Dental vertical root fractures: Value of CT in detection

PURPOSE: To determine the value of computed tomography (CT) in the diagnosi s of dental vertical root fractures relative to the value of conventional d ental radiography. MATERIALS AND METHODS: Thirty-seven patients with 42 teeth in which vertica l root fracture was clinically suspected underwent dental radiography and a xial CT. Two radiologists evaluated the images independently and by consens us for a fracture line. The results were compared with intraoperative findi ngs. RESULTS: Twenty-eight of the 42 teeth were proved intraoperatively to be fr actured. The sensitivity and specificity averaged for the two reviewers in the assessment of vertical fractures were 23% and 70%, respectively, with d ental radiography and 100% and 100%, respectively, with CT. Consensus readi ng showed sensitivities of 25% for dental radiography and 75% for CT. Eight (reviewer A) or nine (reviewer B) false-negative CT findings were encounte red in cases in which metallic artifacts obscured parts of the root and in cases in which the root was very small in diameter. Interobserver agreement was 95% for dental radiography and 93% for CT. CONCLUSION: CT is superior to dental radiography in the detection of dental vertical root fractures.