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Objective: Detection of root fractures in dowel-restored teeth is challenging. Even though cone-beam computed tomography (CBCT) has shown higher sensitivity than intraoral radiography, artifacts may be generated in the presence of intraradicular posts. This study assessed the accuracy and reproducibility of CBCT and digital radiography (DR) in detecting root fractures in teeth restored with metal cast dowel and core (MCDC) or glass fiber dowel and resin composite core (GFDRCC). An additional aim was to evaluate the presence of beam hardening artifacts in CBCTs, especially in teeth restored with glass fiber dowel. Methods: Roots of bovine incisors were endodontically prepared, filled, sealed and randomly divided into two groups to receive MCCDC or GFDRCC (n=15). CBCTs and DRs were obtained prior to and after fracture induction. Results: CBCT were more accurate than DR in detecting root fractures in dowel-restored teeth. Beam hardening was observed in 100% of CBCT obtained from teeth restored with MCDC and in 93% of those in which GFDRCC had been used. Inter-observer agreement was moderate for both CBCT and DR images. Conclusion: Regardless of the dowel type, even though beam hardening had been observed in virtually all dowel-restored teeth, CBCT was the most accurate diagnostic tool in detecting root fractures.

Detection of root fractures in glass fiber and metal cast dowel-restored teeth: Accuracy of Computed Tomography vs Digital Radiography