RESEARCH ARTICLE


Performance of Bioceramic-based Root Filling Material with Artifact Reduction Properties in the Detection of Vertical Root Fractures Using Cone-beam Computed Tomography



Ali Bahmani1, Hamed Karkehabadi2, Abbas Shokri3, *, Maryam Farhadian4
1 Department of Oral and Maxillofacial Radiology, Hamadan University of Medical Sciences, Hamadan, Iran
2 Department of Endodontics, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
3 Dental Implant Research Center, Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
4 Department of Biostatistics, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran


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Creative Commons License
© 2021 Bahmani. et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Correspondence: Address correspondence to this author at Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Shahid Fahmideh Blvd, Hamadan, Iran Tel: +98-813-8251885; Fax: +98-813-8251885; E-mail: Dr.a.shokri@gmail.com


Abstract

Introduction:

In Cone-beam Computed Tomography (CBCT) images, metallic artifacts by root filling materials reduce the quality of images. It seems that bioceramic sealers produce fewer artifacts than gutta-percha. In this situation, the possibility of VRF detection could increase, and therefore, flap and exploratory surgery would not be needed. The purpose of this study was to evaluate the performance of a bioceramic-based root filling material in the detection of Vertical Root Fractures (VRF) in CBCT imaging.

Materials and Methods:

This study was conducted at the dental school from March to August 2019, and 100 healthy human mandibular premolar teeth were obtained and randomly divided into two equal groups. The teeth were filled with either AH26 and gutta-percha or bioceramic root filling materials. VRF was induced on half of the decoronated teeth in each group using a Global Testing Machine, and the others were considered control. CBCT imaging was performed by the Cranex 3D machine. Comparisons of the 2 groups were made using the Mann-Whitney test.

Results:

There was a significant difference between the two groups of bioceramic and gutta-percha in the measured indices, including sensitivity (P=0.017), specificity (P=0.018), positive predictive value (P=0.018), negative predictive value (P=0.018), and accuracy (P=0.011). The Area Under Curve (AUC) also showed a significant difference between the two groups (P=0.011). According to Kappa test results, no significant difference was obtained between the findings of the two observers.

Conclusion:

Different root filling materials showed a different extent of artifact in CBCT images. Bioceramic root filling material induces fewer artifacts in CBCT images, and the diagnostic value of VRF in CBCT images in the root canals filled with it is greater than those filled with AH26 and gutta-percha.

Keywords: Vertical root fracture, Bioceramic, Gutta-percha, Cone-Beam Computed Tomography, Root filling, Premolar teeth.