Is the efficacy of cone beam computed tomography in the diagnosis of tooth ankylosis influenced by dose reduction protocols?

Abstract

To evaluate the diagnostic efficacy of cone beam computed tomography (CBCT) examinations acquired with varying dose protocols in the diagnosis of simulated tooth ankylosis (TA). Tooth ankylosis was simulated in 15 of 30 teeth, and CBCT examinations were acquired at 3 mA levels (8, 6.3, and 5) and 3 voxel sizes (0.08, 0.125, and 0.2 mm). Four radiologists independently assessed the presence of TA using a 5-point scale. Sensitivity, specificity, and area under the curve (AUC) obtained through receiver operating characteristic analysis were compared among mA levels and voxel sizes using two-way analysis of variance (α=0.05). Intra- and interexaminer reliability levels were assessed with the weighted kappa examination. Sensitivity was low (0.32-0.49), and specificity was reasonably high (0.71-0.83). Mean values of AUC were low, ranging between 0.54 and 0.67, which reveals poor overall discrimination between health and disease. The detection of TA was not significantly influenced by mA level or voxel size (P > .05). Intra- and interexaminer agreements ranged from slight to moderate (0.160-0.535) and from fair to substantial (0.236-0.697), respectively. Despite the limited efficacy of CBCT for TA detection, when indicated as a complementary examination, mA reduction should be considered for dose optimization purposes.