***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES The aim of this study was to assess the accuracy of cone beam CT ( CBCT ) in detecting vertical root fractures  and to compare the accuracy with images from an intraoral sensor and from conventional intraoral film . METHODS 60 extracted , single-rooted human teeth were divided equally into two groups : a control group of 30 teeth and an induced fracture group of 30 teeth . All teeth were r and omly placed into sockets in six dry m and ibles . Each tooth was imaged by three modalities : CBCT , intraoral digital radiography and intraoral F-speed film . Three beam angulations ( an orthogonal projection and additional projections with ± 20 ° horizontal shifts of the central ray ) were used when radiographs were made using film and a digital sensor . Three oral and maxillofacial radiologists evaluated the presence of root fractures twice in each image modality using a five-point confidence rating scale . Areas under receiver operating characteristic curves ( A(z ) ) were computed for each observer and modality and were tested for statistical differences using the Kruskal-Wallis test . RESULTS There was no statistical difference in the performance of the three modalities ( mean of A(z ) values : CBCT = 0.811 , film = 0.797 and sensor = 0.775 ; p = 0.771 ) . CONCLUSIONS There was no significant difference between intraoral film , a high-resolution complementary metal oxide semiconductor digital imaging system and CBCT in detecting vertical root fractures in m and ibular single-rooted teeth INTRODUCTION The purpose of this study was to evaluate the influence of cone-beam computed tomography ( CBCT ) imaging modes in the diagnosis of  vertical root fractures with different intracanal material s. METHODS The sample consisted of 30 single-rooted teeth divided into 3 groups ( n = 10 ) , control and complete and incomplete root fracture . In each tooth , different material s were used ( gutta-percha , metal post , and fiber post ) as well as no filling material . Each tooth/root was scanned in a 3D Accuitomo 170 CBCT device by using 4 different imaging modes ( high-resolution , high-fidelity , high-speed , and st and ard ) . In addition , the dose-area product was calculated for each CBCT imaging mode . The images were r and omly evaluated by 5 dentomaxillofacial radiologists . RESULTS Complete root fractures were visualized more easily than incomplete fractures . The presence of metal post and gutta-percha negatively influenced the diagnosis of root fracture . Regarding the CBCT imaging modes , there was no influence for complete root fracture diagnosis . In cases of incomplete root fractures , high-fidelity , high-resolution , and st and ard had a higher diagnostic accuracy , especially in the fiber post and no filling groups . CONCLUSIONS The CBCT imaging modes had little influence in the diagnosis of complete and incomplete root fractures , whereas the presence of intracanal material had greater impact on the diagnostic ability , demonstrating that CBCT is not beneficial for the diagnosis of root fractures when metal posts are present OBJECTIVES Two-dimensional intraoral radiography is the most common tool for diagnosing root fractures ( RFs ) .  Cone beam CT ( CBCT ) is widely used to depict RFs in endodontically treated teeth . Beam hardening and other artefacts caused by gutta percha may result in an incorrect diagnosis when using CBCT only . A comparison of two CBCT machines with photostimulated phosphor ( PSP ) plate images enhanced with the equalization tool was carried out to detect RFs in endodontically treated teeth . METHODS 66 roots were collected , decoronated and treated endodontically using the  same technique with gutta percha . 33 of these roots were r and omly selected and fractured ; the 2 root fragments were glued together with 1 layer of methyl methacrylate and placed r and omly in 8 prepared beef rib fragments . Large fields of view ( FOVs ) were acquired with one CBCT unit and small FOVs with the second CBCT unit . Periapical radiographs ( using intraoral PSP plates ) were also acquired . A contrast enhancement tool was used when evaluating the PSP plate images . RESULTS Small FOV images had significantly higher accuracy ( area under the receiver operating characteristic curve ) and sensitivity in detecting RFs than PSP plates and large FOV images . The specificity of the enhanced PSP images was higher than , although not significantly higher than , the small FOV images and was significantly higher than the large FOV images . CONCLUSIONS CBCT small FOVs should be acquired for depicting RFs of endodontically treated teeth . Images obtained using PSP plates had the lowest rate of false-positive results and their use can save the patient a radiation dose Objectives This study aim ed to compare the diagnostic accuracy of two different cone-beam computed tomography ( CBCT ) units with several intraoral radiography techniques for detecting horizontal root fractures . Methods The study material comprised 82 extracted human maxillary incisors without root fractures that had not undergone any root canal treatment . Root fractures were created in the horizontal plane in 31 teeth by a mechanical force using a hammer with the tooth placed on a soft foundation as described in a previous study . The teeth were divided into two groups : a control group with no fractures and a test group with fractures . These were r and omized to the empty maxillary anterior sockets of a dry human maxilla . Each tooth was imaged at various vertical angles using each of the following modalities : a 3D Accuitomo 170 CBCT , a NewTom 3 G CBCT , a VistaScan PSP , a CCD sensor , and conventional film .  