Análise comparativa da acurácia no diagnóstico de fraturas radiculares in vitro por meio de tomografia computadorizada de feixe cônico e tomografia de coerência óptica

Abstract

This in vitro study aimed to compare through a blind analysis the accuracy of Cone-Beam Computed Tomography and Optical Coherence Tomography in the diagnosis of root fractures in human single-rooted teeth. Forty teeth were randomly distributed in five groups (n = 8): control, with endodontic treatment with and without induction fracture, with endodontic treatment and molten metal nucleus with and without induction fracture, whose crowns were sectioned at the maxillary limit. For the groups with endodontic treatment, the reciprocating system was used and for the preparation of the molten metal cores the direct technique was performed. Root fractures were induced in a universal test machine. The sample was scanned in the Cone-Beam Computed Tomography with and Optical Coherence. Three experienced raters rated the images according to the presence or absence of fracture. For all analyzes, the level of significance was 5%. In the analyzes of root fractures, all cases were evaluated, Cone-Beam Computed Tomography showed to be a good diagnostic method for determining the presence of root fractures. Optical Coherence Tomography showed similar results, however, with better accuracy and better area of the ROC curve (p < 0.0001). In the control group, both methods were the negative predictive value equal to 100%.For evaluation of fractures in teeth with endodontic treatment, the two methods were strictly similar, with high sensitivities. In the analysis of fractures in teeth with endodontic treatment and molten metal nucleus, Optical Coherence Tomography demonstrated better accuracy and better area value in the ROC curve (0.87 and 0.875) than Cone-Beam Computed Tomography (0.81 e 0.813). Within the limitations of this study, it is concluded that the sensitivity, specificity and accuracy of Optical Coherence Tomography to detect the presence of surface root fractures are comparable to those of Cone-Beam Computed Tomography.In this perspective, Optical Coherence Tomography may represent a new alternative, non-invasive, without contact and without exposure to radiation of conventional methods used to evaluate the root fractures in vitro.