The Extent of the Crack on Artificial Simulation Models with CBCT and Periapical Radiography

The aim of this study was to investigate the extent of the crack of a cracked tooth on an artificial simulation model with Periapical Radiography (PR) and cone beam computed tomography (CBCT) in vitro, providing the basis for early diagnosis and an appropriate treatment plan. Forty-four teeth with d...

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Veröffentlicht in:PloS one 2017-01, Vol.12 (1), p.e0169150-e0169150
Hauptverfasser: Wang, Shuang, Xu, Yiran, Shen, Zhengyan, Wang, Lijun, Qiao, Feng, Zhang, Xu, Li, Minghua, Wu, Ligeng
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Xu, Yiran
Shen, Zhengyan
Wang, Lijun
Qiao, Feng
Zhang, Xu
Li, Minghua
Wu, Ligeng
description The aim of this study was to investigate the extent of the crack of a cracked tooth on an artificial simulation model with Periapical Radiography (PR) and cone beam computed tomography (CBCT) in vitro, providing the basis for early diagnosis and an appropriate treatment plan. Forty-four teeth with different extents of artificial cracks, created by exposure to liquid nitrogen after hot water at 100°C, were collected. They were subjected to PR and CBCT. Micro-computed tomography (micro-CT) examination, regarded as a relatively more accurate measurement than others, was used to measure and record the crack depth. Three observers, an endodontic graduate student, an experienced endodontist, and an experienced radiologist, examined the PR and CBCT results independently, and the presence or absence of cracks with PR and CBCT were respectively recorded. The external consistency ICC with 95% confidence interval (95% CI) was used to analyze the consistency among the graduate student, endodontist, and radiologist; ROC curves were used for the analysis of diagnostic performance of both radiographic modalities for tooth cracks with crack depth. For the interpretation of the PR results, there were statistically significant differences among the three different observers (P < 0.001), and the interpretation of the CBCT results (P < 0.001). In the group of results read by the graduate student, the sensitivity of diagnosis with CBCT and PR was 77.27% and 22.73%, respectively (P < 0.001). In the group of results read by the endodontist, the sensitivity of diagnosis with CBCT and PR was 81.81% and 8.19%, respectively (P < 0.001). In the group of results read by the radiologist, the sensitivity of diagnosis with CBCT and PR was 88.64% and 11.36%, respectively (P < 0.001). As for CBCT diagnosis, the critical value for the graduate, endodontist, and radiologist was 3.20 mm, 2.06 mm, and 1.24 mm, respectively. For the PR diagnosis, the critical value for the graduate, endodontist, and radiologist was 6.12 mm, 6.94 mm, and 6.94 mm, respectively. Within the limitations of this study, on an artificial simulation model of cracked teeth for early diagnosis, we recommend that it would be better for a cracked tooth to be diagnosed by a radiologist with CBCT than PR, CBCT with a minimum depth of 1.24 mm.
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Forty-four teeth with different extents of artificial cracks, created by exposure to liquid nitrogen after hot water at 100°C, were collected. They were subjected to PR and CBCT. Micro-computed tomography (micro-CT) examination, regarded as a relatively more accurate measurement than others, was used to measure and record the crack depth. Three observers, an endodontic graduate student, an experienced endodontist, and an experienced radiologist, examined the PR and CBCT results independently, and the presence or absence of cracks with PR and CBCT were respectively recorded. The external consistency ICC with 95% confidence interval (95% CI) was used to analyze the consistency among the graduate student, endodontist, and radiologist; ROC curves were used for the analysis of diagnostic performance of both radiographic modalities for tooth cracks with crack depth. For the interpretation of the PR results, there were statistically significant differences among the three different observers (P &lt; 0.001), and the interpretation of the CBCT results (P &lt; 0.001). In the group of results read by the graduate student, the sensitivity of diagnosis with CBCT and PR was 77.27% and 22.73%, respectively (P &lt; 0.001). In the group of results read by the endodontist, the sensitivity of diagnosis with CBCT and PR was 81.81% and 8.19%, respectively (P &lt; 0.001). In the group of results read by the radiologist, the sensitivity of diagnosis with CBCT and PR was 88.64% and 11.36%, respectively (P &lt; 0.001). As for CBCT diagnosis, the critical value for the graduate, endodontist, and radiologist was 3.20 mm, 2.06 mm, and 1.24 mm, respectively. For the PR diagnosis, the critical value for the graduate, endodontist, and radiologist was 6.12 mm, 6.94 mm, and 6.94 mm, respectively. Within the limitations of this study, on an artificial simulation model of cracked teeth for early diagnosis, we recommend that it would be better for a cracked tooth to be diagnosed by a radiologist with CBCT than PR, CBCT with a minimum depth of 1.24 mm.