Ultrasound Imaging versus Radiographs in Differentiating Periapical Lesions: A Systematic Review

Abstract

Background: Ultrasonography is a non-invasive method of diagnosing periapical lesions while radiologic methods are more common. Periapical lesions due to endodontic infection are one of the most common causes of periapical radiolucency that need to be distinguished to help determine the course of treatment. This review aimed to examine the accuracy of ultrasound and compare it to radiographs in distinguishing these lesions in vivo. Methods: This review process followed the PRISMA guidelines. A literature search of databases (PubMed, Scopus, Embase, and Web of Science) was conducted without any restrictions on time. Articles available in English were included. The selection was done according to the inclusion and exclusion criteria. The QUADAS-2 tool was used to assess the quality of the studies. Results: The search provided a total of 87 articles, out of which, five were selected for the final review. In all the studies, ultrasound had higher accuracy in distinguishing periapical lesions. All the studies indicated a risk of bias, especially in patient selection. Conclusion: Within limitations, the study indicates that ultrasound is a better diagnostic tool to distinguish periapical lesions compared to radiographs but further studies with well-designed, rigorous protocols and low risk of bias are needed to provide stronger evidence.

Diagnostic Accuracy of Cystic Lesions Using a Pre-Programmed Low-Dose and Standard-Dose Dental Cone-Beam Computed Tomography Protocol: An Ex Vivo Comparison Study

“…Nevertheless, PAN and single-tooth radiography are and will remain an essential part of primary diagnosis. Alternative imaging modalities associated with less or no radiation dose, such as ultrasound or magnetic resonance imaging, should also be considered when appropriate [15]. In summary, however, further improvements and standardization of low-dose CBCT protocols are needed in terms of consistency and discriminability, taking into account relevant scientific, economic, and ethical factors that can be translated into personalized therapy.…”

“…Another interesting non-invasive imaging modality for detecting bony lesions in the jaws is ultrasound, as it offers better detectability of lesions than conventional radiation-based imaging. Nevertheless, there are still concerns about its reliability and practicability in everyday clinical practice [15].…”

Ultrasound Imaging in Dentistry: A Literature Overview

“…Moreover, the possibility of applying ionizing-radiation-free diagnostic exams in dentistry, overcoming the limits of this application, has led scientific research in this area to obtain interesting results that bode well for the future. Magnetic resonance imaging (MRI) and ultrasound imaging represent the most interesting evolution of this topic, as underlined by numerous evidence obtained in every branch of dentistry from the application of these diagnostics exams [5][6][7]. The main disadvantage of this examination remains the difficult visualization of tissues poor in water, which, however, has proven to be correctable by dedicated software, and can lead to excellent results.…”

“…In this regard, it is fair to point out that ultrasound has an emission frequency greater than 20 kHz, at the upper limit of human hearing. Ultrasounds with frequencies up to 10 MHz are usually used in medical practice [5,11]. Furthermore, an important and current field of development of ultrasound imaging is represented by the application of high-frequency ultrasound (HFUS), which includes an ultrasound probe frequency of more than 10 MHz.…”

Modern Approaches and Innovations on Methods and Imaging Protocols of the Maxillofacial District

“…In this regard, an increasing amount of attention is being paid to radiation-free imaging techniques, from MRI to imaging techniques that use ultrasound. The use of both in clinical dentistry is increasingly being investigated, and the main difference between them is represented by the learning curve necessary to perform a good ultrasound examination; it is greater than that needed for MRI, which is a more complex examination, due to the long times needed for the acquisition of high-resolution data [ 5 , 14 , 15 , 16 ].…”