Comparison of periapical parallel radiography with cbct with different field of views (FOV) for the detection of periapical lesions

Abstract

Background: Chronic apical periodontitis (AP) may influence the outcome of root canal treatment.
Thus, it is important to diagnose AP using the best method available. This research was done to
compare the diagnostic accuracy of parallel periapical radiography (PR) and different field of
views (FOVs) of cone‑beam computed tomography (CBCT).
Materials and Methods: This ex vivo study was done on six human mandibles. After
extraction of the teeth, periapical lesions with different sizes were prepared randomly by
drilling a hole at the base of the sock et using a bur. From among 67 sockets, 21 sockets had
no lesion (control); then, all mandibles were scanned by CBCT with different FOVs and
paralleling periapical technique radiography. The images were assessed by two examiners. The
quantitative data were analyzed by intraclass correlation coefficient (ICC) and the qualitative
data were analyzed by McNemar’s test (α = 0.05). Sensitivity, specificity, and accuracy were
calculated. Inter‑observer agreement was assessed using kappa statistics for qualitative data
and ICC for quantitative data.
Results: The quantitative scores were compared with the gold standard using ICC, which
showed maximum agreement for the dental FOV of CBCT (93.3) and minimum agreement for
PR (62.5) (P < 0.001). For qualitative data, maximum agreement was found for the dental FOV of
CBCT (97.1%), and minimum agreement was reported for PR (59.7%). Kappa values were variable
between 0.271 and 0.924 (P < 0.001). Maximum sensitivity was found for the dental FOV of
CBCT (96%) and minimum sensitivity was observed for PR (51%). The inter‑observer agreement
was 0.922 for qualitative data and 0.90 for quantitative data (P < 0.001). There were no significant
differences between CBCT with different FOVs and defect sizes (gold standard) while we found
significant differences for periapical by defect sizes.
Conclusion: CBCT with dental FOV presents the highest sensitivity and diagnostic accuracy for
detection and characterization of simulated AP.
Key Words: Cone‑beam computed tomography, periapical periodontitis, radiography

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Mahnaz Sheikhi: Pubmed,Google Scholar