Evaluation of Dental Root Fracture Using Cone-beam Computed Tomography

Objective: To evaluate the application of cone-beam computed tomography (CBCT) in the detection of dental root fractures and to analyse the demographic profile of these fractures. Methods: The study group comprised 398 teeth that were examined by CBCT for determining whether they had a root fracture. Patient characteristics were recorded, and the location, fractured roots, fracture types and three-dimensional images of the related skeletal structures were analysed. Two experienced oral radiologists independently analysed each case and reached a consensus, and the diagnosis was graded in one of the following three categories: fracture definitely present (FDP), fracture probably present (FPP) and no visible fracture (NVF). Results: Among these teeth, 155 (39.0%) were diagnosed as FDP, 14 (3.5%) as FPP and 229 (57.5%) as NVF in the consensus reading. During follow-up, all teeth diagnosed as FDP and 4 of the 14 teeth diagnosed as FPP were intra-operatively demonstrated to be fractured. In FDP cases, 60.0% of the patients were aged from 50 to 69 years. In total, 107 FDP teeth were non-endodontically treated, and the remaining were endodontically treated with (n = 16) or without (n = 32) crown placement. The maxillary and mandibular molars were most frequently affected (81.9%). The fractured roots were mostly palatal (65.7%) in maxillary molars and mesial (84.2%) in mandibular molars. The fractures were characterised as vertical (n = 84), horizontal (n = 34), oblique (n = 5) and complicated (n = 32) fractures. Conclusion: The application of CBCT is valuable for the diagnosis of root fracture. Keywords: cone-beam computed tomography, dental root fracture, imaging diagnosis