Accuracy of Limited Field Cone Beam Computed Tomography in the Detection of Buccal Cortical Plate Perforations Due to Periapical Lesions

Abstract

ACCURACY OF LIMITED FIELD CONE BEAM COMPUTED TOMOGRAPHY IN THE DETECTION OF BUCCAL CORTICAL PLATE PERFORATIONS DUE TO PERIAPICAL LESIONS By Dan-Linh Ha, DDS A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University. Virginia Commonwealth University, 2013. Director: Karan J. Replogle, DDS, MS Program Director, Department of Endodontics Pre-surgical planning for endodontic microsurgery is facilitated by the use of cone beam computed tomography (CBCT). The purpose of this study was to determine whether limited field CBCT accurately predicts buccal cortical plate perforations due to endodontic lesions. Thirtyfive roots that underwent microsurgical root end resection were included in this study. Prior to the surgery, 90 voxel CBCTs were taken with a Carestream 9300. The scans were analyzed by an endodontic resident and oral radiologist to determine the presence of a perforation in the buccal plate. These findings were compared to the clinical appearance of the bone. There was a significant relationship between a judgment of perforation made on the basis of CBCT and actual perforation as observed clinically. The CBCT prediction was accurate 83% of the time. A predicted perforation was validated in 88% of the instances and a predicted non-perforation was validated in 75% of the instances.