Abstract: [Abstract] Objective To compare the accuracy of CBCT scans and digital radiography (DR) for detecting simulated VRF. Methods Twenty-seven teeth of one human skull specimen were extracted out, decoronated and randomly divided into 2 groups. 14 roots were in experimental group and 13 in control group. An awl in root canal was inserted to split up the root to make the vertical fracture model in experimental group. Those in control group were kept intact. Then all teeth were placed back to the skull specimen. CBCT scans and DR were obtained. Two blinded groups of observers evaluated the CBCT and DR images independently to make the diagnosis of fracture. Whether to fracture or not was taken as the gold standard, and the two methods and the consistency of results by the observers were evaluated. Results The sensitivity and specificity of VRF of human specimen diagnosed by the CBCT were 75% and 100%, and those by digital radiography were 60.72% and 84.62%, respectively. The reliability of CBCT (κ=0.743) was higher than that of digital radiography (κ=0.449). The coherence of the two groups of investigators was high with CBCT (κ=0.922) and medium with digital radiography (κ=0.611). Conclusions The results showed higher sensitivity, specificity and reliability for CBCT scans than digital radiography for detecting VRF. The coherence of the observers was higher using CBCT.

Key words: 　　Cone beam computed tomography, Digital radiography, Vertical root fracture, Diagnosis