Periapical radiography and cone beam computed tomography for assessment of the periapical bone defect 1 week and 12 months after root-end resection

• Published in: Dento-maxillo-facial radiology Vol. 38; no. 8; pp. 531 - 536
• Main Authors: Christiansen, R, Kirkevang, L-L, Gotfredsen, E, Wenzel, A
• Format: Journal Article
• Language: English
• Published: England 01.12.2009
• Subjects: Adult; Aged; Alveolar Process - diagnostic imaging; Apicoectomy; Bicuspid - diagnostic imaging; Cephalometry - statistics & numerical data; Cone-Beam Computed Tomography - statistics & numerical data; Cuspid - diagnostic imaging; Dentistry; Female; Follow-Up Studies; Humans; Image Processing, Computer-Assisted; Incisor - diagnostic imaging; Male; Middle Aged; Periapical Granuloma - surgery; Periapical Periodontitis - diagnostic imaging; Periapical Periodontitis - surgery; Periapical Tissue - diagnostic imaging; Radiography, Bitewing - statistics & numerical data; Radiography, Dental, Digital - statistics & numerical data; Root Canal Therapy; Wound Healing - physiology
• DOI: 10.1259/dmfr/63019695
• ISSN: 0250-832X

Our aim was to compare periapical radiography and cone beam CT (CBCT) for assessment of the periapical bone defect 1 week and 12 months after root-end resection. 50 patients (58 teeth) with a persisting apical periodontitis in a root-filled tooth (incisor, canine or premolar) were treated with root-end resection. 1 week and 12 months post-operatively, a CBCT scan (NewTom 3G) and a periapical radiograph (Digora) were obtained. Three observers detected and measured the periapical bone defects on periapical radiographs and CBCT images (coronal and sagittal sections). 1 week post-operatively, a periapical bone defect area was measured in all teeth by all observers. The defect was 10% smaller on periapical radiographs (mean = 12.4 mm2, SD = 8.2) than on the CBCT images measured in the coronal plane (mean = 13.0 mm2, SD = 7.8), a difference which was not statistically significant (P = 0.58). 12 months post-operatively (n = 52), there was considerable variation between the observers' detection of a remaining defect on the periapical radiographs and the CBCT images. The average agreement between the periapical radiograph and the CBCT images in the coronal sections was 67%, and more defects were detected on CBCT than on periapical radiographs. On average, the periapical bone defect measured on periapical radiographs was approximately 10% smaller than on coronally sectioned CBCT images 1 week post-operatively. More remaining defects were detected 1 year after periapical surgery on CBCT images than on periapical radiographs, but it is uncertain how this information is related to success or failure after root-end resection.