Comparison of diagnostic accuracy of conventional radiography, digital radiography, and ultrasound imaging in the detection of periapical lesions

Accurate diagnosis of periapical lesions may be necessary not only to predict the treatment outcome but also to decrease the incidence of root canal treatment failure. Ultrasound imaging is an easy, reproducible technique, which is based on the evaluation of reflected echoes and has the potential to differentiate the periapical lesions. Aim: To compare the diagnostic accuracy of conventional radiography, digital radiography, and ultrasound imaging in the detection of periapical lesions. Materials and Methods: Thirty patients aged between 20 and 40 years, presenting with well-defined periapical radiolucencies in relation to anterior maxillary or mandibular teeth, indicated for extraction or periapical surgery were subjected to conventional and digital radiographic examination by paralleling technique followed by ultrasonological examination. Three observers (A, B, C) gave their radiographic diagnosis twice at an interval of 2 weeks. A sonologist assessed the size, contents, echogenicity and vascular content of the lesions. The diagnosis was compared with histopathological examination of tissues obtained by extraction or periapical surgery. Results: The diagnostic accuracy of ultrasound imaging was 83.33%, which was higher than conventional radiographic examination by all observers (53.33-76.66%) and digital radiographs by observers A and B (70-80%). Conclusion: Our study revealed that ultrasound with color Doppler was an efficient tool for diagnosing periapical lesions as it had better diagnostic accuracy than conventional and digital radiography