Root fracture detection: a comparison of direct digital radiography with conventional radiography

OBJECTIVES: To compare the diagnostic potential of direct digital radiography with conventional film for detecting experimental root fractures. METHODS: Two hundred and one extracted single-rooted human teeth were endodontically instrumented and divided into two groups, a control group of 100 teeth and a fractured group of 101 teeth in which root fractures were produced experimentally. Each tooth was imaged using the paralleling technique with a CCD-based digital system and D-speed film. The images were interpreted by an experienced radiologist without prior knowledge of the distribution of the root fractures. The degree of agreement in detecting root fractures with each imaging system compared with the actual condition was expressed as the kappa value. The difference between the radiographic systems was then assessed by chi(2)-test at the 95% significance level. RESULTS: There was substantial agreement between the digital system and the actual condition (kappa=0.71; 95% Confidence Interval: 0.62 to 0.80) and close agreement between the film and the actual condition (kappa=0.63; 95% Confidence Interval: 0.53 to 0.74). However, this difference was not significantly different (P=0.2). CONCLUSIONS: The performance of CCD-based digital radiography in detecting root fractures is similar to film-based radiography.