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0169150</identifier><identifier>PMID: 28052126</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Biology and Life Sciences ; CAT scans ; Computation ; Computed tomography ; Computer simulation ; Cone-Beam Computed Tomography - methods ; Confidence intervals ; Consistency ; Cracks ; Dental caries ; Dentin ; Dentistry ; Dentists ; Diagnosis ; Diagnostic systems ; Enamel ; Hospitals ; Hot water ; Humans ; Liquid nitrogen ; Medical diagnosis ; Medical prognosis ; Medicine and Health Sciences ; Observers ; Pathology ; People and Places ; Radiography ; Research and Analysis Methods ; Sensitivity ; Simulation ; Statistical analysis ; Studies ; Surgery ; Teeth ; Tooth - diagnostic imaging ; X-Ray Microtomography</subject><ispartof>PloS one, 2017-01, Vol.12 (1), p.e0169150-e0169150</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Wang et al. 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For the interpretation of the PR results, there were statistically significant differences among the three different observers (P &lt; 0.001), and the interpretation of the CBCT results (P &lt; 0.001). In the group of results read by the graduate student, the sensitivity of diagnosis with CBCT and PR was 77.27% and 22.73%, respectively (P &lt; 0.001). In the group of results read by the endodontist, the sensitivity of diagnosis with CBCT and PR was 81.81% and 8.19%, respectively (P &lt; 0.001). In the group of results read by the radiologist, the sensitivity of diagnosis with CBCT and PR was 88.64% and 11.36%, respectively (P &lt; 0.001). As for CBCT diagnosis, the critical value for the graduate, endodontist, and radiologist was 3.20 mm, 2.06 mm, and 1.24 mm, respectively. For the PR diagnosis, the critical value for the graduate, endodontist, and radiologist was 6.12 mm, 6.94 mm, and 6.94 mm, respectively. Within the limitations of this study, on an artificial simulation model of cracked teeth for early diagnosis, we recommend that it would be better for a cracked tooth to be diagnosed by a radiologist with CBCT than PR, CBCT with a minimum depth of 1.24 mm.</description><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>CAT scans</subject><subject>Computation</subject><subject>Computed tomography</subject><subject>Computer simulation</subject><subject>Cone-Beam Computed Tomography - methods</subject><subject>Confidence intervals</subject><subject>Consistency</subject><subject>Cracks</subject><subject>Dental caries</subject><subject>Dentin</subject><subject>Dentistry</subject><subject>Dentists</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Enamel</subject><subject>Hospitals</subject><subject>Hot water</subject><subject>Humans</subject><subject>Liquid nitrogen</subject><subject>Medical diagnosis</subject><subject>Medical prognosis</subject><subject>Medicine and Health Sciences</subject><subject>Observers</subject><subject>Pathology</subject><subject>People and Places</subject><subject>Radiography</subject><subject>Research and Analysis Methods</subject><subject>Sensitivity</subject><subject>Simulation</subject><subject>Statistical analysis</subject><subject>Studies</subject><subject>Surgery</subject><subject>Teeth</subject><subject>Tooth - diagnostic imaging</subject><subject>X-Ray Microtomography</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk11v0zAUhiMEYmPwDxBEQkJw0WLHH3FuJpVqQKWhoa1whWSd-qPxSONiJ7D9e9w1m1q0iykXiU-e8_qc1z5Z9hKjMSYl_nDp-9BCM1771owR5hVm6FF2iCtSjHiByOOd74PsWYyXCDEiOH-aHRQCsQIX_DD7Oa9NfnLVmbbLvc27tJoGUL9y3-aT0DnrlIMmv3CrvoHOpehXr00T87-uq_Ppx-k8h1bn30xwsHYqoeegnV8GWNfXz7MnFppoXgzvo-z7p5P59Mvo9OzzbDo5HamyYN1oQW2BgRNOtbGVEJUAvGAVZ9raFESEcQxYcVNZCxSYqjRgTTUtSq5BU3KUvd7qrhsf5WBMlFgwRpJXCCVitiW0h0u5Dm4F4Vp6cPIm4MNSQupWNUYKjCwRViDQiLIFCGVLiiwqLGbUqippHQ-79YuV0SpZF6DZE93_07paLv0fmSxnBSFJ4N0gEPzv3sROrlxUpmmgNb6_qbuigvIKPQRlpSirQiT0zX_o_UYM1BJSr661PpWoNqJyQktOCcXFpsXxPVR6tFk5lS6cdSm-l_B-LyExnbnqltDHKGcX5w9nz37ss2932NpA09XRN_3mJsZ9kG5BFXyMwdi788BIbubl1g25mRc5zEtKe7V7lndJtwNC_gHiag4x</recordid><startdate>20170104</startdate><enddate>20170104</enddate><creator>Wang, Shuang</creator><creator>Xu, Yiran</creator><creator>Shen, Zhengyan</creator><creator>Wang, Lijun</creator><creator>Qiao, Feng</creator><creator>Zhang, Xu</creator><creator>Li, Minghua</creator><creator>Wu, Ligeng</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20170104</creationdate><title>The Extent of the Crack on Artificial