Abstract
BackgroundCone beam computed tomography (CBCT) has been largely used in dentistry. Nevertheless, there is lack of evidence regarding CBCT accuracy in the diagnosis of early periodontal lesions as well as the correlation between accuracy and lesion size. The aim of this study was to evaluate accuracy of CBCT and conventional intraoral radiographs in detecting different-sized interproximal bone lesions created in pig mandibles. The hypothesis was that CBCT accuracy would be superior to radiographs in detecting incipient bone lesions.MethodsTwenty swine dry mandibles were used, totalizing 80 experimental sites. Four groups were created according to exposure time to perchloric acid 70–72%: controls (no exposure), 2-hour exposure, 4-hour exposure, and 6-hour exposure. Standardized CBCT and conventional intraoral radiographs were taken and analyzed by two trained radiologists. The presence of lesions in the dry mandible was considered the gold standard. Sensitivity, specificity, and accuracy in detecting different-sized bone lesions were calculated for CBCT and intraoral radiographs.ResultsAccuracy of CBCT ranged from 0.762 to 0.825 and accuracy of periapical radiography ranged from 0.700 to 0.813, according to examiner and time of acid exposure. Inter-examiner agreement varied from slight to fair, whereas intra-examiner agreement varied from moderate to substantial.ConclusionsCBCT performance was not superior to that provided by conventional intraoral radiographs in the detection of interproximal bone loss.
Highlights
Cone beam computed tomography (CBCT) has been largely used in dentistry
A small quantity of melted wax was applied to the proximal sides of teeth adjacent to the experimental areas in order to protect them from acid demineralization, since it could induce observers to guess in which areas lesions were created, even without noticing the bone loss
Sensitivity, specificity and accuracy in detecting different-sized bone lesions were calculated for CBCT and conventional intraoral radiography, considering three different thresholds of detection: lesion produced by 2-hour acid exposure; lesion produced by 4-hour acid exposure; and lesion produced by 6-hour acid exposure
Summary
Cone beam computed tomography (CBCT) has been largely used in dentistry. there is lack of evidence regarding CBCT accuracy in the diagnosis of early periodontal lesions as well as the correlation between accuracy and lesion size. Studies conducted with database images [11], human cadavers [12,13,14,15,16,17,18,19], swine mandibles [12, 20, 21] and patients with chronic periodontitis [22,23,24] have analyzed CBCT performance in diagnosis and treatment planning in periodontics These studies suggest that CBCT is more accurate than periapical radiographs in detecting bone craters, dehiscence, fenestration and furcation involvement. Even when considering the studies in which comparisons were made, there was no unanimity in favor to CBCT
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