Detection of simulated vertical root fractures; which is better multi-detector computed tomography or cone beam computed tomography?

Objectives: Multi-detector computed tomography (MDCT) and cone beam computed tomography (CBCT) were compared regarding their ability to detect vertical root fractures. Methods: Sixty four extracted posterior teeth were included in this study. Using a diamond disc, thirty six teeth were cut vertically to simulate a VRF. Twenty eight teeth were used as control. Fractured and non-fractured teeth were randomly positioned in 4 skulls and mandibles. Scanning was performed first on a 16 slice Siemens MDCT, then by i-CAT Next Generation CBCT. Two observers assessed the multiplanar images for vertical root fractures using a 3-point scale. The first observer repeated the assessment after 1 week. Later, the 2 observers re-assessed the images together to reach a consensus score. Results: CBCT showed higher sensitivity, accuracy as well as negative predictive value compared to MDCT. The mean area under the curve was 0.917 for MDCT and 0.972 for CBCT. The difference in diagnostic accuracy between the 2 modalities was statistically significant P = .036. Inter-observer agreement was 0.971 for MDCT and 0.994 for CBCT, whereas intra-observer agreement was 0.981 for MDCT and 0.985 for CBCT. Conclusion: Using the specified scanners at the specified exposure parameters, the diagnostic accuracy of CBCT in detecting vertical root fractures was significantly higher than MDCT. Keywords: Multi-detector computed tomography, Cone-beam computed tomography, Root fracture