Comparative evaluation of advanced and conventional diagnostic AIDS for endodontic management of periapical lesions, an in vivo study.
OBJECTIVE
To evaluate efficacy of Colour Doppler ultrasonography (CDUSG), direct digital radiography (DDR) and conventional radiography (CR) in diagnosis of periapical lesions and to clinically correlate treatment plan of periapical diseases.


METHODS
Thirty patients which were diagnosed with periapical lesions in anterior region by using both conventional and digital radiography were examined using colour doppler ultrasound imaging at the site of lesion. The images of each lesion were analysed by two endodontists and by an expert oral radiologist. A tentative differential diagnosis was agreed upon, based on certain principles discussed in article, then a diagnosis between cyst, granuloma and mixed lesions was made. Periapical lesions diagnosed as mixed lesions by colour doppler ultrasonography (CDUSG) were treated non-surgically whereas other periapical lesions were treated surgically. Tissues obtained during endodontic surgery were processed and examined for histopathological findings, and compared with the diagnosis made by ultrasound images. Statistical analysis was done with Chi-Square test and using one-way-Anova.


RESULTS
The periapical lesions which were diagnosed as granuloma by ultrasonographic findings, was confirmed by the results of histopathological examination in all 16 surgically treated cases. The lesions in rest of the 14 cases which showed vascularity and were diagnosed as mixed lesions by ultrasonography, were treated non-surgically and had a favourable prognosis.


CONCLUSIONS
CR and DDR facilitate diagnosis of the presence of periapical disease, but do not provide and information of its nature. CDUSG imaging facilitates accurate information on the pathological nature of the lesion and hence can lead to predictable treatment planning.
Reader, Department of Conservative Dentistry and Endodontics, MNDAV Dental College , Solan, Himachal Pradesh, India .
Sukhpash Singh
SS
Sandhu
Professor, Department of Conservative Dentistry and Endodontics, Darshan Dental College and Hospital , Udaipur, Rajasthan, India .
Smita
S
Singh
Reader, Department of Conservative Dentistry and Endodontics, Seema Dental College , Rishikesh, Uttarakhand, India .
Saurabh
S
Arora
Private Practitioner, Punjab, India .
Amneet Kaur
AK
Sandhu
Reader, Department of Oral Medicine, Seema Dental College , Rishikesh, Uttarakhand, India .
Ravneet
R
Dhingra
Digital Radiography; Histopathology; Periapical lesions; Ultrasonography