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

treatment can influence the likelihood of file fractures within the root canal. There were
fracture. If both devices are tested under the no false positive diagnoses in the Hosseini
same conditions and using the same tools, the Zarchi et al. study [22] due to the 100%
results may be similar. specificity of all techniques utilized in
Additional research, including larger sample identifying file fractures. The observer's
sizes and a range of clinical circumstances, will extensive knowledge in detecting file fractures
be necessary to assess how well these two inside the root canal contributed to this
devices function. Chang et al. [17] observed challenge. According to a study by Kamburg
sensitivity in the 95% to 98% range when Law et al. [23], it was more difficult to detect file
different CBCT units were tested in analyzing fractures inside the root canal when a metal
horizontal file fractures within the root canal, post was present, as sensitivity and specificity
which was greater than our findings and were decreased. The range of specificity in
consistent with previously described results. other studies using similar voxel sizes was
The absence of a metal post and the probable considerable, ranging between 88% and 100%,
size disparity between the two voxels and the consistent with the present study [23, 24].
two devices were among the factors The limitations of the present study include the
contributing to the high sensitivity in that varying degree of agreement between
investigation. According to a review study by observers in interpreting the images, leading to
Mayer et al., voxel size and dosage had no somewhat contradictory results. Additionally,
bearing on the diagnosis of fractures; however, the nature of in vitro studies affects the
a variety of CBCT imaging setups and generalizability of the results. In vitro studies
apparatuses are reliable for diagnosing root investigate phenomena in a laboratory
fractures [18]. Numerous studies on the environment outside the living organism.
examination of fractures by various CBCT Although useful for understanding basic
systems have been published. The variation in mechanisms and discovering new treatments,
their findings is probably related to various these studies may not fully simulate natural
factors, such as the impact of varying voxel sizes conditions. The limited number of samples and
in the same direction, which aligns with our insufficient diversity may not represent the true
findings. For example, in a study conducted by population. Therefore, additional in vivo studies
Bechera et al. [19], the ProMax3D system are strongly recommended to evaluate the
showed higher accuracy in identifying file results in natural conditions. The results
fractures inside the root canal compared to obtained from clinical settings may differ from
other devices in that study. Additionally, the those of in vitro studies, and interpreting these
accuracy was reduced by the artifact removal results after conducting clinical trials will allow
approach. However, in another research for a more comprehensive analysis.
published by Bayrak et al. [20], this approach
improved the correct diagnosis, which was Conclusion
unrelated to the fracture of the file inside the In conclusion, both CBCT devices demonstrated
root canal. In a study by Sati et al. [21], Vatech equal performance in identifying broken files
CBCT systems outperformed Newtom CBCT in within the root canal system.
detecting file fractures within the root canal.
Certain studies, such as the one conducted by Acknowledgments
Hosseini Zarchi et al. [22], have explored The authors thank the Research Vice Chancellor
alternative systems, including those focused on of Urmia University of Medical Sciences.
artifact removal and filtration.
The results showed that these systems had no Authors’ contributions
bearing on the presence or absence of a metal AAA and AG designed the study and performed
post within the root canal and instead affected the search and data extraction. SAS analyzed the
the diagnosis and accuracy of CBCT in detecting data. AAA, AG, and ASA wrote the manuscript.

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