The present study aimed to evaluate the performance of cone beam computed tomography (CBCT) and digital periapical radiographs (PR) in diagnosing external root resorption (ERR) in human permanent teeth replanted after traumatic avulsion. The samples comprised 39 permanent maxillary incisors replanted after traumatic avulsion. Digital PR and CBCT images were taken from each tooth and independently examined by 2 calibrated examiners to assess the ERR activity regarding type and extension. The degrees of agreement between both imaging examinations were determined by the mean global agreement index using SPSS software. The two imaging examinations diverged greatly in the diagnosis of the type of ERR since CBCT identified more cases as inflammatory ERR and PR as replacement ERR. A discordance level of 69.2% was observed between the two methods in the diagnosis of the type of ERR when CBCT for mesial and distal (MD) surfaces was considered and 61.5% when CBCT for mesial, distal, buccal and lingual (MD/BL) was considered. Likewise, CBCT and PR differed regarding the ERR index. PR examinations classified most cases as moderate or severe (69.2%), while CBCT examinations classified more cases as mild either in the MD surfaces analysis (41.4%) or in the analysis of the MD-BL surfaces (51.3%). In conclusion, the present results highlight a discrepancy between CBCT and digital PR performance in the diagnosis of different types and extent of ERR in replanted teeth.

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