Diagnosis of vertical root fractures in endodontically treated teeth utilising Digital Subtraction Radiography: A case series report

Aust Endod J. 2018 Dec;44(3):286-291. doi: 10.1111/aej.12240. Epub 2017 Dec 11.

Abstract

Vertical root fractures are commonly associated with root-filled teeth. Diagnosis is challenging because the clinical signs are not completely pathognomonic, and conventional periapical radiography is often unreliable. Digital subtraction radiography (DSR) is able to detect small radiographic changes between two successive radiographs by subtracting out consistent radiographic elements. Its use could possibly assist in the diagnostic procedure. Four cases are presented to demonstrate the potential use of DSR in the detection of vertical root fractures in endodontically treated teeth. After the digital subtractions had been carried out, a dark line in the body of the roots was distinguishable, raising the possibility of the presence of a vertical root fracture. The use of contrast enhancement and pseudocolouring techniques assisted with the diagnosis of vertical root fractures. DSR proved to be a useful diagnostic tool for the detection of vertical root fractures in these four clinical cases.

Keywords: detection; diagnostic imaging; root canal therapy; subtraction technique; tooth fractures.

MeSH terms

  • Female
  • Follow-Up Studies
  • Fracture Healing / physiology
  • Humans
  • Male
  • Middle Aged
  • Radiography, Dental, Digital / methods*
  • Risk Assessment
  • Root Canal Therapy / adverse effects*
  • Root Canal Therapy / methods
  • Sampling Studies
  • Tooth Fractures / diagnostic imaging
  • Tooth Fractures / therapy*
  • Tooth Root / injuries*
  • Tooth Root / physiopathology
  • Treatment Outcome