In vivo accuracy of dental magnetic resonance imaging in assessing maxillary molar furcation involvement: A feasibility study in humans

Abstract

Aim To investigate the accuracy and reliability of dental magnetic resonance imaging (dMRI) in assessing maxillary molar furcation involvement (FI). Material and Methods In this prospective study, 22 patients with severe periodontitis underwent cone‐beam computed tomography (CBCT) and dMRI. For 192 furcation entrances, the degree of horizontal FI was assessed by two independent observers on both modalities. Results of dMRI were compared with CBCT (reference modality) to assess the accuracy of dMRI. Cohen's kappa (κ), sensitivity and specificity were calculated for FI classification. Bland–Altman analysis and the Kruskal–Wallis test were used to evaluate measurement accuracy of dMRI. Results Based on CBCT findings, 93 furcation entrances revealed FI (degree I/II/III: 35/19/39). Intra‐ and inter‐reader agreement was excellent for both modalities (κ‐range: 0.884 to 0.933). dMRI measurements showed high agreement with CBCT (bias: 0.17 mm; 95% limits of agreement: −1.05 to 1.38 mm), and measurement accuracy did not differ among different degrees of FI (p = .67). For FI detection, sensitivity and specificity of dMRI were 98% and 99%. For FI classification, sensitivity values of dMRI were 89%/84%/100% for degree I/II/III. Conclusions Compared to CBCT (non‐invasive gold standard), dMRI demonstrates high accuracy and reliability in evaluating the degree of FI in maxillary molars.

Comparison of non‐contrast‐enhanced dental magnetic resonance imaging and cone‐beam computed tomography in assessing the horizontal and vertical components of furcation defects in maxillary molars: An in vivo feasibility study

“…Second, CBCT is superior to current dMRI methods concerning the spatial resolution. In this regard, it should be noted that buccal furcations, which are the narrowest on average (Bower, 1979;Hou et al, 1994), revealed the lowest sensitivity levels for horizontal furcation defects not only in the present NCE-dMRI study but also and in a previous GBCA-dMRI study (Juerchott et al, 2020). This pattern indicates that the sensitivity of dMRI may be reduced for exceptionally narrow furcations due to the lower spatial resolution compared to CBCT.…”

“…These data are of clinical relevance, as correct furcation diagnosis provides the basis for prognosis estimation and treatment decisions (Avila-Ortiz et al, 2015;Dommisch et al, 2020;Jepsen et al, 2019;Sanz et al, 2020;Walter et al, 2011). Most importantly, the dMRI technique applied in this study does not require the administration of GBCA in contrast to an earlier study (Juerchott et al, 2020).…”

“…To date, only one study has investigated the use of dMRI in assessing furcation defects in maxillary molars (Juerchott et al, 2020).…”

“…In recent years, considerable technical advances have been made in the development and implementation of in vivo dental magnetic resonance imaging (dMRI) techniques (Hilgenfeld et al, 2017(Hilgenfeld et al, , 2018(Hilgenfeld et al, , 2019Juerchott et al, 2019;Ludwig et al, 2016;Sedlacik et al, 2016;Tymofiyeva et al, 2010). Recently, it was shown that a dMRI technique using intravenous gadolinium-based contrast agent (GBCA) enables the detection and classification of horizontal furcation defects in maxillary molars with high reliability and accuracy in vivo (Juerchott et al, 2020). In addition, GBCA-dMRI has demonstrated high diagnostic value in other areas of dental imaging (Juerchott et al, 2018;Kress et al, 2004;Lizio et al, 2018;Ploder et al, 2001).…”

Magnetic resonance imaging as a diagnostic tool for periodontal disease: A prospective study with correlation to standard clinical findings—Is there added value?

“…Since over 20 years, MRI has been commonly used to detect inflammatory processes in various soft and hard tissue compartments, including muscles, joints and bones (Patel et al, 1996; Miller et al, 1997; Sempere et al, 2005). Yet, there are only three studies available focusing on MRI as a method to assess inflammatory processes within the gingival soft tissue in the context of periodontitis (Schara et al, 2009; Newbould et al, 2017; Juerchott et al, 2020). MRI bone sequences are able to generate diagnostic data within osseous structures comparable to those as obtained with CBCT independent from the exposure to ionizing radiation (Cho et al, 2019; Juerchott et al, 2020).…”