OBJECTIVETo evaluate the diagnostic accuracy of the cone beam computed tomography (CBCT) in detecting suspicious vertical root fractures (VRF) of molars on periapical radiography.

METHODSForty-five teeth of 45 patients with clinical signs and symptoms suggestive of VRF but not confirmed by periapical radiographs were collected. All of these 45 teeth accepted the examination of CBCT and were extracted for conceivable bad prognosis. All these teeth were extracted by minimally invasive surgery, and the conditions of the roots were observed to make sure the VRF happened or not before extraction. Nine teeth were excluded post operation because of fragmented and horizontal root fracture. Thirty-six teeth were included in this study. Two dentists observed the CBCT images of the teeth independently and reached a consensus. Diagnosis test was performed in this study.

RESULTSThe sensitivity, specificity, and accuracy of the CBCT in detecting VRF were 72.4%, 91.8% and 84.6%. The positive predictive value and negative predictive value and Youden index were 84.0%, 84.9% and 0.642 respectively.

CONCLUSIONSCBCT should be used in diagnosing VRF in those cases which could not be confirmed by clinical signs, symptoms and periapical radiographs. But for those cases with metal restorations were not recommended for further CBCT examination.

Cone-Beam Computed Tomography ; Humans ; Molar ; Sensitivity and Specificity ; Tooth Fractures ; diagnostic imaging ; Tooth Root

Cone-Beam Computed Tomography ; methods ; Humans ; Risk Factors ; Tooth Extraction ; Tooth Fractures ; diagnosis ; diagnostic imaging ; etiology ; therapy ; Tooth Root ; injuries

OBJECTIVETo observe the outcome of the fractured immature anterior permanent teeth after pulpotomy by X-ray measurement.

METHODSA total of 31 (25 cases) fractured immature anterior permanent teeth after pulpotomy was reviewed. Radiographic measurements were performed on 12 cases with unilateral fractured central incisors and completely formed roots after pulpotomy and 100 (50 subjects) healthy maxillary central incisors.

RESULTSThe roots development continued after pulpotomy, and the root length and periapical configuration were both similar to the healthy teeth, but some root canals became narrow or even nearly obturated at the root apex. There was no significant difference in root canal width between healthy right and left maxillary central incisors at the site of 1/4 [right: (0.67 +/- 0.14) mm, left: (0.66 +/- 0.12) mm, P > 0.05], 1/2 [right: (1.05 +/- 0.19) mm, left: (1.04 +/- 0.17) mm, P > 0.05], 3/4 [right: (1.78 +/- 0.34) mm, left: (1.76 +/- 0.30) mm, P > 0.05] of root, but the root canal width of the fractured incisors at the same site was significantly different from that of the contralateral healthy incisor, the 1/4 site pulpotomy: (0.70 +/- 0.23) mm, control: (0.99 +/- 0.17) mm, the 1/2 site pulpotomy: (1.16 +/- 0.24) mm, control: (1.51 +/- 0.25) mm; the 3/4 site pulpotomy: (1.96 +/- 0.34) mm, control: (2.24 +/- 0.36) mm.

CONCLUSIONSThere was a tendency that the root canals of fractured teeth after pulpotomy became narrowed and obturated. It should not be followed up for too long to perform root canal treatment when roots completely formed.

Adolescent ; Female ; Humans ; Incisor ; diagnostic imaging ; injuries ; surgery ; Male ; Pulpotomy ; Radiography ; Root Canal Therapy ; Tooth Fractures ; diagnostic imaging ; surgery ; Treatment Outcome ; X-Ray Film

OBJECTIVE: To study the effect of various intracanal materials on the accuracy of oral maxillofacial cone-beam computed tomography (CBCT) for the diagnosis of vertical root fracture (VRF). METHODS: A total of twenty-four structurally intact single root canal dried and isolated teeth extracted for orthodontic treatment or periodontal disease were collected. The teeth were decrowned along the cemento-enamel junction (CEJ) and then used as samples for the study after conventional root canal preparation and post preparation. The 24 samples were divided into two groups with 12 samples in each group. Group A was the control group (no VRF group). According to intracanal materials, they were divided into five subgroups: blank group, fiber post group, gutta-percha point group, titanium post group and gold-palladium post group. Group B was the experimental group (VRF group), and subgroups were grouped as above. The VRF model was prepared by a unified method in the VRF group: the root was completely fractured in the buccolingual direction with a custom root canal nail and then cemented and reset. The control group was not subjected to the simulation of VRF. Titanium post and gold-palladium post were made according to the individuality of the root canal preparation, and the tightness of the post to the root canal wall was confirmed by X-ray radiograph. Then all the samples were scanned by CBCT in the isolate swine mandibular alveolar sockets. The diagnostic accuracy was statistically analyzed via blind interpretation by experienced endodontic specialists and oral and maxillofacial medical imaging specialists. RESULTS: The accuracy of the diagnosis of VRF in the blank group, fiber post group, gutta-percha point group, titanium post group, and gold-palladium post group in CBCT was 95.83%, 91.67%, 87.50%, 79.17%, and 45.83%, respectively. Compared with the blank group, the differences were not statistically significant in the fiber post group (P>0.999), the gutta-percha point group (P=0.500) and the titanium post group (P=0.125). The lowest diagnostic accuracy of VRF was found in the gold-palladium post group, and the difference was statistically significant compared with all other groups (P < 0.001). CONCLUSION Various intracanal materials have different degrees of influence on the diagnostic accuracy of VRF diagnosis in CBCT. The influence of fiber post, gutta-percha point and titanium post was small, while the influence of gold-palladium post was significant.
Animals ; Cone-Beam Computed Tomography/methods* ; Gold ; Gutta-Percha ; Palladium ; Swine ; Titanium ; Tooth Fractures/diagnostic imaging* ; Tooth Root/injuries* ; Reproducibility of Results

OBJECTIVETo investigate the value of computer aided navigation system (CANS) in the treatment of post traumatic maxillofacial deformation.

METHODSFifty-four patients (M = 37, F = 17) were included in the study, including 31 cases of zygomatic fracture, 7 cases of pure orbital fracture, 11 cases of temporal mandibular joint ankylosis, 1 case of foreign body and 4 cases of defect reconstruction with custom implant. Data acquisition was done through CT scan, and DICOM data was transferred into workstation. Computer assisted design, including osteotomy, reposition, fibula flap design, orbital implant construction was performed using Surgicase CMF and Brain Lab Iplan system. The virtual design was transferred to Brain Lab navigation system, and the osteotomy, reduction, location of bone graft and custom implant were guided by navigation. Postoperative CT scan was required 48 - 72 hours after surgery. Preoperative and postoperative CT images were superimposed automatically in BrainLab Iplan system, and compared both in 3D objects and 2D slices.

RESULTSAll the cases achieved good results without serious complication. The error of important corresponding points in zygomatic fracture reduction, orbital reconstruction and defect reconstruction was 0.2 - 3.5 mm, 0.8 - 2.0 mm and 0.2 - 2.2 mm respectively.

CONCLUSIONSComputer assisted design is of considerable value for the systematic and accurate planning for complicated post traumatic deformation. Virtual plan could be carried out accurately with the assistance of CANS.

Adult ; Computer Simulation ; Computer-Aided Design ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Orbital Fractures ; diagnostic imaging ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgery, Computer-Assisted ; methods ; Tomography, X-Ray Computed ; Tooth Ankylosis ; diagnostic imaging ; surgery ; Young Adult ; Zygomatic Fractures ; diagnostic imaging ; surgery