Intraoral tomosynthesis accuracy for cone length measurement is comparable to physical measurement of gutta-percha.

OBJECTIVE: To assess the efficacy of cone fit measurements of digital periapical (PA) and stationary intraoral tomosynthesis (s-IOT) images and compare them to the physical measurement of gutta-percha (gold standard). STUDY DESIGN: Images of 40 extracted teeth with gutta-percha in their prepared root canals were acquired using digital PA and 3D s-IOT devices (Portray system), while the physical cone length of the gutta-percha was measured using a digital vernier caliper. Digital PA cone length was measured using MiPACS Dental Enterprise Viewer Software with a polyline measurement tool. Cone length in the s-IOT images was measured by scrolling through synthetic images taken at different angle disparities. All measurements were recorded and subjected to statistical analysis. RESULTS: Interclass correlation coefficient (ICC) test showed statistical significance. The gold standard vs s-IOT measurements had the highest reliability across all groups, often exceeding 0.9. Comparisons involving PA (PA vs gold standard and PA vs s-IOT) tend to have lower reliability, with several confidence intervals including 0. Statistically significant P-values across all comparisons suggest these ICCs are meaningful, but confidence intervals highlight potential issues with data variability. CONCLUSIONS: While both modalities differed from the gold standard, s-IOT demonstrated a clear advantage in measurement accuracy and reliability.