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

Objective: 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.

Study Design: 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.

Results: 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.

Conclusion: Limited cone-beam CT is more useful than the other 3 radiographic modalities for diagnostic imaging of horizontal tooth root fracture.