Comparison of cone-beam computed tomography and periapical radiography for detecting simulated apical root resorption.
OBJECTIVE
To compare the diagnostic accuracy between cone-beam computed tomography (CBCT) and periapical radiography for detecting simulated external apical root resorption (EARR) in vitro.


METHODS
The study sample consisted of 160 single-rooted premolar teeth for simulating EARR of varying degrees according to four setups: no (intact teeth), mild (cavity of 1.0 mm in diameter and depth on root surface), moderate (0.4 mm, 0.8 mm, 1.2 mm, and 1.6 mm root shortening), and severe (2.4 mm, 2.8 mm, 3.2 mm, and 3.6 mm root shortening). Two groups of radiographic images were obtained via CBCT and periapical radiography. The absence or presence and the severity for all resorption lesions were evaluated blindly by two calibrated observers.


RESULTS
With the CBCT method, the rates of correct classification of no, mild, moderate, and severe EARR were 96.3%, 98.8%, 41.3%, and 87.5%, respectively; with the periapical radiography method, the rates were 82.5%, 41.3%, 68.8%, and 92.5%, respectively. Highly significant differences were found between the two imaging methods for detection of mild (P < .001), moderate (P < .001), and all EARR (P < .001). For detection of all EARR, the sensitivity and specificity values were 75.8% and 96.3% for CBCT, compared with 67.5% and 82.5% for periapical radiography.


CONCLUSIONS
CBCT is a reliable diagnostic tool to detect simulated EARR, whereas periapical radiography underestimates it. However, if a periapical radiograph is already available to the diagnosis of EARR, CBCT should be used with extreme caution to avoid additional radiation exposure.
Student, Department of Orthodontics, College of Stomatology, Chongqing Medical University, Chongqing, PR China.
Hongyu
H
Ren
Jun
J
Chen
Feng
F
Deng
Leilei
L
Zheng
Xiong
X
Liu
Yanling
Y
Dong
D054893:Cone-Beam Computed Tomography; D006801:Humans; D011861:Radiography, Dental / Q000379:methods*; D012391:Root Resorption / Q000000981:diagnostic imaging*; D019227:Tooth Apex / Q000000981:diagnostic imaging*