Accuracy of Periapical Radiography and CBCT in Endodontic Evaluation

Abstract

Introduction A radiological evaluation is essential in endodontics, for diagnostic purposes, planning and execution of the treatment, and evaluation of the success of therapy. The periapical radiography is nowadays the main radiographic investigations used but presents some limits as 3D anatomic alteration, geometric compression, and possible anatomical structures overlapping that can obscure the area of interest. CBCT (cone beam computed tomography) in endodontics allows a detailed assessment of the teeth and surrounding alveolar anatomy for endodontic diagnosis, treatment planning, and follow-up. Objective The purpose of this study was to evaluate the accuracy of CBCT in comparison with conventional intraoral radiographs used in endodontic procedures. Materials and Methods Statistical analysis was performed on 101 patients with previous endodontic treatments with the relative radiographic documentation (preoperative, postoperative, and follow-up intraoral X-ray) that had underwent at CBCT screening for surgical reasons. The CBCT scans were evaluated independently by two operators and compared with the corresponding periapical images. Results Our analysis shows that the two radiological investigations statistically agree in 100% of cases in the group of patients without any endodontic sign. In the group of patients with an endodontic pathology, detected with CBCT, endodontic under extended treatments (30.6%), MB2 canals in nontreated maxillary molars (20.7%), second canals in nontreated mandibular incisors (9%), root fractures (2.7%), and root resorption (2.7%) were not always visible in intraoral X-ray. Otherwise, positivity in the intraoral X-ray was always confirmed in CBCT. A radiolucent area was detected in CBCT exam in 46%, while the intraoral X-ray exam was positive only in 18%. Conclusions Our study shows that some important radiological signs acquired using CBCT are not always visible in periapical X-ray. Furthermore, CBCT is considered as a II level exam and could be used to solve diagnostic questions, essential to a proper management of the endodontic problems.

Symmetry of root and root canal morphology of mandibular incisors: A cone-beam computed tomography study in vivo

“…In literature, multiple methods have been used to investigate root canal anatomy (7), including canal staining and clearing techniques (8,9), dentin troughing under magnification (10), scanning electron microscope (11,12), micro-computed tomography (micro CT) (13,14), magnetic resonance (15)(16), ultrasonics (17), serial cross-sectioning (18), radiographic examination (19,20) and CBCT (21)(22)(23). CBCT (24) allows in vivo 3D evaluations of canals: it overcomes the limitations of conventional radiography because it reduces the superimposition of the surrounding structures, it also allows to study a greater number of teeth defining symmetry between left and right in the same patient (25). Many articles (26-34) about endodontic anatomy of mandibular incisors are present in literature, showing different possible configurations.…”

Correlation of s-IgA and IL-6 Salivary with Caries Disease and Oral Hygiene Parameters in Children

“…After all parents/tutors signed the informed consent their children were enrolled in the study; considering the non-invasive nature of the test carried out, a health record including anamnestic data was compiled by a single patient and intraoral and radiographic examinations (intraoral bitewing radiograph) were done [18]. Children with a history of systemic and autoimmune diseases or those who took antimicrobial agents during the last three months were excluded from the study.…”

Avaliação da expressão de artefatos de imagem gerados por materiais de alta densidade em tomografia computadorizada de feixe cônico, micro e nanotomografia computadorizadas

“…A utilização da TCFC como ferramenta complementar de diagnóstico por imagem no planejamento e na proservação do tratamento endodôntico tem sido cada vez mais frequente (SEDENTEXCT, 2012;SZABO et al, 2012;DOMARK et al, 2013;MARCA et al, 2013;EE et al, 2014;ELNAGHY;ELSAKA, 2014;PATEL et al, 2014;RAJASEKHARAN et al, 2014;ESTRELA et al, 2015a;ESTRELA et al, 2015b;MICHETTI et al, 2015;SEIXAS et al, 2015;SUOMALAIMEN et al, 2015;VASCONCELOS et al, 2015;AAE, 2016;ESTRELA et al, 2016;KOCASARAC et al, 2016;PATEL, 2016;PATEL et al, 2016;CELIKTEN et al, 2017;CODARI et al, 2017;EZELDEEN et al, 2017;FAKHAR et al, 2017;MAMEDE-NETO et al, 2017;ORDINOLA-ZAPATTA et al, 2017;QUEIROZ et al, 2017;AMINOSHARIAE;SYED, 2018;BEACHMAN et al, 2018;DE MARTIN E SILVA et al, 2018;DOYLE et al, 2018;ESTRELA et al, 2018;FONTANELE et al, 2018;LO GIUDICE et al, 2018;MARTINS et al, 2018;PAUWELS, 2018;FARMAN, 2018;TANG et al, 2018;TOLENTINO et al, 2018;WANDERLEY et al, 2018). Entretanto, a presença de materiais obturadores nos canais radiculares leva à ocorrência do fenômeno de endurecimento dos feixes de raios X, e consequentemente à formação de artefatos (estrias escuras, áreas hipodensa...…”

“…Dra. Erika Calvano Küchler, Jovem Pesquisadora da FAPESP junto ao Introdução O diagnóstico em Endodontia deve ser fundamentado nos dados obtidos a partir da anamnese e exame clínico, por meio da inspeção, palpação, percussão e teste de vitalidade pulpar (GUERRERO et al, 2006;SUKOVIC, 2006;PATEL et al, 2009a;PATEL et al, 2009b;HORNER, 2009;PATEL et al, 2012;BRITTO-JÚNIOR et al, 2014;WEISSMAN et al, 2015;CELIKTEN et al, 2017;DUQUE et al, 2017;PATEL et al, 2017;RODRIGUEZ et al, 2017;ESTRELA, 2018;LAMIRA, 2018) que, associados aos exames complementares por imagem, como a radiografia periapical (RP) e tomografia computadorizada de feixe cônico (TCFC), fornecem informações essenciais a respeito dos dentes, sistema de canais radiculares e estruturas anatômicas adjacentes (COTTON et al, 2007;PATEL et al, 2007a;PATEL et al, 2007b;PATEL, 2012;AMINOSHARIAE;SYED, 2018;ESTRELA et al, 2018;LAMIRA, 2018;LO GIUDICE et al, 2018;TOLENTINO et al, 2018), auxiliando na determinação do prognóstico e elaboração do planejamento e protocolo de tratamento.…”