The Effect of CBCT Voxel Size on Detection of Horizontal Root Fracture: An Ex-Vivo study

Rabea, Ahmed Reda; Ashmawy, Mostafa Saad El Din; Abu El-Ela, Walaa Hussein

doi:10.21608/asdj.2025.350122.1765

The Effect of CBCT Voxel Size on Detection of Horizontal Root Fracture: An Ex-Vivo study

Document Type : Original articles

Authors

¹ Demonastrator at Oral and Maxillofacial radiology department faculty of dentistry Ain shams university, Cairo ,Egypt

² Oral and Maxillofacial radiology department faculty of dentistry Ain shams university ,Cairo ,Egypt

³ Oral and Maxillofacial radiology, department faculty of dentistry Ain shams university ,Cairo ,Egypt

10.21608/asdj.2025.350122.1765

Abstract

Aim: To assess the impact of cone-beam computed tomography (CBCT) voxel size on the observers’ ability to detect horizontal root fracture.
Materials and methods: One hundred and four extracted posterior teeth with sound roots were prepared to have root canal filling (RCF). The teeth were then divided equally into four groups: RCF only, RCF with simulated horizontal root fracture (HRF), RCF and metallic post, and RCF with post and HRF. The teeth were randomly distributed and adapted into sockets of dry skull and mandible. Each assembly was scanned by two CBCT machines and two voxel sizes for each. Two oral radiologists assessed the images for HRF detection using a five-confidence scale. Sensitivity, specificity, and accuracy were measured.
Results: Inter-observer reliability ranged from very good to excellent. There was an excellent intra-observer agreement. Gendex machine images (0.2- and 0.08-mm voxel sizes) were more sensitive and accurate for fracture detection while i-CAT^® images (0.2- and 0.125-mm voxel sizes) were more specific in sound roots identification. However, both machines and voxel sizes revealed significantly high diagnostic performance in HRF detection. The presence of intracanal metallic post resulted in higher accuracy compared to presence of RCF only but without a significant difference.
Conclusion: Consider using the large voxel size of both machines which provide appropriate accuracy for fracture detection and saving patient form excess x-radiation.

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