Efficacy of Contrast Medium-assisted Imaging in Diagnosing Cracked Tooth

Abstract

Introduction: This experimental study aimed to evaluate the efficacy of contrast medium-aided intraoral periapical radiographic imaging in the detection of cracked teeth and to determine optimal in-vitro compression force for crack detection. Methods: 27 extracted human lower premolar teeth were randomly divided into two groups: the control group, which was imaged using the conventional radiography and the experimental group which was imaged using a contrast medium (Iopamidol®). Both group were examined by transillumination to confirm the presence of a crack prior to imaging. A compression test using a Universal Testing Machine was used to induce the crack. Two dental clinicians blinded to the imaging technique evaluated the images and determined the presence or absence of cracks. Results: The force needed to produce a superficial crack ranges from 200N to 500N with a median compression force of 400N. The range of force to produce partial crack was 200N to 550N with the median force slightly higher than superficial crack which is 435N. The force to produce dentinal fracture ranges from 300N to 1100N with the highest median of 525N. The results showed that there were no visible cracks were detected in IOPA with/without contrast medium. Conclusions: The study did not find contrast-enhance IOPA to be effective in detecting cracks, but the study did establish the optimal median compression force values for inducing cracks which is between 400N to 525N. IOPA with contrast medium is not an effective diagnostic tool for cracked teeth compared to transillumination.