Comparison of Cone-Beam Computed Tomography and Periapical Radiography in Predicting Treatment Decision for Periapical Lesions: A Clinical Study

Balasundaram, Ashok; Shah, Punit; Hoen, Michel; Wheater, Michelle; Bringas, Josef S.; Gartner, Arnold H.; Geist, James R.

doi:10.1155/2012/920815

Cited by 30 publications

(43 citation statements)

References 23 publications

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“…Presumably, a CBCT examination would not be beneficial to those patients and would thus expose them to deleterious radiation without gain. Balasundaram et al 38 compared CBCT examination with intraoral radiographs and found that for easily diagnosed endodontic cases, CBCT examination does not provide , number of patients; n t , number of examined teeth; T1, was not in the patient's best interest; T2, had no influence in therapy; T3, did not change therapy but increased confidence; T4, contributed to a change in the selected therapy; T5, was the most important factor in the therapy change. birpublications.org…”

Section: Consideration Of the Resultsmentioning

confidence: 99%

The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics

Almeida¹,

Knutsson²,

Flygare³

2014

Dentomaxillofacial Radiology

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Objectives: The aim was to assess to what extent cone beam CT (CBCT) used in accordance with current European Commission guidelines in a normal clinical setting has an impact on therapeutic decisions in a population referred for endodontic problems. Methods: The study includes data of consecutively examined patients collected from October 2011 to December 2012. From 2 different endodontic specialist clinics, 57 patients were referred for a CBCT examination using criteria in accordance with current European guidelines. The CBCT examinations were performed using similar equipment and standardized among clinics. After a thorough clinical examination, but before CBCT, the examiner made a preliminary therapy plan which was recorded. After the CBCT examination, the same examiner made a new therapy plan. Therapy plans both before and after the CBCT examination were plotted for 53 patients and 81 teeth. As four patients had incomplete protocols, they were not included in the final analysis. Results: 4% of the patients referred to endodontic clinics during the study period were examined with CBCT. The most frequent reason for referral to CBCT examination was to differentiate pathology from normal anatomy, this was the case in 24 patients (45% of the cases). The primary outcome was therapy plan changes that could be attributed to CBCT examination. There were changes in 28 patients (53%). Conclusions: CBCT has a significant impact on therapeutic decision efficacy in endodontics when used in concordance with the current European Commission guidelines.

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Section: Consideration Of the Resultsmentioning

confidence: 99%

The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics

Almeida¹,

Knutsson²,

Flygare³

2014

Dentomaxillofacial Radiology

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“…Estrela et al [14] reported that only progressed periapical lesions were identified correctly by conventional radiography. In contrast, Balasundaram et al [15] reported an only insignificant impact of CBCT diagnosis for the treatment of a respective lesion. Due to the underlying physical principle, all X-ray (XR)-based imaging techniques have limited capabilities in soft tissue characterization and are supposed to be limited in the differentiation between chronic and acute periapical lesions that may have an impact on the treatment strategy.…”

Section: Materials Und Methoden: In Die Studie Wurden 19mentioning

confidence: 93%

Assessment of Apical Periodontitis by MRI: A Feasibility Study

Geibel

Schreiber

Bracher

et al. 2015

Fortschr Röntgenstr

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Purpose: The purpose of this clinical feasibility study was to evaluate the applicability of magnetic resonance imaging (MRI) for the assessment of apical periodontitis in direct comparison with cone beam CT (CBCT). Materials and Methods: 19 consecutive patients (average age 43???13 years) with 34 lesions in total (13 molars, 14 premolars and 7 front teeth) were enrolled in this feasibility study. Periapical lesions were defined as periapical radiolucencies (CBCT) or structural changes in the spongy bone signal (MRI), which were connected with the apical part of a root and with at least twice the width of the periodontal ligament space. The location and dimension of the lesions were compared between MRI and CBCT. Results: While mainly mineralized tissue components such as teeth and bone were visible with CBCT, complimentary information of the soft tissue components was assessable with MRI. The MRI images provided sufficient diagnostic detail for the assessment of the main structures of interest. Heterogeneous contrast was observed within the lesion, with often a clear enhancement close to the apical foramen and the periodontal gap.?No difference for lesion visibility was observed between MRI and CBCT. The lesion dimensions corresponded well, but were slightly but significantly overestimated with MRI. A heterogeneous lesion appearance was observed in several patients. Four patients presented with a well circumscribed hyperintense signal in the vicinity of the apical foramen. Conclusion: The MRI capability of soft tissue characterization may facilitate detailed analysis of periapical lesions. This clinical study confirms the applicability of multi-contrast MRI for the identification of periapical lesions. Key Points: ??MRI can be applied for the identification of periapical lesions without ionizing radiation exposure ??MRI might facilitate more detailed characterization of periapical lesions ??MRI might provide more accurate lesion dimensions as X-ray-based methods Citation Format: ??Geibel MA., Schreiber ES, Bracher AK et?al. Assessment of Apical Periodontitis by MRI: A Feasibility Study. Fortschr R?ntgenstr 2015; 187: 269???275

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“…Thus, there is a need for a noninvasive method to diagnose lesions involving the periapical area. Recently with the advent of imaging modalities such as digital radiography, densitometry methods, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and cone beam computed tomography (CBCT), differences in density may permit more accurate preoperative diagnosis [1, 3, 4]. …”

Section: Introductionmentioning

confidence: 99%

“…Many subsequent studies since that time have underscored the difficulty of detecting periapical lesions using IOPA radiographs. Therefore, considering some limitations on conventional radiography for detection of periapical bone lesions, advanced imaging methods such as CBCT might add benefits to endodontics and offer a higher quality for the diagnosis, treatment planning, and prognosis [1, 2, 4–9]. …”

Section: Introductionmentioning

confidence: 99%

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Cone Beam Computed Tomography Evaluation of the Diagnosis, Treatment Planning, and Long-Term Followup of Large Periapical Lesions Treated by Endodontic Surgery: Two Case Reports

Shekhar¹,

K²

2013

Case Reports in Dentistry

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The aim of this case report is to present two cases where cone beam computed tomography (CBCT) was used for the diagnosis, treatment planning, and followup of large periapical lesions in relation to maxillary anterior teeth treated by endodontic surgery. Periapical disease may be detected sooner using CBCT, and their true size, extent, nature, and position can be assessed. It allows clinician to select the most relevant views of the area of interest resulting in improved detection of periapical lesions. CBCT scan may provide a better, more accurate, and faster method to differentially diagnose a solid (granuloma) from a fluid-filled lesion or cavity (cyst). In the present case report, endodontic treatment was performed for both the cases followed by endodontic surgery. Biopsy was done to establish the confirmatory histopathological diagnosis of the periapical lesions. Long-term assessment of the periapical healing following surgery was done in all the three dimensions using CBCT and was found to be more accurate than IOPA radiography. It was concluded that CBCT was a useful modality in making the diagnosis and treatment plan and assessing the outcome of endodontic surgery for large periapical lesions.

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Comparison of Cone-Beam Computed Tomography and Periapical Radiography in Predicting Treatment Decision for Periapical Lesions: A Clinical Study

Cited by 30 publications

References 23 publications

The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics

The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics

Assessment of Apical Periodontitis by MRI: A Feasibility Study

Cone Beam Computed Tomography Evaluation of the Diagnosis, Treatment Planning, and Long-Term Followup of Large Periapical Lesions Treated by Endodontic Surgery: Two Case Reports

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