title: Accuracy of periapical radiography and cone-beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard.
abstract: BACKGROUND
  The aim of this study was to evaluate the accuracy of two imaging methods in diagnosing apical periodontitis (AP) using histopathological findings as a gold standard.
  
  
  METHODS
  The periapex of 83 treated or untreated roots of dogs' teeth was examined using periapical radiography (PR), cone-beam computed tomography (CBCT) scans, and histology. Sensitivity, specificity, predictive values, and accuracy of PR and CBCT diagnosis were calculated.
  
  
  RESULTS
  PR detected AP in 71% of roots, a CBCT scan detected AP in 84%, and AP was histologically diagnosed in 93% (p = 0.001). Overall, sensitivity was 0.77 and 0.91 for PR and CBCT, respectively. Specificity was 1 for both. Negative predictive value was 0.25 and 0.46 for PR and CBCT, respectively. Positive predictive value was 1 for both. Diagnostic accuracy (true positives + true negatives) was 0.78 and 0.92 for PR and CBCT (p = 0.028), respectively.
  
  
  CONCLUSIONS
  A CBCT scan was more sensitive in detecting AP compared with PR, which was more likely to miss AP when it was still present.
authors: Department of Pediatric Clinics, Preventive and Social Dentistry, School of Dentistry, University of São Paulo, Ribeirão Preto, Brazil. franciscogarcia@forp.usp.br
authors: Francisco Wanderley Garcia
authors: FW
authors: de Paula-Silva
authors: Min-Kai
authors: MK
authors: Wu
authors: Mário Roberto
authors: MR
authors: Leonardo
authors: Léa Assed Bezerra
authors: LA
authors: da Silva
authors: Paul R
authors: PR
authors: Wesselink
mesh_terms: D000818:Animals; D054893:Cone-Beam Computed Tomography; D004285:Dogs; D010485:Periapical Periodontitis / Q000000981:diagnostic imaging* / Q000473:pathology; D011861:Radiography, Dental / Q000379:methods*; D012680:Sensitivity and Specificity