Detection of Root Fractures on Digital and Conventional Radiographs

Objectives:The aim of this study was to compare the diagnostic accuracy of digital radiographic images with conventional radiographs for detecting experimentally induced root fractures. Methods:In this in vitro study, 45 extracted single rooted human teeth and 30 molars were used.We experimentally induced horizontal and vertical fractures in 15 single rooted teeth respectively and vertical fractures in 15 molars.15 single rooted teeth and 15 molars were non fractured and used as control group.The teeth were mounted in dried mandibles and the parallel technique was used.The digital radiographs were taken with a CCD based Plannmeca imaging system and their conventional counterparts with F-speed films.All 150 images were examined and interpreted by 6 experienced radiologists and 1 experienced endodontist unaware of which images were of fractured roots.The kappa statistic was calculated to evaluate the degree of agreement in detecting root fractures with both techniques and differencies between the two calculated using c² distribution at the 95% significance level. Results:There was substantial agreement between image interpretation and the actual condition for both systems.The kappa values (and 95% CIs) were 0.67 (0.58-0.76) and 0.60 (0.48-0.72).The difference was not statistically significant (P>0.05). Conclusions:In this in vitro study the two radiographic systems did not affect the detection of root fractures.