[The application of cone-beam computed tomography in diagnosing the lesions of apical periodontitis of posterior teeth].

ABSTRACT

PURPOSE: To evaluate the effect of periapical radiography in diagnosing the lesions of the apical periodontitis (AP) of posterior teeth, with CBCT imaging as a standard. METHODS: One hundred and six posterior teeth in 80 patients were examined by periapical radiography and CBCT, which consisted of healthy teeth (58 teeth), chronic pulpitis (11 teeth), chronic apical periodontitis (34 teeth), remnant teeth with normal apical images after root canal therapy (3 teeth). All images were measured and evaluated by two experienced dentists by using periapical index (PAI) to ensure the classifications. The results were analyzed statistically with SPSS 13.0 software package for χ2 test. RESULTS: AP was identified in 39.6% and 59.4% of 106 cases by radiography and CBCT, the difference was significant (χ2=8.32, P<0.01). The use of conventional radiography for detection of AP should be done with care because of the great possibility of artifacts which might lead to misdiagnosis. Because of its accuracy, CBCT is more useful for clinic diagnosis and therapy. Furthermore, the images of CBCT could show destruction of cortical bone that couldn't detect by periapical radiography. CONCLUSIONS: CBCT is more accurate than periapical radiography for AP diagnosis. CBCT can reveal the details of the lesions and adjacent structures and provide correct clinical diagnosis and scientific treatment planning with accurate evidence.