Establishment of Narrow Root Fracture Models Using Modified Temperature Cycling Method and Diagnosis Using Different Cone-Beam CT Units

Abstract

Aim. Using a modified thermal cycling method to establish narrow root fracture models and evaluate the diagnosis efficiency of them using four different cone-beam CT (CBCT) units. Methodology. Fifty-six intact teeth were selected, and the crowns of the teeth were embedded using general purpose acrylic resin. 50 root fracture models were established by soaking these teeth in liquid nitrogen and hot water cyclically; 6 teeth were used as the negative control. All the 56 teeth were scanned with the smallest voxel size of four different CBCT units (NewTom VGi, Planmeca Promax 3D Max, Kavo 3D eXam, and Soredex Scanora3D). 10 teeth were randomly selected, and the roots were sliced using slow-speed saw to obtain horizontal root sections. Scanning electron microscope (SEM) was used to measure the width of the fracture lines (FLs). The CBCT images were evaluated for the presence or absence of fracture lines. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for the diagnosis of FLs using the four CBCT units. Results. Fifty narrow root fracture models were successfully established, and 25 root sections with 45 FLs were acquired. The width of FLs was from 3.43 μm to 143 μm; 32.2% of the points had width under 25 μm, while only 9.6% of them had width over 75 μm. The accuracy was 0.41, 0.54, 0.41, and 0.30 for NewTom VGi, Planmeca Promax 3D Max, Kavo 3D eXam, and Soredex Scanora3D, respectively. Conclusions. The modified temperature cycling method is a simple and effective method to establish narrow root fracture models, and the diagnosis efficiency for these narrow fracture lines was quite poor using all the four different CBCT units.