Which factors related to apical radiolucency may influence its radiographic detection? A study using CBCT as reference standard
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Objectives: This study aimed to evaluate the detection rate of apical radiolucencies in 2-dimensional images using cone-beam computed tomography (CBCT) as the reference standard, and to determine which factors related to the apical radiolucencies and the teeth could influence its detection. Materials and Methods: The sample consisted of exams of patients who had panoramic (PAN) and/or periapical (PERI) radiography and CBCT. The exams were assessed by 2 oral radiologists and divided into PAN+CBCT (227 teeth–285 roots) and PERI+CBCT (94 teeth–115 roots). Radiographic images were evaluated for the presence of apical radiolucency, while CBCT images were assessed for presence, size, location, and involvement of the cortical bone (thinning, expansion, and destruction). Diagnostic values were obtained for PERI and PAN. Results: PERI and PAN presented high accuracy (0.83 and 0.77, respectively) and specificity (0.89 and 0.91, respectively), but low sensitivity, especially for PAN (0.40 vs. 0.65 of PERI). The size of the apical radiolucency was positively correlated with its detection in PERI and PAN (p < 0.001). For PAN, apical radiolucencies were 3.93 times more frequently detected when related to single-rooted teeth (p = 0.038). The other factors did not influence apical radiolucency detection (p > 0.05). Conclusions: PERI presents slightly better accuracy than PAN for the detection of apical radiolucency. The size is the only factor related to radiolucency that influences its detection, for both radiographic exams. For PAN, apical radiolucency is most often detected in single-rooted teeth.
Abstract
Objectives: This study aimed to evaluate the detection rate of apical radiolucencies in 2-dimensional images using cone-beam computed tomography (CBCT) as the reference standard, and to determine which factors related to the apical radiolucencies and the teeth could influence its detection. Materials and Methods: The sample consisted of exams of patients who had panoramic (PAN) and/or periapical (PERI) radiography and CBCT. The exams were assessed by 2 oral radiologists and divided into PAN+CBCT (227 teeth–285 roots) and PERI+CBCT (94 teeth–115 roots). Radiographic images were evaluated for the presence of apical radiolucency, while CBCT images were assessed for presence, size, location, and involvement of the cortical bone (thinning, expansion, and destruction). Diagnostic values were obtained for PERI and PAN. Results: PERI and PAN presented high accuracy (0.83 and 0.77, respectively) and specificity (0.89 and 0.91, respectively), but low sensitivity, especially for PAN (0.40 vs. 0.65 of PERI). The size of the apical radiolucency was positively correlated with its detection in PERI and PAN (p < 0.001). For PAN, apical radiolucencies were 3.93 times more frequently detected when related to single-rooted teeth (p = 0.038). The other factors did not influence apical radiolucency detection (p > 0.05). Conclusions: PERI presents slightly better accuracy than PAN for the detection of apical radiolucency. The size is the only factor related to radiolucency that influences its detection, for both radiographic exams. For PAN, apical radiolucency is most often detected in single-rooted teeth.
참고문헌 (21)
- Estrela C, "A new periapical index based on cone beam computed tomography", J Endod, 34, pp.1325~1331 (2008)
- Estrela C, "Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis", J Endod, 34, pp.273~279 (2008)
- de Freitas JV, "Efficacy of different cone-beam computed tomographic protocols in the identification of mesiobuccal canals of maxillary first molars: a tomographic and ex vivo study", J Endod, 43, pp.810~815 (2017)
- Patel S, "New dimensions in endodontic imaging: part 2. Cone beam computed tomography", Int Endod J, 42, pp.463~475 (2009)
- Moura MS, "Influence of length of root canal obturation on apical periodontitis detected by periapical radiography and cone beam computed tomography", J Endod, 35, pp.805~809 (2009)
- Durack C, "Cone beam computed tomography in endodontics", Braz Dent J, 23, pp.179~191 (2012)
- Patel S, "Cone beam computed tomography in endodontics - a review of the literature", Int Endod J, 52, pp.1138~1152 (2019)
- Pope O, "A comparative investigation of cone-beam computed tomography and periapical radiography in the diagnosis of a healthy periapex", J Endod, 40, pp.360~365 (2014)
- Nardi C, "Accuracy of orthopantomography for apical periodontitis without endodontic treatment", J Endod, 43, pp.1640~1646 (2017)
- Nardi C, "Is panoramic radiography an accurate imaging technique for the detection of endodontically treated asymptomatic apical periodontitis?", J Endod, 44, pp.1500~1508 (2018)
- Esposito S, "A suggested technique for the application of the cone beam computed tomography periapical index", Dentomaxillofac Radiol, 40, pp.506~512 (2011)
- Kapila R, "Evaluation of juxta-apical radiolucency in cone beam CT images", Dentomaxillofac Radiol, 43, pp.20130402~ (2014)
- Patel S, "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, 45, pp.711~723 (2012)
- Davies A, "The detection of periapical pathoses in root filled teeth using single and parallax periapical radiographs versus cone beam computed tomography - a clinical study", Int Endod J, 48, pp.582~592 (2015)
- López FU, "Accuracy of cone-beam computed tomography and periapical radiography in apical periodontitis diagnosis", J Endod, 40, pp.2057~2060 (2014)
- Kanagasingam S, "Diagnostic accuracy of periapical radiography and cone beam computed tomography in detecting apical periodontitis using histopathological findings as a reference standard", Int Endod J, 50, pp.417~426 (2017)
- Abella F, "An evaluation of the periapical status of teeth with necrotic pulps using periapical radiography and cone-beam computed tomography", Int Endod J, 47, pp.387~396 (2014)
- Kanagasingam S, "Accuracy of single and parallax film and digital periapical radiographs in diagnosing apical periodontitis - a cadaver study", Int Endod J, 50, pp.427~436 (2017)
- Kruse C, "Cone beam computed tomography and periapical lesions: a systematic review analysing studies on diagnostic efficacy by a hierarchical model", Int Endod J, 48, pp.815~828 (2015)
- Bender IB, "Factors influencing the radiographic appearance of bony lesions", J Endod, 23, pp.5~14 (1997)
- Bender IB, "Roentgenographic and direct observation of experimental lesions in bone: II. 1961", J Endod, 29, pp.707~712 (2003)