Comparison of Diagnostic Accuracy of Indirect Digital Radiography and Paper Print Images in Vertical Root Fracture (In vitro)
Author(s): Sanaz Sharifi Shooshtari, Mashid Razavy, Mehraban Mohamadian, Lida Naderi
Background and Aim: The development of dental treatments and the long-term maintenance of teeth increased the incidence of complications such as root fractures. Failure to detect root fractures may lead to progressive bone loss and unnecessary treatments. Therefore, an early diagnosis of this complication is important for both the patient and dentist. The role of radiographic examinations in the detection of such lesions is remarkable. The current study aimed at determining the diagnostic accuracy of digital radiography images printed on paper in vertical root fractures and comparing its efficacy with indirect digital radiography.
Materials and Methods: The current in vitro study was conducted on 40 extracted human premolars that were fixed by using wax in the sheep mandibular bone. Imaging of the mounted teeth was performed horizontally at 0° and 15° using and X-ray machine (XGenus, De Götzen SRL, Varese, Italy) on the photostimulable storage phosphor (PSP) image plate. Then the teeth were extracted the teeth were extracted from the bony socket of the mandible. After creating a vertical root fracture and fastening the two-piece, the teeth were again fixed with wax in the mandible and indirect digital images were taken under the conditions similar to those of the initial ones All images were processed by Digora Optime (Soredex, Orion Corporation, Helsinki, Finland) and then transferred to Scanora 5.0 (Soredex Corp, Helsinki, Finland). The images were inverted into the desire sized using Scanora, and then all were printed on a silk paper (Fujifilm, São Paulo, Brazil) using a hp color laserjet 1600 printer, 2400 dpi. The images displayed on monitors and printed on papers were separately assessed by two radiologists and the data were analyzed by statistical tests, proportions, and Cochran formula. The agreement between the observers was determined by Kappa index (α=0.05).
Results: The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of vertical root fracture detection in images printed on paper were not significantly different from those of indirect digital radiographic images (P>0.05).
Conclusion: There were no significant differences between the diagnostic accuracy of indirect digital images (PSP) displayed on monitors and paper printed images in the detection of vertical root fractures. Therefore, in order to detect the vertical root fractures, use of paper printed images can be considered as a complementary method, but not a specific diagnostic method.