Which factors related to apical radiolucency may influence its radiographic detection? A study using CBCT as reference standard
Fontenele Rocharles Cavalcante, Nascimento Eduarda Helena Leandro, Gaeta-Araujo Hugo, de Araujo Cardelli Lais Oliveira, Freitas Deborah Queiroz,
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( Fontenele Rocharles Cavalcante ) - University of Campinas Piracicaba Dental School Department of Oral Diagnosis
( Nascimento Eduarda Helena Leandro ) - Federal University of Sergipe Department of Dentistry
( Gaeta-Araujo Hugo ) - Federal University of Alfenas School of Dentistry Oral Radiology Section
( de Araujo Cardelli Lais Oliveira ) - University of Campinas Piracicaba Dental School Department of Oral Diagnosis
( Freitas Deborah Queiroz ) - University of Campinas Piracicaba Dental School Department of Oral Diagnosis
Abstract
Objectives: This study aimed to evaluate the detection rate of apical radiolucencies in 2-dimensional images using cone-beam computed tomography (CBCT) as the reference standard, and to determine which factors related to the apical radiolucencies and the teeth could influence its detection.
Materials and Methods: The sample consisted of exams of patients who had panoramic (PAN) and/or periapical (PERI) radiography and CBCT. The exams were assessed by 2 oral radiologists and divided into PAN+CBCT (227 teeth?285 roots) and PERI+CBCT (94 teeth?115 roots). Radiographic images were evaluated for the presence of apical radiolucency, while CBCT images were assessed for presence, size, location, and involvement of the cortical bone (thinning, expansion, and destruction). Diagnostic values were obtained for PERI and PAN.
Results: PERI and PAN presented high accuracy (0.83 and 0.77, respectively) and specificity (0.89 and 0.91, respectively), but low sensitivity, especially for PAN (0.40 vs. 0.65 of PERI). The size of the apical radiolucency was positively correlated with its detection in PERI and PAN (p < 0.001). For PAN, apical radiolucencies were 3.93 times more frequently detected when related to single-rooted teeth (p = 0.038). The other factors did not influence apical radiolucency detection (p > 0.05).
Conclusions: PERI presents slightly better accuracy than PAN for the detection of apical radiolucency. The size is the only factor related to radiolucency that influences its detection, for both radiographic exams. For PAN, apical radiolucency is most often detected in single-rooted teeth.
키워드
Endodontics; Cone-beam computed tomography; Panoramic; Periapical; Radiography
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