Variations in the interpretation of periapical radiolucencies

Evaluation of Chronic Periapical Lesions by Digital Subtraction Radiography by Using Adobe Photoshop CS: A Technical Report

“…Regions that represent areas of new bone tissue exhibited a radiopaque appearance, whereas regions with bone tissue resorption were radiolucent (Figs. [3][4][5]. A smooth anatomic image in black background was observed on digital subtraction images.…”

“…However, the suggested radiographic criteria, including lesion persistence and increase of periapical lesion size, are qualitative and subjective (3). Several methods have been described to measure periapical radiolucencies, including measurement of the diameter, distance between root surface and radiolucency outlines, use of a specific classification, and determination of the area by means of tracing (4).…”

Clinical Science Comparison of Xeroradiographs and Film for Detection of Periapical Lesions

“…Multiple investigators have found that the radiographic detection of experimental periapical lesions depends on the visualization of destruction of the bony cortex adjacent to the tooth (Duinkerke et al, 1975;Manson-Hing, 1971;Phillips and Shawkat, 1973;Bender and Seltzer, 1961 a and b;Schwartz and Foster, 1971). The recent availability of xeroradiography (Jeromin et al, 1980;Gratt et al, 1980 b) and Kodak Ektaspeed film (Silha, 1981 a and b) offers the possibility that either of these alternative imaging systems might offer diagnostic sensitivity either the same as or greater than that of Kodak Ultraspeed film for the radiographic detection of periapical lesions.…”

Pre-operative diagnostic radiograph interpretation by general dental practitioners for root canal treatment

“…9,[12][13][14][15][16][17][18] The results of the present study indicate that general dental practitioners are more able to detect periapical changes and canal calcification changes in radiographs when there were moderate to extensive in nature (Tables 3 and 4), but when these changes were to a milder degree they were more likely to be missed by a practitioner. Periapical changes of grade 4 and 5 (according to PAI) were detected by 14-17 practitioners for all the groups of teeth, whereas grade 1 and 2 periapical changes (according to PAI) were detected only by 1-3 practitioners, and 16-18 practitioners missed the radiographic changes altogether.…”

“…[6][7][8][9] From an intraoral periapical view radiograph, the following radicular findings should be assessed: 4,10,11 1. length of root 2. curvature of root both mesial-distal and buccallingual curvatures This inconsistency is due to wide variation in interpretation among different observers and within the same observers at different times. 9,[12][13][14][15][16][17][18] Kaffe et al 9 suggested providing dentists with better radiographic diagnostic criteria for a more consistent evaluation of radiographs and to find the most important and reliable radiographic features that will enable the clinician to interpret them correctly. The purpose of this study was to evaluate which radicular radiographic features the general dentists will want to interpret in a pre-operative diagnostic intraoral periapical radiograph for root canal treatment, determine which radicular radiographic features general dentists interpret correctly and which ones they miss in an intraoral diagnostic periapical radiograph and correlate how correctly general dentists are able to interpret radicular radiographic features that they want to interpret for root canal treatment.…”