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Influence of the technical parameters of CBCT image acquisition on vertical root fracture diagnosis: a systematic review and meta-analysis

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Abstract

Objectives

To evaluate the influence of image acquisition parameters (voxel, FOV, kVp, mA) on the accuracy of cone-beam computed tomography (CBCT) in detecting vertical root fracture (VRF).

Material and methods

Searches were performed in 6 main databases and the gray literature, without restrictions of language or date. Observational clinical studies (OCS) and in vitro-extracted teeth (IV) studies were considered eligible for inclusion when investigating the accuracy (sensitivity, specificity) of CBCT in detecting VRF in human teeth. The risk of bias was assessed using QUADAS-2, and a meta-analysis was performed using Review Manager v5.4 software and Jamovi software v1.6.

Results

A total of 60 out of 132 articles was included after fulfilling the eligibility criteria. Of these, 54 were IV studies while 6 were OCS. In the IV studies, it was seen that smaller FOV sizes tended to present higher accuracy values. The meta-analysis of the 6 OCS showed that the overall sensitivity and specificity values for 0.08 mm and 0.1 mm voxels were greater (0.84 and 0.79, respectively) than the sensitivity and specificity values for 0.125 mm and 0.2 mm voxels (0.70 and 0.55, respectively).

Conclusions

Despite the uncertain risk of bias found for the IV and OCS studies, smaller voxel and FOV sizes seem to provide more accurate VRF detection values when using CBCT.

Clinical relevance

This information is crucial for supporting the clinician when prescribing CBCT in cases of a clinical suspicion of VRF, and contributes to the personalization of the CBCT prescription, thereby ensuring greater accuracy in the VRF diagnosis.

Registration

This protocol was registered at the PROSPERO database (International Prospective Register of Systematic Review) under registration number CRD42020210118.

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All authors contributed to study conception and design. Material preparation, data collection, and analysis were performed by Kaique Leite de Lima, Lorena Rosa Silva, and Fernanda Paula Yamamoto-Silva. The first draft of the manuscript was written by Kaique Leite de Lima, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Brunno Santos de Freitas Silva.

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de Lima, K.L., Silva, L.R., de Paiva Prado, T.B. et al. Influence of the technical parameters of CBCT image acquisition on vertical root fracture diagnosis: a systematic review and meta-analysis. Clin Oral Invest 27, 433–474 (2023). https://doi.org/10.1007/s00784-022-04797-z

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