Thermography as a non-ionizing quantitative tool for diagnosing periapical inflammatory lesions

M Atef Aboushady,Nivin Ragy,Tarek M.Elshazly,Zaid Hamdoon,Sameh Talaat,Christoph Bourauel,Wael Talaat

doi:10.1186/s12903-021-01618-9

Abstract

BackgroundThermography is a contemporary imaging modality based on acquiring and analyzing thermal data using non-contact devices. The aim of the present study was to assess the validity of thermography, compared with that of the reference-standard, for the diagnosis of periapical inflammatory lesions and to evaluate the temperature ranges for acute pulpitis with apical periodontitis (AAP), acute periapical abscess (AA) and chronic periapical abscess (CA).MethodsAAP, AA and CA were diagnosed based on clinical and radiographic criteria. Thermographic data were acquired using the FLIR E-5 Infrared Camera. Extraoral thermal images were taken from the front and right and left sides of patients whose mouths were closed, and one intraoral thermal image was taken from the palatal perspective. Agreement in the diagnoses based on the combination of clinical and radiographic assessments and the thermographic evaluation was calculated. The temperature ranges of the three diagnostic subgroups were also measured.ResultsA total of 80 patients were enrolled in this study. The mean intraoral thermal image temperature for AA was 37.26 ± 0.36, that for CA was 35.03 ± 0.63 and that for AAP was 36.07 ± 0.45. The differences between the mean intraoral thermal temperatures of the three diagnostic groups were statistically significant (P < 0.001). The result of the Kappa coefficient of agreement between the combination of clinical and radiographic assessments and the thermographic evaluation was significant (P < 0.001).ConclusionsThermography is an effective, quantitative and nonionizing approach that can be used for the diagnosis of periapical inflammatory lesions. The results of the present study indicated that the highest thermal image temperatures were recorded for AA. Thermography might be able to detect inflammatory reactions during the preclinical stage, leading to early diagnosis.

Highlights

Thermography is a contemporary imaging modality based on acquiring and analyzing thermal data using non-contact devices
Twenty-seven patients with a mean age of 37.37 ± 9.97 years were diagnosed with acute periapical abscess (AA), 29 patients with a mean age of 39.1 ± 12.34 years were diagnosed with chronic periapical abscess (CA), and 24 patients with a mean age of 36.96 ± 10.98 years were diagnosed with apical periodontitis (AAP)
The rates of change in extraoral thermal temperatures with time for the 3 diagnostic groups are shown in Table 2 and Fig. 3

Summary

Introduction

Thermography is a contemporary imaging modality based on acquiring and analyzing thermal data using non-contact devices. The aim of the present study was to assess the validity of thermography, compared with that of the reference-standard, for the diagnosis of periapical inflammatory lesions and to evaluate the temperature ranges for acute pulpitis with apical periodontitis (AAP), acute periapical abscess (AA) and chronic periapical abscess (CA). Periapical inflammatory lesions result from pulpal lesions or disrupted periodontal attachments that extend to the apex, furcation or lateral canals. The diagnosis of periapical inflammatory lesions is always a challenge, even for experienced dental practitioners, due to the multifactorial origin of these lesions, which include diverse interactions between different strains and species of microbes [1]. Temperature differences can be charted on a two-dimensional image, and the temperatures of individual spots in an area of interest at a certain time can be recorded [3]

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