Digital Orthopantomography vs Cone Beam Computed Tomography—Part 1: Detection of Periapical Lesions

Marco Baldoni,Elisa Bonfanti,Claudio Luigi Citterio

doi:10.5005/jp-journals-10024-2564

Marco Baldoni, Elisa Bonfanti + Show 1 more

Open Access

https://doi.org/10.5005/jp-journals-10024-2564

Copy DOI

Abstract

Digital orthopantomography (OPT) is usually the first examination step in supervising an incoming patient. Cone beam computed tomography (CBCT) is the most refined and affordable method to search for different dental lesions. The aim of this paper is to evaluate the effectiveness of OPT and CBCT in detecting periapical lesions in different dental groups. An OPT and a CBCT scan of the dental arches of 45 patients were examined. The presence of AP was pointed out for OPT and CBCT. Sensitivity, specificity, predictive values, and accuracy were calculated for OPT, using CBCT as the reference standard. OPT showed low sensitivity (40.0), positive predictive value (90.4), negative predictive value (90.0), accuracy (90.0), and high specificity (99.2). It was found to have higher sensitivity in the lower front and premolar areas, while the lowest was found in the upper molar area. OPT can be used for endodontic diagnosis in the lower central and premolar sections, but CBCT plays a decisive role in the evaluation of molar areas and in the endodontic treatment planning, when a close relationship between apex and important anatomical structures exists. CBCT exposes the patient to higher doses of radiations when compared with OPT, but CBCT, with its more selective sensitivity and the possibility to offer a three-dimensional (3D) rendering of dental and periodontal structures, is an elective choice for uncertain cases and for specific dental areas.

Highlights

IntroductionCone beam computed tomography (CBCT) was introduced a decade ago to create three-dimensional (3D) images of dentition, surrounding soft and hard tissues.[1]
Cone beam computed tomography (CBCT) was introduced a decade ago to create three-dimensional (3D) images of dentition, surrounding soft and hard tissues.[1]It can be a powerful method in endodontics, by-passing the disturbances created by surrounding tissues and offering the opportunity to see in detail current pathologies affecting the apexes and improvement after treatments
OPT appeared useful for the diagnosis of apical lesions in specific dental sectors, it can be used with advantages for endodontic

Summary

Introduction

Cone beam computed tomography (CBCT) was introduced a decade ago to create three-dimensional (3D) images of dentition, surrounding soft and hard tissues.[1]. If CBCT is currently not suggested as routine assessment to evaluate the outcome of root canal treatment,[1] its use, on the contrary, could be surely be justified as a second-level examination to provide a more objective and sound information. This is especially relevant when children, who are more susceptible to the potential effects of ionizing radiation, are under examination.[13] When a radiographic procedure is prescribed, it should be carried out with a dose as low as reasonably achievable (ALARA), as patient exposure to ionizing radiation such as X-rays must never be considered as routine.[14,15] to ensure patient safety as an effective way to reduce the patient dose, personnel who use a CBCT scanner must have appropriate training and knowledge of patient’s radiation doses related to the specific CBCT scanner they are using. They were used to calculate sensitivity (40.0%), specificity (99.2%), positive predictive value (90.4%), negative predictive value (90.0%), and diagnostic accuracy of the OPT (90.0%) (Table 5)

Findings

Discussion

Conclusions