Purpose:
To assess the agreement between periapical radiograph (PA) and cone-beam computed tomography (CBCT) for periapical assessment of root filled maxillary and mandibular molars.
Materials/Methods:
- N= 60 teeth
- Exclusion criteria: N/A
- Inclusion criteria: Patients who had received RCT of max/mand molar in a dental teaching hospital between 2001-2005.
- Positive/negative control: N/A
- Control & Design: Patients were recalled that had RCT performed between 2001-2005. One intraoral paralleling radiograph w/size 2 x-ray film and XCP. In-house CBCT was then performed. 2 Pre-calibrated examiners (Endodontist, Oral radiologist) then examined the films. PA’s were measured using stainless steel ruler. CBCT images assessed using iCAT Vision.
- Criteria of evaluation: Mean difference in (i) number of canals per tooth, (ii) number of lesions per tooth, (iii) M-D diameter of lesions, (iv) C-A diameter of lesions and (v) number of ‘J’ shaped lesions was compared.
Results:
- No significant differences between Endodontist and Radiologist findings
- Significant differences in: mean number of canals identified, mean number of lesions identified, size of lesions (M/D, C/A), J shape lesions (few cases).
- Discrepancy more pronounced in maxillary molars in terms of presence/size of lesion
Clinical Significance:
CBCT has some obvious advantages to PA in terms of identification of lesions/canals. Consideration need be given to exposure vs. benefit however. Also, the study is limited due to only having one endodontist/radiologist and could benefit from an increased sample size.