World Journal of Dentistry

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VOLUME 10 , ISSUE 5 ( September-October, 2019 ) > List of Articles


A Comparative Study of Periapical Radiographs and Cone-beam Computed Tomography to Detect the Effects of Periapical Lesions

Fatima M Jadu, Ahmed M Jan

Keywords : Cone-beam computed tomography, Diagnostic accuracy, Periapical lesion, Periapical radiographs, Root resorption

Citation Information : Jadu FM, Jan AM. A Comparative Study of Periapical Radiographs and Cone-beam Computed Tomography to Detect the Effects of Periapical Lesions. World J Dent 2019; 10 (5):346-349.

DOI: 10.5005/jp-journals-10015-1667

License: CC BY-NC 4.0

Published Online: 01-10-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Aim: To compare the diagnostic performance of cone-beam computed tomography (CBCT) relative to periapical radiographs (PAs) for detecting the effects of periapical lesions (PLs) on the roots and surrounding structures. Materials and methods: This prospective study considered teeth with PLs referred for extraction. To be included, the teeth must also have a recent diagnostic quality PA and a recent CBCT examination with the tooth in question imaged clearly. The images were anonymized, scrambled, and reviewed by two calibrated observers. The extracted teeth were sent along with their periapical tissues for histopathologic examination. Data collected included patient age and gender, the tooth in question, and the histopathologic diagnosis of the apical tissues. The observers were required to record the presence or absence of root resorption, encroachment on the maxillary sinus, and compression of the mental foramen and/or mandibular canal. Results: Cone-beam computed tomography performed superior to PA, detecting more effects on the surrounding structures, but this was only statistically significant for the effect of external root resorption (ERR) (p < 0.001). This was true irrespective of the histopathologic diagnosis of PL. Conclusion: The diagnostic performance of CBCT was significantly superior to that of PA for detecting ERR on teeth with PL. Clinical significance: The diagnostic accuracy of CBCT exceeds that of PA for detecting the effects of PL. However, the diagnostic accuracy is one of many factors to consider when choosing a diagnostic imaging modality for a specific task. Overall, CBCT examinations should be reserved for challenging cases after PAs have failed to provide all the required diagnostic information.

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  1. Balasundaram A, Shah P, Hoen MM, et al. Comparison of cone-beam computed tomography and periapical radiography in predicting treatment decision for periapical lesions: a clinical study. Int J Dent 2012;2012:920815. DOI: 10.1155/2012/920815.
  2. Wallace JA, Nair MK, Colaco MF, et al. A comparative evaluation of the diagnostic efficacy of film and digital sensors for detection of simulated periapical lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92(1):93–97. DOI: 10.1067/moe.2001.115974.
  3. Bender IB. Factors influencing the radiographic appearance of bony lesions. J Endod 1997;23(1):5–14. DOI: 10.1016/S0099-2399(97)80199-9.
  4. Halse A, Molven O, Fristad I. Diagnosing periapical lesions—disagreement and borderline cases. Int Endod J 2002;35(8):703–709. DOI: 10.1046/j.1365-2591.2002.00552.x.
  5. Administration SSUSFaD. U. S. Food and Drug Administration. Statistical guidance on reporting results from studies evaluating diagnostic tests. Available from: http: //wwwfdagov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm071148htm [Google Scholar]. issued 2007 March 13, cited 2011 December 25.
  6. Jadu FM, Lam EW. A comparative study of the diagnostic capabilities of 2D plain radiograph and 3D cone beam CT sialography. Dentomaxillofac Radiol 2013;42(1):20110319. DOI: 10.1259/dmfr.20110319.
  7. Yi J, Sun Y, Li Y, et al. Cone-beam computed tomography versus periapical radiograph for diagnosing external root resorption: A systematic review and meta-analysis. Angle Orthod 2017;87(2):328–337. DOI: 10.2319/061916-481.1.
  8. Lima TF, Gamba TO, Zaia AA, et al. Evaluation of cone beam computed tomography and periapical radiography in the diagnosis of root resorption. Aust Dent J 2016;61(4):425–431. DOI: 10.1111/adj.12407.
  9. Estrela C, Bueno MR, De Alencar AH, et al. Method to evaluate inflammatory root resorption by using cone beam computed tomography. J Endod 2009;35(11):1491–1497. DOI: 10.1016/j.joen.2009.08.009.
  10. Patel S, Wilson R, Dawood A, et al. The detection of periapical pathosis using digital periapical radiography and cone beam computed tomography - part 2: a 1-year post-treatment follow-up. Int Endod J 2012;45(8):711–723. DOI: 10.1111/j.1365-2591.2012.02076.x.
  11. Jadu FM, Alzahrani AA, Almutairi MA, et al. The effect of varying cone beam computed tomography image resolution and field-of-view centralization on effective radiation dose. Saudi Med J 2018;39(5):470–475. DOI: 10.15537/smj.2018.5.21658.
  12. Lorenzoni DC, Bolognese AM, Garib DG, et al. Cone-beam computed tomography and radiographs in dentistry: aspects related to radiation dose. Int J Dent 2012;2012:813768. DOI: 10.1155/2012/813768.
  13. Kadesjo N, Lynds R, Nilsson M, et al. Radiation dose from X-ray examinations of impacted canines: cone beam CT vs two-dimensional imaging. Dentomaxillofac Radiol 2018;47(3):20170305. DOI: 10.1259/dmfr.20170305.
  14. Jadu FM, Hill ML, Yaffe MJ, et al. Optimization of exposure parameters for cone beam computed tomography sialography. Dentomaxillofac Radiol 2011;40(6):362–368. DOI: 10.1259/dmfr/81159071.
  15. Liedke GS, da Silveira HE, da Silveira HL, et al. Influence of voxel size in the diagnostic ability of cone beam tomography to evaluate simulated external root resorption. J Endod 2009;35(2):233–235. DOI: 10.1016/j.joen.2008.11.005.
  16. American Association of E, American Academy of O and Maxillofacial R. Use of cone-beam computed tomography in endodontics Joint Position Statement of the American Association of Endodontists and the American Academy of Oral and Maxillofacial Radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111(2):234–237. DOI: 10.1016/j.tripleo.2010.11.012.
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