title: Ultrasound in differential diagnosis of periapical radiolucencies: A radiohistopathological study.
abstract: OBJECTIVE
  To evaluate the efficacy of ultrasound in differential diagnosis of periapical radiolucencies.
  
  
  METHODS
  Ten patients aged between 19 years and 40 years with periapical lesions associated with anterior maxillary or mandibular teeth were selected and consented for the study. Pre-operative periapical radiographs were obtained. Measurements and provisional diagnoses of the apical areas were made by two specialist observers on two separate occasions. Preoperative ultrasound examinations with Doppler flowmetry were then performed and the images assessed by two specialist observers for the size, contents, vascular supply and a provisional diagnosis made as to whether the lesion was a cyst or granuloma. Endodontic surgery was performed including curettage of the apical tissues to enable histopathological investigation, which provided the gold standard diagnosis. All measurements and findings were compared and statistically analyzed.
  
  
  RESULTS
  Total 10 lesions were identified in 10 patients. On periapical radiographs, lesions were readily identified but observers were unable to differentiate granuloma from cyst using either modality. Where sufficient buccal cortical bone had been resorbed, ultrasound imaging was simple but underestimated the size of the lesions compared with periapical radiographs. In all cases, the ultrasound diagnosis agreed with the histopathological gold standard.
  
  
  CONCLUSIONS
  Ultrasonography (USG) can provide accurate information about the nature of intraosseous lesions of the jaws before any surgical procedure. It is proposed that USG with Doppler flowmetry can provide an additional diagnostic tool without invasive surgery, where treatment option is nonsurgical.
authors: Department of Oral Medicine, Diagnosis and Radiology, Chatrapati Shahu Maharaj Shikshan Sanstha Dental College and Hospital, Aurangabad, India.
authors: Neha
authors: N
authors: Khambete
authors: Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Mission's Dental College and Hospital, Navi Mumbai, Maharashtra, India.
authors: Rahul
authors: R
authors: Kumar
keywords: Diagnosis; periapical; radiolucent; ultrasound
references: J Endod. 2008 Nov;34(11):1312-5
references: 18928838
references: Int Endod J. 2003 Aug;36(8):556-63
references: 12887385
references: Int Endod J. 1998 May;31(3):155-60
references: 10321160
references: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Sep;110(3):379-85
references: 20727498
references: Dentomaxillofac Radiol. 2006 Sep;35(5):326-33
references: 16940480