Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology

doi:10.1016/j.tripleo.2006.01.001

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology

Volume 103, Issue 1, January 2007, Pages 114-119

https://doi.org/10.1016/j.tripleo.2006.01.001 Get rights and content

Objective

To compare intraoral periapical radiography with 3D images for the diagnosis of periapical pathology.

Study design

Maxillary molars and premolars and mandibular molars with endodontic problems and examined with periapical radiographs and a 3D technique (3D Accuitomo) were retrospectively selected and evaluated by 3 oral radiologists. Numbers of roots and root canals, presence and location of periapical lesions, and their relation to neighboring structures were studied.

Results

Among 46 teeth, both techniques demonstrated lesions in 32 teeth, and an additional 10 teeth were found in the Accuitomo images. As regards individual roots, 53 lesions were found in both techniques, and 33 more roots were found to have lesions in Accuitomo images. Artefacts were sometimes a problem in Accuitomo images. In 32 of the 46 cases, all observers agreed that additional clinically relevant information was obtained with Accuitomo images.

Conclusions

A high-resolution 3D technique can be of value for diagnosis of periapical problems.

Section snippets

Patients

Among all patients referred to the Clinic of Oral and Maxillofacial Radiology at the Public Dental Health Service, Göteborg, Sweden, between April 2003 and July 2004, we identified 36 patients in whom the referring dentist specifically had asked for detailed information about anatomy and pathology and who fulfilled the following criteria:

Clinical and/or radiographic findings (in periapical radiographs) of a periapical lesion.

Maxillary premolar or maxillary/mandibular first or second molar.

Results

Of all 46 teeth analyzed, 41 (89%) had been endodontically treated, of which 23 (56%) had a post in one or more root canals. In the periapical radiographs, 2 premolars were assessed to have 2 roots whereas only 1 was seen in the Accuitomo images, 3 maxillary molars were assessed as having 2 roots and 3 also found in the Accuitomo images. With respect to root canals, 124 were found in the periapical radiographs and 12 (10%) more in the Accuitomo images (7 in maxillary and 5 in mandibular

Discussion

The results suggest that 3D imaging of teeth and surrounding bone may be of value in cases of endodontic problems, not least when related to multirooted teeth. There are several reasons for this. When using tomographic slices, rather than images in which an entire volume is compressed into a 2D image, the problem of superimposition of unrelated structures onto the features of interest decreases. In periapical radiography, especially in the maxillary molar region, the irradiation geometry often

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Oral and maxillofacial radiologyLimited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology

Objective

Study design

Results

Conclusions

Section snippets

Patients

Results

Discussion

J Am Dent Assoc

J Am Dent Assoc

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

J Endod

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

J Endod

J Endod

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Oral and maxillofacial radiology
Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology