Abstract
AIM: The aim of this systematic review is to critically evaluate the current evidence regarding diagnostic value of contrast-enhanced cone-beam computed tomography (CBCT) in increasing the detectability of cracks and fractures in teeth.
MATERIALS AND METHODS: Literature was reviewed from PubMed, Science Direct, Web of Science, and Saudi Digital Library in January 2025. The searched keywords included "Cone-beam computed tomography", "CBCT", "Contrast agents", "Tooth cracks", and "Tooth fractures". Only articles in the English language were included. The final analysis included four publications that satisfied the eligibility requirements.
RESULTS: The evidence indicates that CBCT imaging with contrast improves the sensitivity, specificity, and accuracy of diagnosis. Enhanced sensitivity and specificity were over 80%. Contrast-enhanced CBCT successfully reduced artifacts and detected subsurface cracks, with accuracy gains ranging from 4.4 to 72.1%. Imaging protocols affected the performance, while using sodium iodide, dimethyl sulfoxide, ethyl alcohol, and ethyl acetate produced the best accuracy (100%, p < 0.01).
CONCLUSION: In contemporary dentistry, contrast-enhanced CBCT is a promising development.
CLINICAL SIGNIFICANCE: The use of contrast-enhanced CBCT imaging could significantly improve the diagnostic precision of teeth cracks and fractures identification, which could lead to earlier detection and advanced treatment planning with better patient outcomes. How to cite this article: Sabban H, Abdel-Wahed N. Effectiveness of Contrast Agents in Cone-beam Computed Tomography for Diagnosing Tooth Cracks and Fractures: A Systematic Review and Meta-analysis. J Contemp Dent Pract 2025;26(5):519-525.