A Comparative Study to Evaluate Periapical Pathology Using Mid Field of View CBCT and Direct Digital Radiography

BACKGROUND Local response of the bone surrounding the apex of the tooth as a result of pulp necrosis or destruction of the periapical tissues caused by significant periodontal disease is known as a periapical inflammatory lesion. Intraoral radiography is the most commonly used technique but has limitations in representing only 2- dimensional images. CBCT was created primarily to provide 3-dimensional maxillary skeletal images and a smaller and mid field of view (FOV) have a higher spatial resolution and improved diagnostic potential. The intention of this study was to compare and evaluate the results of limited view CBCT and DDI in the diagnosis of periapical pathology. METHODS In this study, a total of 25 patients who visited the oral medicine department with clinical and or radiographic findings were included. Periapical lesions were assessed using a cone-beam CT periapical index (CBCTPAI) scoring system in both direct digital imaging (DDI) radiographs and CBCT images. RESULTS Periapical lesions were found to be more prevalent in 30 - 39 years (40 %) with a male predilection (64 %) and maxillary anterior (36 %) more commonly affected. Wilcoxon signed-rank test performed to assess the mean difference between the two imaging modalities revealed a P < 0.001 and was statistically significant. CONCLUSIONS This study highlights the role of CBCT in diagnosing periapical lesions which can be missed or misdiagnosed on DDI. KEY WORDS Cone Beam Computed Tomography (CBCT); Direct Digital Imaging (DDI); Periapical Lesions