title: Comparison of periapical radiography and limited cone-beam tomography in posterior maxillary teeth referred for apical surgery.
abstract: This study compared periapical (PA) radiography and cone-beam tomography (CBT) for preoperative diagnosis in posterior maxillary teeth of consecutive patients referred for possible apical surgery. Images were concurrently analyzed by an oral radiologist and an endodontist to reach consensus in interpretation of the radiographic findings. The final material included 37 premolars and 37 molars with a total of 156 roots. CBT showed significantly more lesions (34%, p < 0.001) than PA radiography. Detecting lesions with PA radiography alone was most difficult in second molars or in roots in close proximity to the maxillary sinus floor. Additional findings were seen significantly more frequently in CBT compared with PA radiography including expansion of lesions into the maxillary sinus (p < 0.001), sinus membrane thickening (p < 0.001), and missed canals (p < 0.05). The present study highlights the advantages of using CBT for preoperative treatment planning in maxillary posterior teeth with apical pathology.
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland; Dental Clinic, Alexandra Hospital, Singapore.
authors.forename: Kenneth M T
authors.initials: KM
authors.lastname: Low
authors.forename: Karl
authors.initials: K
authors.lastname: Dula
authors.forename: Walter
authors.initials: W
authors.lastname: Bürgin
authors.forename: Thomas
authors.initials: T
authors.lastname: von Arx
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001047:Apicoectomy; D001641:Bicuspid / Q000000981:diagnostic imaging; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla; D008443:Maxillary Sinus / Q000000981:diagnostic imaging; D008875:Middle Aged; D008963:Molar / Q000000981:diagnostic imaging; D010485:Periapical Periodontitis / Q000000981:diagnostic imaging* / Q000601:surgery; D011300:Preoperative Care; D011861:Radiography, Dental / Q000379:methods*; D012017:Referral and Consultation; D019233:Retreatment; D019227:Tooth Apex / Q000000981:diagnostic imaging*