RESUMO
AIM: To evaluate (i) the accuracy of three intra-oral digital systems in detecting vertical root fractures (VRFs); and (ii) the influence of different intracanal conditions (without filling, filled with Gutta-percha and metal or fibreglass post). METHODOLOGY: Forty single-rooted human teeth were decoronated and the root canals prepared. VRFs were induced using a universal testing machine on 20 teeth. Radiographic images were obtained using the paralleling technique with three different horizontal angulations on conventional E/F film, two storage phosphor plates (Digora Optime and VistaScan) and one sensor system (SnapShot). All teeth were radiographed with all intracanal conditions tested. All images were evaluated by five examiners. After 30 days, 25% of the images were reviewed. Areas under ROC curves, sensitivity, specificity, accuracy, positive predictive and negative predictive values were compared by anova. RESULTS: The weighted kappa values for intra- and interobserver reproducibility were 0.48-0.74 and 0.57-0.66, respectively. The sensitivity revealed a significant difference between imaging modalities, with higher values for SnapShot (0.53) and VistaScan (0.46), followed by the film (0.41) and Digora (0.38). The area under the ROC curve for SnapShot (0.82) was greater than for the other systems in the teeth with a fibreglass post (VistaScan: 0.70; Digora: 0.64; film: 0.60). CONCLUSION: All systems gave a similar performance for detecting VRFs; all gave a good performance in the absence of intracanal materials, but performed less well in the presence of a metal post or Gutta-percha. In teeth with a fibreglass post, digital systems with higher resolution should be used.
Assuntos
Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/lesões , Vidro , Guta-Percha/uso terapêutico , Humanos , Técnica para Retentor Intrarradicular , Radiografia Dentária Digital , Reprodutibilidade dos Testes , Materiais Restauradores do Canal Radicular/uso terapêutico , Obturação do Canal Radicular/métodos , Dente não Vital/diagnóstico por imagemRESUMO
AIM: To compare the diagnostic accuracy of digital enhancement filters in the diagnosis of vertical root fractures. METHODOLOGY: The sample consisted of 40 single-rooted teeth randomly divided into two groups: experimental and control. Vertical root fractures were induced in the experimental group using a universal testing machine. All teeth were individually radiographed with three different horizontal angles using the Digora Optime(®) digital system. Three observers separately examined the original and filtered images (3D Emboss, Negative, Sharpen and Shadow). The area under Receiver Operating Characteristic curve values (Az) for each protocol were compared by one-way anova with post hoc Bonferroni test. The significance level was set at 5%. RESULTS: The highest Az value was obtained using the Sharpen filter, with significant differences from the original and other filtered images (P < 0.05). The 3D Emboss filter had the lowest Az value, which was significantly different from the other filtered images (P < 0.05). CONCLUSION: When using the Digora Optime(®) system, the 'Sharpen' filter is recommended to improve the radiographic detection of vertical root fractures.