Simulation Models with CBCT and Periapical Radiography</title><author>Wang, Shuang ; Xu, Yiran ; Shen, Zhengyan ; Wang, Lijun ; Qiao, Feng ; Zhang, Xu ; Li, Minghua ; Wu, Ligeng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c725t-b4f21a6364def98898a1b5965dff36403561a1c6e9ffa4a5c9da1d4d4276dad43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>CAT scans</topic><topic>Computation</topic><topic>Computed tomography</topic><topic>Computer simulation</topic><topic>Cone-Beam Computed Tomography - methods</topic><topic>Confidence intervals</topic><topic>Consistency</topic><topic>Cracks</topic><topic>Dental caries</topic><topic>Dentin</topic><topic>Dentistry</topic><topic>Dentists</topic><topic>Diagnosis</topic><topic>Diagnostic systems</topic><topic>Enamel</topic><topic>Hospitals</topic><topic>Hot water</topic><topic>Humans</topic><topic>Liquid nitrogen</topic><topic>Medical diagnosis</topic><topic>Medical prognosis</topic><topic>Medicine and Health Sciences</topic><topic>Observers</topic><topic>Pathology</topic><topic>People and Places</topic><topic>Radiography</topic><topic>Research and Analysis Methods</topic><topic>Sensitivity</topic><topic>Simulation</topic><topic>Statistical analysis</topic><topic>Studies</topic><topic>Surgery</topic><topic>Teeth</topic><topic>Tooth - diagnostic imaging</topic><topic>X-Ray Microtomography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Shuang</creatorcontrib><creatorcontrib>Xu, Yiran</creatorcontrib><creatorcontrib>Shen, Zhengyan</creatorcontrib><creatorcontrib>Wang, Lijun</creatorcontrib><creatorcontrib>Qiao, Feng</creatorcontrib><creatorcontrib>Zhang, Xu</creatorcontrib><creatorcontrib>Li, Minghua</creatorcontrib><creatorcontrib>Wu, Ligeng</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing &amp; 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Forty-four teeth with different extents of artificial cracks, created by exposure to liquid nitrogen after hot water at 100°C, were collected. They were subjected to PR and CBCT. Micro-computed tomography (micro-CT) examination, regarded as a relatively more accurate measurement than others, was used to measure and record the crack depth. Three observers, an endodontic graduate student, an experienced endodontist, and an experienced radiologist, examined the PR and CBCT results independently, and the presence or absence of cracks with PR and CBCT were respectively recorded. The external consistency ICC with 95% confidence interval (95% CI) was used to analyze the consistency among the graduate student, endodontist, and radiologist; ROC curves were used for the analysis of diagnostic performance of both radiographic modalities for tooth cracks with crack depth. For the interpretation of the PR results, there were statistically significant differences among the three different observers (P &lt; 0.001), and the interpretation of the CBCT results (P &lt; 0.001). In the group of results read by the graduate student, the sensitivity of diagnosis with CBCT and PR was 77.27% and 22.73%, respectively (P &lt; 0.001). In the group of results read by the endodontist, the sensitivity of diagnosis with CBCT and PR was 81.81% and 8.19%, respectively (P &lt; 0.001). In the group of results read by the radiologist, the sensitivity of diagnosis with CBCT and PR was 88.64% and 11.36%, respectively (P &lt; 0.001). As for CBCT diagnosis, the critical value for the graduate, endodontist, and radiologist was 3.20 mm, 2.06 mm, and 1.24 mm, respectively. For the PR diagnosis, the critical value for the graduate, endodontist, and radiologist was 6.12 mm, 6.94 mm, and 6.94 mm, respectively. Within the limitations of this study, on an artificial simulation model of cracked teeth for early diagnosis, we recommend that it would be better for a cracked tooth to be diagnosed by a radiologist with CBCT than PR, CBCT with a minimum depth of 1.24 mm.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28052126</pmid><doi>10.1371/journal.pone.0169150</doi><tpages>e0169150</tpages><oa>free_for_read</oa></addata></record>
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subjects Analysis
Biology and Life Sciences
CAT scans
Computation
Computed tomography
Computer simulation
Cone-Beam Computed Tomography - methods
Confidence intervals
Consistency
Cracks
Dental caries
Dentin
Dentistry
Dentists
Diagnosis
Diagnostic systems
Enamel
Hospitals
Hot water
Humans
Liquid nitrogen
Medical diagnosis
Medical prognosis
Medicine and Health Sciences
Observers
Pathology
People and Places
Radiography
Research and Analysis Methods
Sensitivity
Simulation
Statistical analysis
Studies
Surgery
Teeth
Tooth - diagnostic imaging
X-Ray Microtomography
title The Extent of the Crack on Artificial Simulation Models with CBCT and Periapical Radiography
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