Abstract
The objective of this study was to evaluate the diagnostic yield of dental radiography (DR) and 3 cone-beam computed tomography (CBCT) software modules for the identification of 32 pre-defined dentoalveolar lesions in cats. For 5 feline cadaver heads and 22 client-owned cats admitted for evaluation and treatment of dental disease, 32 predefined dentoalveolar lesions were evaluated separately and scored by use of dental radiography and 3 CBCT software modules [multiplanar reconstructions (MPR), tridimensional (3-D) rendering, and reconstructed panoramic views]. A qualitative scoring system was used. Dentoalveolar lesions were grouped into 14 categories for statistical analysis. Point of reference for presence or absence of a dentoalveolar lesion was determined as the method that could be used to clearly identify the disorder as being present. Accuracy, sensitivity, specificity, and positive and negative predictive values were calculated with the McNemar χ2 test of marginal homogeneity of paired data. When all 3 CBCT software modules were used in combination, the diagnostic yield of CBCT was significantly higher than that of dental radiography for 4 of 14 categories (missing teeth, horizontal bone loss, loss of tooth integrity, feline resorptive lesions), and higher, although not significantly so, for 9 categories (supernumerary teeth, supernumerary roots, abnormally shaped roots, vertical bone loss, buccal bone expansion, periapical disease, inflammatory root resorption, and external replacement root resorption). In conclusion, we found that CBCT provided more clinically relevant detailed information as compared to dental radiography. Therefore, CBCT should be considered better suited for use in diagnosing dentoalveolar lesions in cats.
Highlights
The incorporation of dental radiography (DR) into veterinary dentistry has substantially improved the ability to diagnose dentoalveolar lesions in cats
Specificity was significantly higher for the multiplanar reconstructions (MPR) method for 2 dentoalveolar lesions
All the teeth that were truly missing as determined by the point of reference were correctly identified by use of both the DR and MPR methods, 15 additional teeth were incorrectly identified as missing by use of the DR method, when truly root remnants were present
Summary
The incorporation of dental radiography (DR) into veterinary dentistry has substantially improved the ability to diagnose dentoalveolar lesions in cats. Cone-beam computed tomography (CBCT) is making inroads into veterinary dental practice, both in terms of adding the third dimension to diagnosis, and in terms of enabling image-guided treatment strategies [3]. Market penetration in the human field has been rapid, presumably because CBCT permits a paradigm shift in dental care due to its increased image accuracy, rapid scan time, radiation dose reduction, reduced image artifact, and availability of display modules unique to maxillofacial imaging, compared to conventional CT. Cone-beam computed tomography routinely used in human medicine, has recently become a viable and costeffective diagnostic alternative that can identify several different types of dentoalveolar lesions in domestic animals [4]. As well as part 1 of the present study, have documented its superiority to dental radiography for identifying numerous anatomic structures and dentoalveolar pathologies in domestic species [5,6,7]
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