Accuracy of Cone-Beam Computed Tomography and Periapical Radiography in Detecting Small Periapical Lesions

Tsai, Patrick; Torabinejad, Mahmoud; Rice, Dwight; Azevedo, Bruno

doi:10.1016/j.joen.2012.03.001

Cited by 110 publications

(88 citation statements)

References 26 publications

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“…A few recent studies clearly indicate the potential improvement of the diagnosis of periapical lesions by the introduction of CBCT. In a comparison to conventional radiographs, Tsai et al [12] and Liang et al [13] proved a higher sensitivity of CBCT especially for smaller lesions and an overall increase in diagnostic fidelity. Estrela et al [14] reported that only progressed periapical lesions were identified correctly by conventional radiography.…”

Section: Materials Und Methoden: In Die Studie Wurden 19mentioning

confidence: 99%

Assessment of Apical Periodontitis by MRI: A Feasibility Study

Geibel

Schreiber

Bracher

et al. 2015

Fortschr Röntgenstr

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Purpose: The purpose of this clinical feasibility study was to evaluate the applicability of magnetic resonance imaging (MRI) for the assessment of apical periodontitis in direct comparison with cone beam CT (CBCT). Materials and Methods: 19 consecutive patients (average age 43???13 years) with 34 lesions in total (13 molars, 14 premolars and 7 front teeth) were enrolled in this feasibility study. Periapical lesions were defined as periapical radiolucencies (CBCT) or structural changes in the spongy bone signal (MRI), which were connected with the apical part of a root and with at least twice the width of the periodontal ligament space. The location and dimension of the lesions were compared between MRI and CBCT. Results: While mainly mineralized tissue components such as teeth and bone were visible with CBCT, complimentary information of the soft tissue components was assessable with MRI. The MRI images provided sufficient diagnostic detail for the assessment of the main structures of interest. Heterogeneous contrast was observed within the lesion, with often a clear enhancement close to the apical foramen and the periodontal gap.?No difference for lesion visibility was observed between MRI and CBCT. The lesion dimensions corresponded well, but were slightly but significantly overestimated with MRI. A heterogeneous lesion appearance was observed in several patients. Four patients presented with a well circumscribed hyperintense signal in the vicinity of the apical foramen. Conclusion: The MRI capability of soft tissue characterization may facilitate detailed analysis of periapical lesions. This clinical study confirms the applicability of multi-contrast MRI for the identification of periapical lesions. Key Points: ??MRI can be applied for the identification of periapical lesions without ionizing radiation exposure ??MRI might facilitate more detailed characterization of periapical lesions ??MRI might provide more accurate lesion dimensions as X-ray-based methods Citation Format: ??Geibel MA., Schreiber ES, Bracher AK et?al. Assessment of Apical Periodontitis by MRI: A Feasibility Study. Fortschr R?ntgenstr 2015; 187: 269???275

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Section: Materials Und Methoden: In Die Studie Wurden 19mentioning

confidence: 99%

Assessment of Apical Periodontitis by MRI: A Feasibility Study

Geibel

Schreiber

Bracher

et al. 2015

Fortschr Röntgenstr

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“…[7][8][9][10][11][12][13][14][15][16] The literature, mainly based on in vitro studies, supports the hypothesis that CBCT is a method with greater accuracy than periapical radiographs in detecting apical periodontitis, resorptions and root fractures. [17][18][19][20][21][22][23][24][25][26][27] The effective radiation dose using the state-of-the-art radiologic technique with rectangular collimator and a high-speed film or digital sensor is extremely low. 28 For a CBCT examination to be justified, it needs to be of potential benefit to the patient, i.e.…”

Section: Introductionmentioning

confidence: 99%

The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics

Almeida¹,

Knutsson²,

Flygare³

2014

Dentomaxillofacial Radiology

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Objectives: The aim was to assess to what extent cone beam CT (CBCT) used in accordance with current European Commission guidelines in a normal clinical setting has an impact on therapeutic decisions in a population referred for endodontic problems. Methods: The study includes data of consecutively examined patients collected from October 2011 to December 2012. From 2 different endodontic specialist clinics, 57 patients were referred for a CBCT examination using criteria in accordance with current European guidelines. The CBCT examinations were performed using similar equipment and standardized among clinics. After a thorough clinical examination, but before CBCT, the examiner made a preliminary therapy plan which was recorded. After the CBCT examination, the same examiner made a new therapy plan. Therapy plans both before and after the CBCT examination were plotted for 53 patients and 81 teeth. As four patients had incomplete protocols, they were not included in the final analysis. Results: 4% of the patients referred to endodontic clinics during the study period were examined with CBCT. The most frequent reason for referral to CBCT examination was to differentiate pathology from normal anatomy, this was the case in 24 patients (45% of the cases). The primary outcome was therapy plan changes that could be attributed to CBCT examination. There were changes in 28 patients (53%). Conclusions: CBCT has a significant impact on therapeutic decision efficacy in endodontics when used in concordance with the current European Commission guidelines.

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“…Patrick ve ark. 15 CBCT cihazlarının 0,8 mm'den büyük lezyonların tespitinde geleneksel radyografilerden daha iyi sonuçlar verdiğini bildirmişlerdir. 0.8 mm'den küçük lezyonlarda geleneksel radyografiler gibi CBCT cihazlarının da limitasyonlara sahip olduğunu ifade edilmiştir.…”

Section: Apikal Periodontitisin Tespitiunclassified