Interpretation of chemically created periapical lesions using 2 different dental cone-beam computerized tomography units, an intraoral digital sensor, and conventional film.

OBJECTIVE To assess the diagnostic potential of 2 different cone-beam computerized tomography (CT) units and compare this with intraoral digital and conventional film in the detection of chemically created periapical lesions. STUDY DESIGN Periapical lesions were created chemically in 27 intact roots of 23 teeth (6 incisors, 4 canines, 6 premolars, and 7 molars). Cone-beam CT and digital and film images of the teeth were obtained before and after the lesions were created. Three observers separately used a 5-point scale to rate the images for the presence or absence of periapical pathology. Images were scored twice by each observer, with an interval of 4 weeks. Kappa values were calculated to assess intra- and interobserver agreement. Data were analyzed using repeated-measures analysis of variance for nested designs. R(2) values were used to assess the models for each observer for each method. Differences between observers and methods were tested for statistical significance with the paired t test. RESULTS Kappa coefficients for intraobserver agreement ranged from 0.196 to 0.542 for the 2-dimensional (2D) images and from 0.533 to 0.699 for the cone-beam CT images, whereas kappa coefficients for interobserver agreement ranged from 0.223 to 0.302 for the 2D images and from 0.417 to 0.461 for the cone-beam CT images. The R(2) values for each observer showed that cone-beam CT images were superior to 2D intraoral images. There was no difference between the 2 cone-beam CT units tested (P > .05), and no difference was found between the 2 intraoral radiographic techniques tested (P > .05). CONCLUSION The 2 cone-beam CT units tested performed similarly, and both performed better than intraoral digital and film radiography in detecting chemically created periapical lesions.