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. 2024 Jun;27(6):626-633.
doi: 10.4103/JCDE.JCDE_178_24. Epub 2024 Jun 6.

Influence of periapical lesion volume on the radiodensity of surrounding bone: A CBCT study

Matthew Boubaris  1 , Andrew B Cameron  1 , Robert Love  1 , Roy George  1
Affiliations

Influence of periapical lesion volume on the radiodensity of surrounding bone: A CBCT study

Matthew Boubaris et al. J Conserv Dent Endod. 2024 Jun.

Abstract

Aim: This study assesses if the size of periapical lesions has an effect on the bone immediately peripheral to an apical lesion.

Methods: Cone-beam computed tomography (CBCT) images of 271 periapical lesions were analyzed using Mimics Research™ to determine the CBCT periapical lesion volume index (CBCTPAVI) score, along with the radiodensity of the lesion, lesion border, and surrounding bone in 0.5 mm increments up to 2.0 mm peripheral to the apical lesion. The one-way analysis of variance was used to assess for significant differences in the radiodensity of the lesion, border, and peripheral bone, as well as differences among CBCTPAVI scores.

Results: The radiodensity of bone peripheral to the apical lesion increased significantly up to 1.0 mm around the lesion's perimeter. In addition, lesions with higher CBCTPAVI scores showed a significantly greater difference in the radiodensity from the lesion to the lesion border and the peripheral bone, compared to lesions with smaller CBCTPAVI scores.

Conclusions: This study for the first time shows the influence of periapical lesion size on the radiodensity of bone peripheral to an apical lesion. Variations in radiodensity at the perimeter of a periapical lesion can be influenced by the size of the lesion, possibly indicating differences in defense response. Knowledge of these phenomena may provide information on bone healing and enhance our understanding of bone peripheral to a periapical lesion.

Keywords: Cone-beam computed tomography; endodontics; periapical lesion; radiodensity; volume.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Mask of the segmented periapical lesion in the coronal slice. Masks of lesion border (yellow), bone 0.0–0.5 mm (blue), 0.51–1.0 mm (red), 1.01–1.5 mm (purple), and 1.51–2.0 mm (green) peripheral to the lesion for radiodensity measurements in (b) coronal, (c) sagittal, and (d) axial slices
Figure 2
Figure 2
Flowchart of methodology showing creation and use of three-dimensional masks of the periapical lesion, lesion border, and surrounding bone to determine radiodensity. The methodology involved the creation of rescaled standard tessellation language (STL) files of the lesions (step 1), the creation of masks from the rescaled STL files (step 2), mask subtraction process (step 3), and manual adjustments to the masks (step 4). STL: Standard tessellation language
See this image and copyright information in PMC

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