Evidence map›Paper›PMID 41510664›Full record

ArticleInternational endodontic journal2026

Photon-Counting CT for Diagnosing Vertical Root Fractures in Teeth With Metal Posts: An Ex Vivo Comparative Analysis With Four CBCT Devices.

Renata M S Leal, Fernanda B Fagundes, Maria F S A Bortoletto, Samuel C Kluthcovsky, Walter Coudyzer, Bruno C Cavenago, Reinhilde Jacobs, Rocharles Cavalcante Fontenele

Abstract readComparative Study
In one paragraph

Article in International endodontic journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Renata M S LealDepartment of Restorative Dentistry, Federal University of Paraná, Paraná, Brazil.ORCID https://orcid.org/0000-0002-8448-6671
Fernanda B FagundesDepartment of Oral Diagnosis, Area of Dental Radiology, Piracicaba Dental School, State University of Campinas (UNICAMP), São Paulo, Brazil.ORCID https://orcid.org/0000-0002-9777-4197
Maria F S A BortolettoDepartment of Oral Diagnosis, Area of Dental Radiology, Piracicaba Dental School, State University of Campinas (UNICAMP), São Paulo, Brazil.ORCID https://orcid.org/0000-0003-2300-3143
Samuel C KluthcovskyDepartment of Mechanical Engineering, Federal University of Paraná, Paraná, Brazil.ORCID https://orcid.org/0000-0002-2096-0688
Walter CoudyzerDepartment of Radiology, University Hospitals Leuven, Leuven, Belgium.ORCID https://orcid.org/0000-0002-6406-7496
Bruno C CavenagoDepartment of Restorative Dentistry, Federal University of Paraná, Paraná, Brazil.ORCID https://orcid.org/0000-0003-3203-0899
Reinhilde JacobsOMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium.ORCID https://orcid.org/0000-0002-3461-0363
Rocharles Cavalcante FonteneleOMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium.ORCID https://orcid.org/0000-0002-6426-9768

Funding

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
6 · The paper itself

Abstract

objectivePhoton-counting computed tomography (PCCT) represents a major innovation in X-ray detection technology, offering improved signal efficiency and reduced electronic noise compared with cone-beam computed tomography (CBCT), which can enhance image quality. This study aimed to evaluate the diagnostic performance of PCCT in detecting vertical root fractures (VRF), in comparison with four CBCT devices. METHODOLOGY: Eighteen single-rooted teeth were endodontically treated, and VRF was induced in eight of them. Each tooth was individually placed into the mandibular first premolar empty socket of an anthropomorphic phantom and scanned under three conditions: without a metal post, with a nickel-chromium metal post (Ni-Cr), and with a cobalt-chromium metal post (Co-Cr) in five CT devices: the NAEOTOM Alpha PCCT (Siemens Healthineers) device and four CBCT devices (3D Accuitomo 170-Morita, Veraview X800-Morita, NewTom VGi evo-NewTom, and Carestream 9600-Carestream). The highest-resolution protocol available on each device was used, resulting in a total of 270 scans. Five experienced dentomaxillofacial radiologists independently and blindly evaluated the scans using a five-point confidence scale. Diagnostic accuracy was assessed by calculating the area under the ROC curve (AUC), sensitivity, and specificity, with results compared by two-way ANOVA with post hoc Tukey's test (α = 0.05).

resultsNewTom VGi and PCCT devices showed significantly higher AUC values than the Veraview X800, regardless of the metal post material (p < 0.05). CS9600 and PCCT devices exhibited significantly higher sensitivity values in diagnosing with Ni-Cr posts than the Accuitomo 3D and Veraview X800 devices (p < 0.05). With the Co-Cr metal post, the NewTom VGi, CS9600, and PCCT devices showed significantly higher sensitivity values compared to the Veraview X800 device (p < 0.05). There were no statistically significant differences in specificity, regardless of the CT device or metal post material (p > 0.05).

conclusionsThe NEAOTOM Alpha PCCT showed high diagnostic accuracy for VRF detection in an ex vivo model, comparable to high-resolution CBCT devices, highlighting its diagnostic performance under controlled ex vivo conditions.

Indexed as

Cone-Beam Computed TomographyPost and Core TechniqueTomography, X-Ray ComputedTooth FracturesTooth RootHumansIn Vitro TechniquesPhantoms, ImagingPhotonsSensitivity and Specificitycone‐beam computed tomographydiagnostic imagingmetalsphoton‐counting computed tomographyvertical root fracture

Identifiers

PMID41510664
PMCPMC12977933

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.