AI Article Synopsis

  • The study analyzed the effectiveness of cone-beam computed tomography (CBCT) and digital periapical radiography (DPR) in detecting separated endodontic instruments in root canals.
  • Out of 108 root canals tested, DPR successfully identified 37.5% of separated instruments, while none were detected with CBCT methods.
  • Overall, DPR was found to be the most accurate diagnostic tool for this purpose, although a significant number of separated instruments still went undetected.

Article Abstract

Introduction: This study compared the accuracy, sensitivity, and specificity of different imaging diagnostic protocols, cone-beam computed tomography (CBCT) and digital periapical radiography (DPR), in identifying separated endodontic instruments in filled root canals.

Methods: One hundred eight root canals from 36 mandibular molars were prepared and obturated. Of these, 84 were filled without separated instruments, and 24 were filled with the presence of a separated instrument (stainless steel hand file or reciprocating instrument). Subsequently, different CBCT imaging protocols were acquired: i-CAT Classic (ICC) (0.25-mm isotropic voxel), i-CAT Next Generation (ICN) (0.125-mm isotropic voxel), and PreXion 3D (PXD) (0.09-mm isotropic voxel). Moreover, a DPR exam was obtained (08 mA, 70 kVp, and exposure time of 0.2 seconds). Two calibrated endodontists evaluated each image for the presence or absence of fractured files on a 5-point scale, ranging from definitely absent to definitely present. The accuracy, sensitivity, and specificity measures for each method were estimated. The data were evaluated by Fisher exact test and binomial test.

Results: Nine instruments were identified in DPR (37.5%) and none in the CBCT protocols (P > .05). The type of instrument (stainless steel hand file or reciprocating instrument) did not influence the identification of the separated instrument (P > .05). This study showed that DPR is the most accurate and sensitive imaging technique, with 83.3% and 37.5%, respectively.

Conclusions: DPR is the better imaging diagnostic exam to evaluate the presence of separated endodontic instruments inside a root canal in comparison with the ICC, ICN, and PXD tomographic protocols. However, most of the separated instruments were not identified.

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Source
http://dx.doi.org/10.1016/j.joen.2020.08.011DOI Listing

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