Use of Large-volume Cone-Beam Computed Tomography in Identification and Localization of Horizontal Root Fracture
in the Presence and Absence of Intracanal Metallic Post
Felipe Ferreira Costa, DDS, Bruno Felipe Gaia, DDS, Otavio Shoiti Umetsubo, DDS, MS,
Lucas Rodrigues Pinheiro, DDS, Isabel Peixoto Tortamano, DDS, MS, PhD,
and Marcelo Gusmão Paraiso Cavalcanti, DDS, MD, PhD
Abstract
Introduction: The objective of the study was to eval-
uate the ability of large-volume cone-beam computed
tomography (CBCT) to detect horizontal root fracture
and to test the influence of a metallic post. Methods:
Through the examination of 40 teeth by large-volume
CBCT (20-cm height and 15-cm diameter cylinder) at
0.2-mm voxel resolution, 2 observers analyzed the
samples for the presence and localization of horizontal
root fracture. Results: The values of accuracy in the
groups that had no metallic post ranged from 33%–
68%, whereas for the samples with the metallic post,
values showed a wide variation (38%–83%). Intraob-
server agreement showed no statistically significant
difference between the groups with/without metallic
post; both ranged from very weak to weak (kappa,
0.09–0.369). Conclusions: The low accuracy and low in-
traobserver and interobserver agreement reflect the diffi-
culty in performing an adequate diagnosis of horizontal
root fractures through a large-volume CBCT by using
a small voxel reconstruction. (J Endod 2012;38:856–859)
Key Words
Cone-beam computed tomography scanning, diagnosis,
horizontal root fracture
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