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Dental Vertical Root Fractures: Value of CT in Detection

¹ Departments of Radiology (S.Y., A.G., R.D., F.M.K.)
² Oral Surgery (T.B.), University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.

PURPOSE: To determine the value of computed tomography (CT) in the diagnosis of dental vertical root fractures relative to the value of conventional dental radiography.

MATERIALS AND METHODS: Thirty-seven patients with 42 teeth in which vertical root fracture was clinically suspected underwent dental radiography and axial CT. Two radiologists evaluated the images independently and by consensus for a fracture line. The results were compared with intraoperative findings.

RESULTS: Twenty-eight of the 42 teeth were proved intraoperatively to be fractured. The sensitivity and specificity averaged for the two reviewers in the assessment of vertical fractures were 23% and 70%, respectively, with dental radiography and 100% and 100%, respectively, with CT. Consensus reading showed sensitivities of 25% for dental radiography and 75% for CT. Eight (reviewer A) or nine (reviewer B) false-negative CT findings were encountered in cases in which metallic artifacts obscured parts of the root and in cases in which the root was very small in diameter. Interobserver agreement was 95% for dental radiography and 93% for CT.

CONCLUSION: CT is superior to dental radiography in the detection of dental vertical root fractures.

Index terms: Fractures, 25.4153 • Jaws, CT, 24.1211 • Teeth, 25.1211, 25.4153

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