Comparison of cone beam computed tomography and intra oral periapical radiography in detecting periapical lesions –A systematic review

Abstract

Introduction: Cone-beam computerized tomography (CBCT) is a medical image acquisition technique based on a cone-shaped X-ray beam centered on a two-dimensional (2D) detector. The source-detector system performs one rotation around the object producing a series of 2D images. The images are reconstructed in a three-dimensional (3D) data set using a modification of the original cone-beam algorithm developed by Feldkamp 1 et al in 1984. This technique is widely used in different industrial and biomedical applications such as micro- CT. Among the first clinical applications were single photon emission computerized tomography (SPECT), angiography and image-guided radiotherapy. Dedicated cone-beam computerized tomography scanners for the oral and maxillofacial (OMF) region were pioneered in the late 1990s independently by Arai 2 et al. in Japan. This Systematic review aims at comparing cone -beam computerized tomography and periapical radiography in detection of periapical lesion. Objective: To compare the accuracy of cone beam computed tomography (CBCT) and intra oral periapical radiography (IOPA) in diagnosis of periapical pathology Search Strategy: Database such as Pub med Central and Medline were searched for the related topics from February 1996 till July 2013. Selection Criteria: Trials were selected if they met the following criteria: Clinical trials comparing the accuracy of Cone beam computed tomography (CBCT) and intra oral periapical radiography (IOPA). Data Collection and Analysis: All the studies included were based on the data extraction and analysis of the studies for quality and publication bias. The data collection form was customized. The primary outcome is to compare Cone beam computed tomography (CBCT) and intra oral periapical radiography (IOPA) in detection of periapical lesions. Main Results: The review concluded that cone beam computed tomography is superior to conventional intra oral periapical radiography in detection of periapical lesions. Conclusion: The probability of detecting periapical lesions was more in case of cone-beam computerized tomography when compared to conventional intra oral periapical radiography where external factors such as anatomical noise and poor irradiation geometry which are not in operators control are eliminated. I. Background Traditionally, the diagnosis of periapical lesion was based on clinical and radiographic presentations; confirmatory diagnosis was only by a biopsy which was highly impossible in the case of a non surgical procedure. If biopsy is taken the treatment is no longer a non surgical procedure (Simon et al 1980)