Maha Sayed Mohamed , Salma Belal Eiid , Dina Mohamed El Beshlawy And Sahar Hosny El Dessouky,

ABSTRACT

Objectives: The Purpose Of This Study Was To Compare The Intraoral Periapical Radiographic Techniques (parallel And Bisecting Techniques) And The ULD CBCT Protocol For Their Detection Capabilities Of Simulated Horizontal Root Fractures With Different Angles. Methodology: 195 Extracted Incisors Were Divided Into Three Equal Groups Of 65 Teeth Each. Artificially Simulated Incomplete HRF Were Prepared In Two Groups With Two Different Angulations (75? & 45?), And At Two Different Locations (cervical And Middle) By Using A Separating Disk, Where The Third Group Was The Control Group. Positioning Of The Teeth Was Randomly Undertaken In The Sockets Of A Dry Human Skull And Mandible, And Then Imaged Using The Three Radiographic Techniques. For Qualitative Analysis, Sensitivity, Specificity, And Test Diagnostic Accuracy Were Calculated. For Quantitative Assessment, Dahelberg Error (DE) And Bland And Altman Limits Of Agreements (LOA) Were Applied. For Inter And Intra-observer Reliability Analysis, Kappa Measure Of Inter-rater Agreement And Intra-class Correlation Coefficients (ICC) Were Calculated.

Results: The ULD CBCT Has The Highest Sensitivity, Specificity And Diagnostic Accuracy For Detecting HRF At Any Angle And Location. Regarding The Accurate Determination Of The Oblique Course Of Fracture Lines, The Intraoral Radiographic Techniques Showed A Very Low Concordance Compared To ULD CBCT. The Magnitude Of Absolute Measurement Error For The Whole Set Of Teeth Was 1.89? With No Statistical Significant Difference, 95% CI (-5.09 ? 5.41). Additionally, Very Good To Excellent Inter And Intra-observer Agreement Was Perceived When Considering The Measurement Of The Simulated HRF Angulation (0.78 - 0.99). Conclusion: The ULD CBCT Imaging Protocol Of Planmeca Promax 3D Mid Was The Best Modality For Detection And Localization Of HRF With High Validity And Reliability In Angular Measurement Assessment.