title: External Cervical Resorption: A Comparison of the Diagnostic Efficacy Using 2 Different Cone-beam Computed Tomographic Units and Periapical Radiographs.
abstract: BACKGROUND
  The aim of this study was to compare the diagnostic efficacy of 2 cone-beam computed tomographic (CBCT) units with parallax periapical (PA) radiographs for the detection and classification of simulated external cervical resorption (ECR) lesions.
  
  
  METHODS
  Simulated ECR lesions were created on 13 mandibular teeth from 3 human dry mandibles. PA and CBCT scans were taken using 2 different units, Kodak CS9300 (Carestream Health Inc, Rochester, NY) and Morita 3D Accuitomo 80 (J Morita, Kyoto, Japan), before and after the creation of the ECR lesions. The lesions were then classified according to Heithersay's classification and their position on the root surface. Sensitivity, specificity, positive predictive values, negative predictive values, and receiver operator characteristic curves as well as the reproducibility of each technique were determined for diagnostic accuracy.
  
  
  RESULTS
  The area under the receiver operating characteristic value for diagnostic accuracy for PA radiography and Kodak and Morita CBCT scanners was 0.872, 0.99, and 0.994, respectively. The sensitivity and specificity for both CBCT scanners were significantly better than PA radiography (P < .001). There was no statistical difference between the sensitivity and specificity of the 2 scanners. The percentage of correct diagnoses according to the tooth type was 87.4% for the Kodak scanner, 88.3% for the Morita scanner, and 48.5% for PA radiography.The ECR lesions were correctly identified according to the tooth surface in 87.8% Kodak, 89.1% Morita and 49.4% PA cases. The ECR lesions were correctly classified according to Heithersay classification in 70.5% of Kodak, 69.2% of Morita, and 39.7% of PA cases.
  
  
  CONCLUSIONS
  This study revealed that both CBCT scanners tested were equally accurate in diagnosing ECR and significantly better than PA radiography. CBCT scans were more likely to correctly categorize ECR according to the Heithersay classification compared with parallax PA radiographs.
authors.affiliation: Postgraduate Endodontic Unit, Kings College Dental Institute at Guy's King's and St Thomas' Hospital, London, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Vaz de Souza
authors.affiliation: Postgraduate Endodontic Unit, Kings College Dental Institute at Guy's King's and St Thomas' Hospital, London, UK.
authors.forename: Elia
authors.initials: E
authors.lastname: Schirru
authors.affiliation: Postgraduate Endodontic Unit, Kings College Dental Institute at Guy's King's and St Thomas' Hospital, London, UK.
authors.forename: Francesco
authors.initials: F
authors.lastname: Mannocci
authors.affiliation: Postgraduate Endodontic Unit, Kings College Dental Institute at Guy's King's and St Thomas' Hospital, London, UK.
authors.forename: Federico
authors.initials: F
authors.lastname: Foschi
authors.affiliation: Postgraduate Endodontic Unit, Kings College Dental Institute at Guy's King's and St Thomas' Hospital, London, UK. Electronic address: shanonpatel@gmail.com.
authors.forename: Shanon
authors.initials: S
authors.lastname: Patel
mesh_terms: D054893:Cone-Beam Computed Tomography / Q000379:methods*; D006801:Humans; D015588:Observer Variation; D011861:Radiography, Dental / Q000379:methods*; D015203:Reproducibility of Results; D012391:Root Resorption / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity
keywords: Cone-beam computed tomography; external cervical resorption; invasive cervical resorption; periapical radiographs