Identification of simulated periapical diseases using five different diagnostic imaging methods

Objectives: To assess and compare five diagnostic imaging methods used in the identification of periapical diseases, of different diameters, mechanically simulated. Methods: The sample of the present study consisted of 12 dried human mandibles. Digital panoramic radiography, conventional and digital periapical radiography (charged couple device and photo-stimulable phosphor plate), and high-resolution cone beam computed tomography (CBCT) were previously performed to exclude regions presenting periapical lesions or similar conditions, which then formed the control and experimental groups. Then, periapical diseases were progressively produced with drills of different diameters, thus creating lesions of different sizes. The different image diagnosis methods were applied after each lesion produced. The data were assessed using the Kappa test, ROC curve graphs and Cochran’s Q test. The significance level was set at 0.05. Results: The images obtained with conventional film and digital panoramic radiography showed the worse results (0.65 and 0.55, respectively), and statistically significant differences compared to the controls (p < 0.05) for lesions artificially produced with #6 drill. With regard to high-resolution CBCT, the area values were found to be high for all lesion sizes. Conclusion: Conventional periapical radiography and digital panoramic radiography did not provide satisfactory images for the identification of incipient periapical diseases. The highresolution CBCT showed high accuracy in the diagnosis of periapical diseases in both regions evaluated, and proved to be the most reliable method for the identification of initial periapical diseases (1.8 mm). © 2016 Sociedade Portuguesa de Estomatologia e Medicina Dentária. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). ∗ Corresponding author. E-mail address: [email protected] (E.M. Villoria). http://dx.doi.org/10.1016/j.rpemd.2016.08.002 1646-2890/© 2016 Sociedade Portuguesa de Estomatologia e Medicina Dentária. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Document downloaded from http://www.elsevier.es, day 25/11/2017. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited.