Comparison of Root Canal Morphology in Intraoral Periapical Radiographs and Cone-Beam Computed Tomography: An In vitro Study

Abstract

Backgrounds and Objectives: Intraoral periapical radiographs (IOPAR) are routinely used to fulfill the preoperative, par-operative and postoperative imaging needs in endodontic treatment. IOPAR is not a sensitive tool for identification of complex root canal morphology with failure rates of up to 34%. Cone-beam computed tomography (CBCT) provides three-dimensional imaging and has been recommended when endodontic imaging needs cannot be met by IOPAR. There is a need to understand which anatomic parameters are better viewed in CBCT and which on IOPAR. Hence, this study is planned to compare the root canal morphology on IOPAR and CBCT and correlate with chemically cleared tooth. Methods: One hundred recently extracted teeth were collected and subjected to IOPAR and CBCT scanning. A total of six root canal morphologies were compared in both the imaging modalities and with the teeth itself after making it chemically transparent. Results: CBCT and IOPAR showed a good agreement in detection of fractured tooth roots with P < 0.005. However, CBCT was better than IOPAR in detection of the number of accessory canals, ramifications, and obliterations in the root canal and fractures with P < 0.005. IOPAR showed reduced artifacts with P < 0.005. During working length measurement, both CBCT and IOPAR showed increased values than the cleared teeth although CBCT was more accurate. Conclusion: We can conclude from this study CBCT is more accurate in detection of root canal morphologies in comparison to IOPAR.