Ultrasonography with color Doppler and power Doppler in the diagnosis of periapical lesions

Abstract

Aim:To evaluate the efficacy of ultrasonography (USG) with color Doppler and power Doppler applications over conventional radiography in the diagnosis of periapical lesions.Materials and Methods:Thirty patients having inflammatory periapical lesions of the maxillary or mandibular anterior teeth and requiring endodontic surgery were selected for inclusion in this study. All patients consented to participate in the study. We used conventional periapical radiographs as well as USG with color Doppler and power Doppler for the diagnosis of these lesions. Their diagnostic performances were compared against histopathologic examination. All data were compared and statistically analyzed.Results:USG examination with color Doppler and power Doppler identified 29 (19 cysts and 10 granulomas) of 30 periapical lesions accurately, with a sensitivity of 100% for cysts and 90.91% for granulomas and a specificity of 90.91% for cysts and 100% for granulomas. In comparison, conventional intraoral radiography identified only 21 lesions (sensitivity of 78.9% for cysts and 45.4% for granulomas and specificity of 45.4% for cysts and 78.9% for granulomas). There was definite correlation between the echotexture of the lesions and the histopathological features except in one case.Conclusions:USG imaging with color Doppler and power Doppler is superior to conventional intraoral radiographic methods for diagnosing the nature of periapical lesions in the anterior jaws. This study reveals the potential of USG examination in the study of other jaw lesions.

An Insight into Histopathologic Examination as a Gold Standard for the Diagnosis of Chronic Apical Periodontitis

“…This had probably led to unnecessary surgery, as apical granulomas can be successfully treated by conservative endodontic therapy. Many studies have emphasized the need to subject all periapical lesions removed during surgery to histopathological examination [5,20]. The results of our study confirmed as well that histopathology is superior to radiography in the accurate diagnosis of apical granulomas and cysts.…”

Differential diagnosis between a granuloma and radicular cyst: effectiveness of magnetic resonance imaging

“…Ultrasonography is a safe imaging technique based on the propagation and reflection of ultrasound waves according to the different structural features of the tissues. It enables differentiation of cysts from granulomas (Cotti et al 2003, Gundappa et al 2006, Goel et al 2011, Prince et al 2012, Musu et al 2016) by identifying specific patterns (cyst, transonic or hypoechoic lesion with no evidence of internal vascularity; granuloma, poorly defined echogenic area with a rich vascular supply (Cotti et al 2003)). Considering its wide availability and reduced time for image acquisition, ultrasonography is a viable investigative option.…”

“…Ultrasound real-time imaging, which is noninvasive, can provide information on the structure of a lesion and its vascular components (Cotti et al 2003, Gundappa et al 2006, Goel et al 2011, Prince et al 2012, Musu et al 2016), but is not reliable to characterize deep intraosseous lesions and is heavily dependent on the ability of the operator (Gundappa et al 2006, Prince et al 2012.…”

Ultrasound evaluation of intra-osseous cavity: A preliminary study in pig mandibles

“…In Group 1 (three dental radiologists), the hemi-mandibles (10 per evaluator) were rated as being of high (8), moderate (8), and low (14) translucency.…”

“…1 Ultrasound has been successfully used in dentistry and by several researchers who investigate its use for evaluation of temporomandibular joint, periodontal and periapical lesions, and mandibular fracture, [2][3][4][5][6][7] as well as its benefits compared to other imaging modalities. 7,8 Ultrasound has been shown to be an interesting alternative new tool over the last few years for diagnosis of intra-osseous lesions in jaws, overcoming the limitations of conventional radiography and computerized tomography (CT) due to its availability of real-time multiplanar images, absence of ionizing radiation and accurate analysis. 1,2,4,5,7,9 The purpose of this study was to perform an experimental model and assess whether ultrasound is effective for evaluation of intra-osseous lesions in the mandible.…”