in endodontic therapy using digital radiographs. This study aimed to carry out a comparison of the diagnostic accuracy of Cone Beam Computed Tomography (CBCT) and Radio Visio Graphy (RVG) in detecting simulated VRFs with varying thicknesses in extracted human single-rooted premolars

Materials and Methods: Sixty freshly extracted human single-rooted premolar teeth were collected and prepared. After decoronation, access was gained to the canal, and biomechanical preparation was performed. The teeth were categorized into three experimental groups and one control group. VRFs were then simulated in the three experimental groups by the mallet and chisel delivering force vertically from above, hence resulting in two vertical fragments of teeth which were re-attached at gaps of 0.4 mm (Group 1), 0.2 mm (Group 2), and less than 0.2 mm (Group 3). CBCT and RVG imaging were performed on all groups to detect VRFs. Descriptive statistics, chi-square tests, and Kappa coefficient tests were conducted using SPSS.

Results: CBCT scans demonstrated higher overall accuracy compared to RVG for detecting VRFs. The sensitivity of RVG compared to CBCT for 0.4 mm, 0.2 mm, and less than 0.2 mm fractures was 66.7%, 40%, and 25%, respectively. The Kappa coefficient test indicated non-significant agreement (p>0.05) between CBCT and RVG in diagnosing VRFs. CBCT was found to be significantly more accurate in detecting VRFs less than 0.2 mm thick (p<0.05) as compared to RVG.

Conclusion: Within the limitations of this in-vitro study, CBCT showed superior accuracy compared to RVG in detecting VRFs of different thicknesses, particularly for fractures less than 0.2 mm thick. CBCT exhibited higher sensitivity, making it a more reliable diagnostic tool for VRFs.