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. 2015 Feb;40(1):58-67.
doi: 10.5395/rde.2015.40.1.58. Epub 2014 Nov 13.

Detection of root perforations using conventional and digital intraoral radiography, multidetector computed tomography and cone beam computed tomography

Abbas Shokri  1 , Amir Eskandarloo  1 , Maruf Noruzi-Gangachin  1 , Samira Khajeh  2
Affiliations

Detection of root perforations using conventional and digital intraoral radiography, multidetector computed tomography and cone beam computed tomography

Abbas Shokri et al. Restor Dent Endod. 2015 Feb.

Abstract

Objectives: This study aimed to compare the accuracy of conventional intraoral (CI) radiography, photostimulable phosphor (PSP) radiography, cone beam computed tomography (CBCT) and multidetector computed tomography (MDCT) for detection of strip and root perforations in endodontically treated teeth.

Materials and methods: Mesial and distal roots of 72 recently extracted molar were endodontically prepared. Perforations were created in 0.2, 0.3, or 0.4 mm diameter around the furcation of 48 roots (strip perforation) and at the external surface of 48 roots (root perforation); 48 roots were not perforated (control group). After root obturation, intraoral radiography, CBCT and MDCT were taken. Discontinuity in the root structure was interpreted as perforation. Two observers examined the images. Data were analyzed using Stata software and Chi-square test.

Results: The sensitivity and specificity of CI, PSP, CBCT and MDCT in detection of strip perforations were 81.25% and 93.75%, 85.42% and 91.67%, 97.92% and 85.42%, and 72.92% and 87.50%, respectively. For diagnosis of root perforation, the sensitivity and specificity were 87.50% and 93.75%, 89.58% and 91.67%, 97.92% and 85.42%, and 81.25% and 87.50%, respectively. For detection of strip perforation, the difference between CBCT and all other methods including CI, PSP and MDCT was significant (p < 0.05). For detection of root perforation, only the difference between CBCT and MDCT was significant, and for all the other methods no statistically significant difference was observed.

Conclusions: If it is not possible to diagnose the root perforations by periapical radiographs, CBCT is the best radiographic technique while MDCT is not recommended.

Keywords: Cone beam computed tomography; Conventional intraoral radiography; Multidetector computed tomography; Photostimulable phosphor radiography; Root perforation; Strip perforation.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Perforation in danger zone creates strip perforation. A, Danger zone; B, Safety zone.
Figure 2
Figure 2
Periapical radiography taken with conventional intraoral (CI) imaging technique. (a) Standard angulation; (b) Distal angulation. Arrow shows strip perforation.
Figure 3
Figure 3
Periapical radiography taken with digital photostimulable phosphor (PSP) radiographic imaging technique. (a) Standard angulation; (b) Distal angulation. Arrow shows strip perforation.
Figure 4
Figure 4
Images taken with cone beam computed tomography (CBCT) imaging technique. (a) Root perforation (arrow); (b) Strip perforation (arrow).
Figure 5
Figure 5
Images taken with multidetector computed tomography (MDCT) imaging technique. (a) Root perforation (arrow); (b) Strip perforation (arrow).
See this image and copyright information in PMC

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