Sensitivity and specificity of cone-beam computed tomography and micro-computed tomography in the detection of calcified root canals
Keywords:calcified root canal, cone-beam computed tomography, micro-computed tomography, periapical radiograph, tooth sectioning
Objective: To evaluate the sensitivity and the specificity of cone-beam computed tomography (CBCT) and micro-computed tomography (micro-CT) in detection of calcified canals indiscernible in digital periapical radiographs (PA) compared to tooth-sectioning method, and to identify the sizes of calcified canals that could not be detected in CBCT and micro-CT.
Methods: Forty-eight roots with calcified canals indiscernible in PA were included. The roots were placed in a jaw model and scanned using a CBCT scanner (3D Accuitomo 170). The roots were removed from the model and re-scanned using a micro-CT scanner (SkyScan 1773). A presence of root canal along the root length was identified from either CBCT or microCT images in every 1-mm root slice. Each root was serially sectioned in 1 mm thick and examined under a stereomicroscope to confirm the presence of root canal at each level, which was compared to the results of CBCT and micro-CT. The sensitivity and the specificity of CBCT and micro-CT in detection of calcified canals were calculated (%). The sizes of root canals were measured and compared between micro-CT images and sectioned specimens. The average size of root canals only detected in the sectioned roots (but undetected in CBCT and/or micro-CT images) were reported.
Results: From 48 roots with 207 root slices, the sensitivity and the specificity in detection of calcified canals were 33.2% and 100% for CBCT, and 81.9% and 85.7% for micro-CT. The canal sizes in micro-CT images and the sectioned specimens were not significantly different (p≥.05). The average sizes of canals undetected in the tomography were 0.071±0.041 mm for CBCT and 0.030±0.022 mm for micro-CT.
Conclusion: CBCT showed low sensitivity and high specificity to detect calcified canals, in which the canals larger than 0.07 mm could be identified. Micro-CT showed high sensitivity and high specificity to detect calcified canals that were larger than 0.03 mm. The canal sizes in micro-CT images and sectioned specimens were not different.
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