Purpose:
Compare appearance of healthy periapical tissues in cone-beam with PA and measure PDL on CBCT in health vs necrosis
Materials/Methods:
N=200 teeth that had PA, pulp tested, and CBCT from endodontists
- 2 independent, blind examiners analyzed the images using a modified CBCT-PAI (CBCT- Periapical Index) score and PAI score for PA radiographs
- Fisher exact and X(2) analysis for relationships between CBCT-PAI, PAI, and pulp status
Results:
- 166 out of 200 were vital
- 72 % CBCT-PAI was greater than PAI in vital teeth with radiographic PDL widening of 0-1 mm (p< 0.001)
- 2 healthy teeth showed 2-4 mm radiolucencies on CBCT when PA radiograph showed none
- In 20% of vital teeth had CBCT-PAI of 2+
- PDL > 1-2 mm was indicative of a necrotic pulp (p< 0.001)
Clinical Significance:
- Teeth with necrotic pulps were more likely to have PDL widening
- Most healthy teeth showed some widening
- The normal 3-dimensional anatomy of the PDL space appears to entail greater variation than previously thoughtà questions traditional radiographic interpretation
- CBCT must be further investigated before usage in outcome or epidemiological investigations