A comparison of detailed zonography with periapical radiography for the detection of periapical lesions.

Abstract

The diagnostic accuracy of detailed zonography using the Scanora multimodal X-ray system was compared with that of periapical radiography. The study was based on the detection of periapical bone lesions at 259 dental sites distributed evenly throughout the dentitions of 164 patients. Each site was examined by periapical radiography and zonography, in parallel. The zonograms consisted of four detailed images that could also be read as stereopairs, in either the horizontal or vertical direction. Five observers evaluated the sites for the presence or absence of periapical osteolysis or sclerosis and apical widening of the periodontal ligament space for the whole dentition, and for three dental regions. ROC analysis revealed no significant overall or regional differences between the diagnostic accuracies of the periapical and zonographic techniques, regardless of whether the zonograms were read as sets of four images (multiview) or stereoscopic images. The sensitivity of periapical radiography was 72%, that of multiview zonography 88%, and that of stereoscopic zonography 85%. Specificities were 93%, 84% and 89%, respectively. The energy imparted during detailed zonography was 0.98 mJ. It is concluded that zonography is as good as periapical radiography for the detection of periapical pathology.

Detailed tomography of periapical and periodontal lesions. Diagnostic accuracy compared with periapical radiography.

“…Differences in overall sensitivities between detailed tomography and DNBR [11][12] and DZ [20][21][22] were minor. Sensitivities with tomography for periapical lesions in the mandibular premolar and molar regions were lower than those of DNBR 11 and DZ 2 ".…”

“…However, in clinical studies, this is not always possible for practical and ethical reasons [20][21][22] . Because we could not know the actual state of the patients in this study, we evaluated the diagnostic ability of detailed tomography by comparing it with that of periapical radiography.…”

“…These findings are in agreement with our previous studies comparing DNBR 11 · 12 and DZ 2 "· 22 . The good diagnostic outcome with DNBR, especially for marginal widening of the periodontal ligament space, is likely to be due to the intra-oral position of the effective focus and the two horizontal projections used in this technique [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] . In spiral tomography, any point on an object will be depicted from as many angular positions as there are turns in the spiral.…”

“…A film was used to determine the beam size. A more detailed description of the measurements has been given previously 20 . The conversion factors for the tomographic beam qualities were determined by extrapolation from the data obtained by Aim Carlsson et al iH , using water slabs 15 cm thick.…”

Radiographic manifestations of periapical inflammatory lesions

“…8). It has been demonstrated that the visualization of periapical bone lesions, particularly in the premolar and molar regions, is better than that achieved with intraoral periapical radiography (7). Not surprisingly, differences between those techniques were smaller for lesions in the anterior jaw regions.…”