Accuracy of intraoral radiography, multidetector helical CT, and limited cone-beam CT for the detection of horizontal tooth root fracture

Abstract

The accuracies of intraoral radiography (IOR), multidetector helical computerized tomography (MDHCT) at slice thicknesses 0.63 mm and 1.25 mm, and limited cone-beam computerized tomography (LCBCT) were compared for detection of horizontal tooth root fracture. In 7 beagle dogs, 28 maxillary anterior teeth were used, of which 13 had artificially induced horizontal root fracture. The specimens were examined by the above-mentioned 4 modalities. Diagnosis of root fracture was based on direct visualization of radiolucent line in each image by 6 radiologists. Sensitivity, negative predictive value, and diagnostic accuracy (true positives + true negatives) for detecting fracture lines in LCBCT (0.96 +/- 0.04, 0.97 +/- 0.03, 0.93 +/- 0.04, respectively) were significantly higher than MDHCT at 0.63 mm (0.76 +/- 0.09, 0.8 +/- 0.05, 0.8 +/- 0.05, respectively), MDHCT at 1.25 mm (0.49 +/- 0.09, 0.66 +/- 0.04, 0.69 +/- 0.05, respectively), and IOR (0.51 +/- 0.18, 0.67 +/- 0.08, 0.69 +/- 0.08, respectively). Specificity and positive predictive value showed no significant intermethod difference among the 4 modalities. Limited cone-beam CT is more useful than the other 3 radiographic modalities for diagnostic imaging of horizontal tooth root fracture.