Elsevier

Dental Abstracts

Volume 61, Issue 5, September–October 2016, Pages 270-271
Dental Abstracts

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Cone-beam tomography versus radiographs

https://doi.org/10.1016/j.denabs.2016.05.039Get rights and content

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Background

Apical periodontitis (AP) causes apical bone resorption but is often asymptomatic and only detected during routine radiographs. However, periapical and panoramic radiographs can suffer limitations that make them unreliable for demonstrating all cases of bone lesions. Thus extensive bone resorption can occur even without radiographic evidence. Cone-beam computed tomography (CBCT) allows one to visualize anatomic structures in three dimensions and offers higher resolution than radiographs. It has

Methods

Searches were conducted of the Embase, Google Scholar, LILACS, MEDLINE (Ovid), PubMed, Science Direct, Scopus, and Web of Science databases. In addition, a hand search was done and the reference lists of selected articles were screened. The 9 studies selected included radiographic examinations of dry human mandibles or fresh human jaws and covered between 4 and 28 mandibles (18 to 120 apical sites). They were divided into studies using conventional periapical radiography (CPR), digital

Results

The CPR group consisted of 5 studies that compared the results with the diagnostic accuracy of DPR and found no significant difference in diagnostic performance. Pooled sensitivity and specificity were poor and good, respectively.

DPR diagnostic accuracy was evaluated in 8 studies. Pooled sensitivity was poor and specificity good. The diagnostic performance was similar regardless of sensor type used.

Five studies evaluated CBCT and ranked it as an excellent method for correctly identifying AP and

Discussion

The diagnostic accuracy of CBCT was excellent and the accuracy for CPR and DPR was good. If CBCT imaging is chosen to make a diagnosis of AP, the FOV should be adjusted to use the lowest radiation dose possible, limiting the patient’s exposure to radiation.

Clinical Significance

CBCT showed that it was an excellent imaging modality for evaluating patients for the presence of AP. Use of a low dose of radiation should be part of the examination protocol, in line with the principle of “as low as

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Dutra KL, Haas L, Porporatti AL, et al: Diagnostic accuracy of cone-beam computed tomography and conventional radiography on apical periodontitis: A systematic review and meta-analysis. J Endod 42:356-364, 2016

Reprints available from KL Dutra, Postgraduate Program in Dentistry, Health Sciences Ctr, Federal Univ of Santa Catarina, Campus Universitário, Trindade CEP: 88040-370, Florianopolis, SC, Brazil; e-mail: [email protected]

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