Specificity and sensitivity for assessing horizontal root fracture by each radiographic technique were calculated . Chi-square statistics were used to evaluate differences between modalities . Kappa statistics assessed the agreement between observers . Results were considered significant at P < 0.05 . Results The kappa values for inter-observer agreement between observers ranged between 0.88 and 0.98 for the 3D Accuitomo 170 , 0.82 and 0.91 for the NewTom 3 G , and 0.61 and 0.72 for the different types of intraoral images . The diagnostic accuracy for detecting fracture lines in 3D Accuitomo 170 ( 0.93 ) was significantly higher than NewTom 3 G ( 0.87 ) , VistaScan ( 0.71 ) , CCD ( 0.70 ) , and CF ( 0.68 ) . Conclusions 3D Accuitomo 170 has the highest sensitivity and diagnostic accuracy for detecting horizontal root fracture among the 5 radiographic modalities examined . CBCT should be considered as the most reliable imaging modality of choice for the diagnosis of horizontal root fracture . Clinical relevance CBCT imaging offers the clear advantage over conventional imaging that traumatized teeth can be visualized in all three dimensions — especially the oro-facial AIM To compare the accuracy of digital radiography ( DR ) , multidetector computed tomography ( MDCT ) and cone beam computed tomography ( CBCT ) in detecting  vertical root fractures ( VRF ) in the absence and presence of gutta-percha root filling . METHODOLOGY The root canals of 100 extracted human single-rooted teeth were prepared and r and omly divided into four groups : two experimental groups with artificially fractured root and two intact groups as controls . In one experimental and one control group , a size 40 , 0.04 taper gutta-percha cone was inserted in the root canals . Then DR , MDCT and CBCT were performed and the images evaluated . Statistical analyses of sensitivity , specificity and accuracy of each imaging technique in the presence and absence of gutta-percha were calculated and compared . RESULTS In the absence of gutta-percha , the specificity of DR , MDCT and CBCT was similar .  CBCT  was the most accurate and sensitive imaging technique ( P < 0 .05 ) . In the presence of gutta-percha , the accuracy of MDCT  was higher than the other imaging techniques ( P < 0.05 ) . The sensitivity of CBCT and MDCT  was significantly higher than that of DR ( P < 0.05 ) , whereas CBCT was the least specific technique . CONCLUSIONS Under the conditions of this ex vivo study , CBCT was the most sensitive imaging technique in detecting vertical root fracture . The presence of gutta-percha reduced the accuracy , sensitivity and specificity of CBCT but not MDCT . The sensitivity of DR was reduced in the presence of gutta-percha . The use of MDCT as an alternative technique may be recommended when VRF are suspected in root filled teeth . However , as the radiation dose of MDCT is higher than CBCT , the technique could be considered at variance with the principles of ALARA AIM To assess the failure and bone-to-implant contact rate of  dental implants placed on osteoporotic subjects . METHODS Extensive examination strategies were created to classify studies for this systematic review . MEDLINE ( via PubMed ) and EMBASE data base were examined for studies in English up to and including May 2014 . The examination presented a combination of the MeSH words described as follow : " osteoporosis " or " osteopenia " or " estrogen deficiency " AND " implant " or " dental implant " or " osseointegration " . Assessment of clinical and /or histological peri-implant conditions in osteoporosis subjects treated with titanium dental implants . The examination included a combination of the MeSH terms described as follow : " osteoporosis " or " osteopenia " or " estrogen deficiency " AND " implant " or " dental implant " or " osseointegration " . RESULTS Of 943 potentially eligible articles , 12 were included in the study . A total of 133 subjects with osteoporosis , 73 subjects diagnosed with osteopenia and 708 healthy subjects were assessed in this systematic review . In these subjects were installed 367 , 205 , 2981 dental implants in osteoporotic , osteopenic and healthy subjects , respectively . The failure rate of dental implant was 10.9 % in osteoporotic subjects , 8.29 % in osteopenic and 11.43 % in healthy ones . Bone-to-implant contact obtained from retrieved implants ranged between 49.96 % to 47.84 % , for osteoporosis and non-osteoporotic subjects . CONCLUSION Osteoporotic subjects presented higher rates of implant loss , however , there is a lower evidence to strengthen or refute the hypothesis that osteoporosis may have detrimental effects on bone healing . Consequently , final conclusions regarding the effect of osteoporosis in dental implant therapy can not be made at this time . There are no r and omized clinical trial accessible for evaluation and the retrospective nature of the evaluated studies shall be taken in account when interpreting this study This is the second in a series of five articles Considerable effort has been expended at the interface between clinical medicine and scientific methods to achieve the maximum validity and usefulness of diagnostic tests . This article focuses on the specific kinds of questions that arise in diagnostic research and the study architectures ( the conversions of these clinical questions into appropriate research design s ) used to answer them . As an example we shall take shall take assessment of the value of the plasma concentration of B-type natriuretic peptide ( BNP )  in the diagnosis of left ventricular dysfunction.1  R and omised controlled trials are dealt with elsewhere . As in other forms of clinical research , there are several different ways study ing the potential or real diagnostic value of a physical sign or laboratory test , and each is appropriate to one kind of question and inappropriate for others . Among the possible questions about the relation between a putative diagnostic test and a target disorder ( for example , the concentration of BNP and left ventricular dysfunction ) , four are most relevant . # # # # Summary points Diagnostic studies should match methods to diagnostic questions The keys to validity in diagnostic test studies are Both specificity and sensitivity may change as the same diagnostic test is applied in primary , 
    Output:
    
Diagnostic odds ratio values revealed a wide range of results across the studies and determined a higher heterogeneity for PR compared with CBCT .
CBCT was the imaging exam that rendered a higher diagnostic accuracy for root fractures