We developed a novel, powerful segmentation algorithm and an intuitive 3-D visualization tool for the examination of root fractures with minimum user intervention. The application computes and displays a suitable oblique orientation on a selected tooth by placing at least two splines (inside and outside of the tooth) in just one slice of the volume. Next, it allows the user to scroll through the volume, slice-by-slice in parallel to the plane, or to examine the tooth by changing the orientation of a 3-D object plane (called a virtual bitewing ), which is placed, at the same time, in a volume rendition. Both the root canal and the root fracture are highlighted during the examination phase. Doctors (end users) are in control to quickly and confidently examine root fractures in 3-D, for any given oblique orientation, without worrying about missing a selected tooth. We have designed and implemented these algorithms using the image foresting transform (IFT) technique for interactive tooth segmentation and used a multi-scale parameter search for automatic oblique orientation estimation. © 2013 SPIE.8671 Aeroflex Incorporated,CREOL - Univ. Central Florida, Coll. Opt. Photonics,DQE Instruments, Inc.,Medtronic, Inc.,PIXELTEQ, Multispectral Sensing and ImagingCotton, T.P., Geisler, T.M., Holden, D.T., Schwarts, S.A., Schindler, W.G., Endodontic application of cone-beam volumetric tomography (2007) J. Endod., 33 (9), pp. 1121-1132Patel, S., Dawood, A., Ford, T.P., Whaites, E., The potential applications of cone beam computed tomography in the management of endodontic problems (2007) Int. Endod. J., 40 (10), pp. 818-830Hassan, B., Metska, M.E., Ozok, A.R., Van Der Stelt, P., Wesselink, P.R., Detection of vertical fractures in endodontically treated teeth by a cone beam computed tomography scan (2009) J. Endod., 35 (5), pp. 719-722Palomo, L., Palomo, J., Cone beam CT for diagnosis and planning in trauma cases (2009) Dent. Clin. North Am., 53 (4), pp. 717-727Falcão, A., Stolfi, J., Lotufo, R., The image foresting transform: Theory, algorithms, and applications (2004) IEEE Trans. Pattern Anal. Mach. Intell., 26 (1), pp. 19-29Falcão, A., Bergo, F., Interactive volume segmentation with differential image foresting transforms (2004) IEEE Trans. Med. Imaging., 23 (9), pp. 1100-1108Chiachia, G., Falcão, A., Rocha, A., (2011) Multiscale Parameter Search (MSPS): A Deterministic Approach for Black-box Global Optimization, , Tech. Report IC 11-15, Institute of Computing - Unicamp, Campinas-SP, BrazilBergo, F., Falcão, A., Miranda, P., Rocha, L., Automatic image segmentation by tree pruning (2007) J. Math. Imaging Vis., 29, pp. 141-162Miranda, P., Falcão, A., Links between image segmentation Based on Optimum-Path Forest and Minimum Cut in graph (2009) J. Math. Imaging Vis., 35, pp. 128-142Ciesielski, K., Udupa, J., Falcão, A., Miranda, P., Fuzzy connectedness image segmentation in graph cut formulation: A linear-time algorithm and a comparative analysis (2012) J. Math. Imaging Vis., 44, pp. 375-398Schroeder, W., Martin, K., Lorensen, B., (2006) The Visualization Toolkit: An Object-Oriented Approach to 3D Graphics, , 4th Edition, Kitware, Clifton Park, NYRashedi, E., Nezamabadi-pour, H., Saryazdi, S., GSA: A gravitational search algorithm (2009) Inf. Sci., 179 (13), pp. 2232-2248