Ultrasonography and Color Doppler in the Differential Diagnosis of Periapical Cyst and Granuloma

Abstract

ABSTRACTBackground and objectivesThough ultrasonography and color Doppler are well established diagnostic techniques in medical sciences, it is not so popular in dentistry. Aim of the study was to evaluate the diagnostic value of ultrasonography and color Doppler in periapical cysts and granulomas in the anterior region of the jaws.Materials and MethodsThirty patients aged between 30 and 50 years with periapical lesions in anterior teeth were selected and consented for ultrasonography and color Doppler examinations. Shape, boundary, echo intensity, echo pattern, acoustic enhancement and vascularity of the periapical lesions and adjacent tissues were studied. After endodontic filling, lesions were enucleated and histopathology was done. Ultrasonographic/color Doppler findings and histopathology were statistically evaluated with Chi-square tests at p < 0.001. Sensitivity, specificity, positive and negative predictive values and accuracy of the method were then determined.ResultsNoninfected cysts showed as anechoic areas while infected cysts appeared as hypoechoic. Vascular hypoechoic areas proved to be periapical granulomas. Periapical infected and noninfected cysts maintained 100% correlation with histopathology, while periapical granuloma had only 70% relation due to thick overlying cortical bones. It implied an accuracy of 90% for this method with overall positive and negative predictive values of 86.96% and 100% respectively.ConclusionThe study demonstrated efficacy of USG in combination with color Doppler as a safe, noninvasive option to diagnose solid/cystic periapical lesions. However, it also highlighted the need for further investigations in resolving diagnostic issues of periapical lesions covered with thick cortical bones.How to cite this articleTiwari B, Krishnan M, Popli M, Iyer SR, Arora V. Ultrasonography and Color Doppler in the Differential Diagnosis of Periapical Cyst and Granuloma. J Contemp Dent 2014;4(1):17-21.