Abstract

The aim of this study was to compare the accuracy of different sub-200 µm voxel reconstruction of CBCT scans in the identification of root canal anatomy. Cadaveric dentate maxillae and mandibles with soft tissues attached (69 teeth comprising 91 roots) were assessed with scans reconstructed at voxel sizes of 80 µm, 125 µm, and 160 µm. Three examiners recorded the canal configuration, presence of lateral canals, PAI score, and image quality seen on the scans. Micro-computed tomography (micro-CT) scans of the specimens reconstructed at 10 µm served as the reference standard. There was no significant difference between 80 µm and 125 µm reconstructions, but 80 µm scans were more accurate than 160 µm scans (p = 0.04). The findings suggest that canal anatomical complexity may have a greater influence on diagnostic accuracy than differences among the sub-200 µm voxel reconstructions evaluated. Lateral canals were only noted in 2% of roots in CBCT scans, but were present in 55% of roots assessed with micro-CT. There was significantly more variation in the assessment of image quality for 80 µm compared with 125 µm (p = 0.01) and 160 µm (p = 0.003) scans. Generally, 80 µm reconstructions provided marginally improved diagnostic yield compared with 160 µm scans; however, CBCT scans showed limited accuracy for more complex canal configurations. The poorer image quality of 80 µm scans may be due to the limited field of view, which causes partial volume effects rather than being reconstructed at 80 µm per se.

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