Overall, AUC, sensitivity, and specificity did not differ significantly (p > 0.05) between the dose protocols. Area under the ROC curve (AUC), sensitivity, and specificity were calculated and compared using ANOVA (α = 0.05). Five radiologists evaluated the images and indicated the presence of VRF using a 5-point scale. All teeth were individually placed in a human mandible covered with a soft tissue equivalent material, metallic materials were placed at different dispositions in the exomass and/or endomass, and CBCT scans were obtained at two dose protocols: standard and optimised. Twenty teeth were endodontically instrumented and VRF was induced in half of them. The aim of this study was to evaluate the diagnostic accuracy of an optimised CBCT protocol in the detection of simulated vertical root fracture (VRF) in the presence of metal in the exomass and/or inside the FOV. Although the reduction of the field-of-view (FOV) size has shown to be an effective strategy, this indirectly increases the negative effect from the exomass. Dose optimisation has been revisited in the literature due to the frequent use of cone beam computed tomography (CBCT).
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