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Abdollahi et. al Diagnostic Accuracy of Different Devices and Settings of …

substandard material quality, flawed file design, the equipment used by CBCT operators and
improper usage, overuse, application of differences in device settings, such as contrast
excessive force in curved or calcified canals strength, field of view, and voxel sizes [11].
during preparation, and the intricate anatomy Unlike periapical radiography, CBCT images
of the root canal (1,2) [1]. The advent of new examine the area in three dimensions,
nickel-titanium rotary files has heightened the preventing the superimposition of anatomical
likelihood of these instruments malfunctioning markers or other root canals. Therefore it is
during root canal therapy [2]. Consequently, the usually advised that using the appropriate
failure rate of nickel-titanium files ranges from imaging equipment is essential to achieving
0.4% to 4.6%. Separation of these files can accurate diagnoses and successful treatment
occur unexpectedly [3]. The presence of a outcomes.
fractured file within the canal significantly Given the discrepancies in results across studies
undermines treatment success, with studies regarding the detection of broken files and the
indicating a 19% increase in the probability of significant influence of device type and
treatment failure when a fractured file remains specifications on these outcomes, there is a
[4]. Therefore, it is preferrable to remove clear need for a study that identifies the most
fractured files from the root canal to efficient CBCT types and specifications for this
substantially enhance treatment outcomes [2]. purpose. Accurate diagnosis of broken files in
Conventional intraoral and panoramic the root canal using advanced imaging methods
radiography may not always provide sufficient such as cone beam computed tomography
information about endodontic treatment (CBCT) is crucial. CBCT offers the ability to
failures. However, numerous studies have examine the complex anatomy of the root canal
investigated the use of CT scans in endodontic in three dimensions, precisely determine the
treatment, as they offer three-dimensional exact position of the broken file segment, and
insights into the anatomy and development of evaluate the root canal's length and its
root canals [5]. Compared to CT scans, CBCT relationship with adjacent anatomical
images yield sections in the coronal, axial, and structures. Moreover, this imaging technique
sagittal planes, as well as 3D reconstructions, enhances the dentist's ability to perform
allowing for precise morphological evaluation treatments with greater care and precision [14,
with high resolution and less radiation 15]. Therefore, this study aims to address the
exposure [6]. Before identifying the primary existing knowledge gap and provide clear
issue, it is crucial to locate any fractured files guidance on the optimal use of CBCT for
within the root canal. The presence of a broken detecting broken files, ultimately improving
file inside the canal increases the risk of root clinical outcomes and patient care.
canal weakening and perforation during
therapy. Identifying a fractured file using Materials and Methods
periapical and panoramic radiographs can be This project received ethical approval from
challenging, especially when the contrast the Urmia University of Medical Sciences
between the broken file and the root canal Research and Ethics Committee, Urmia,
obturation material is similar. This difficulty is Iran (IR.UMSU.REC.1400.182). Seventy-two
particularly pronounced in teeth where the root extracted human single-rooted teeth were used
canal is filled up to the fracture site [7-10]. For in this in vitro investigation. The sample size
teeth with complex morphology, cone-beam was determined by a 70% accuracy rate
computed tomography (CBCT) has been identified in the study by Ayatollahi et al. [16]
extensively used during root canal therapy [11]. regarding the CBCT device's ability to detect
However, studies have yielded conflicting broken files. According to this data, we require
results regarding the effectiveness of CBCT in 36 samples for each device(total=72). This
identifying broken files [11-13]. These determination was made using a statistical
discrepancies can be attributed to variations in formula that incorporates an alpha level of 5%,

71 Summer And Autumn 2024; Vol. 36, No. 3-4