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Comparative Study
. 2009 Jul;35(7):1009-12.
doi: 10.1016/j.joen.2009.04.006.

Accuracy of periapical radiography and cone-beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard

Francisco Wanderley Garcia de Paula-Silva  1 , Min-Kai Wu, Mário Roberto Leonardo, Léa Assed Bezerra da Silva, Paul R Wesselink
Affiliations
Comparative Study

Accuracy of periapical radiography and cone-beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard

Francisco Wanderley Garcia de Paula-Silva et al. J Endod. 2009 Jul.

Abstract

Introduction: The aim of this study was to evaluate the accuracy of two imaging methods in diagnosing apical periodontitis (AP) using histopathological findings as a gold standard.

Methods: The periapex of 83 treated or untreated roots of dogs' teeth was examined using periapical radiography (PR), cone-beam computed tomography (CBCT) scans, and histology. Sensitivity, specificity, predictive values, and accuracy of PR and CBCT diagnosis were calculated.

Results: PR detected AP in 71% of roots, a CBCT scan detected AP in 84%, and AP was histologically diagnosed in 93% (p = 0.001). Overall, sensitivity was 0.77 and 0.91 for PR and CBCT, respectively. Specificity was 1 for both. Negative predictive value was 0.25 and 0.46 for PR and CBCT, respectively. Positive predictive value was 1 for both. Diagnostic accuracy (true positives + true negatives) was 0.78 and 0.92 for PR and CBCT (p = 0.028), respectively.

Conclusion: A CBCT scan was more sensitive in detecting AP compared with PR, which was more likely to miss AP when it was still present.

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