Comparative Evaluation of Periapical Lesions Using Periapical Index Adapted for Panoramic Radiography and Cone Beam Computed Tomography
Clinical and Experimental Health Sciences
INTRODUCTION The field of radiology shows continuous development in order to improve the image quality and to reduce the patient radiation dose. At present, conventional radiography is replaced with digital radiography (DR) because of emerging radiographic technologies (1-4). Dental radiographic imaging is a significant tool to achieve an accurate diagnosis. Traditional radiographic methods such as panoramic radiography (PR) provide adequate information; yet, these radiographic techniques
... ic techniques provide a two-dimensional (2D) representation of 3-dimensional (3D) structures. Their limited film size, image distortion, magnification, and 2D view restrict their use in this field. To overcome the limitation, medical computed tomography (CT) began to be used for dental applications in the mid-1980s; however, due to the level of radiation exposure during image acquisition, this device received some criticism. Recently, cone beam computed tomography (CBCT) systems have become available for 3D visualization of the craniofacial complex (5). Abstract Objective: The aim of this retrospective study was to comparatively evaluate periapical lesions using the periapical index adapted for panoramic radiography and cone beam computed tomography (CBCT-PAI). Methods: The study group consisted of pre-existing panoramic radiographs and CBCT records of 200 individuals (100 women and 100 men). In this study, panoramic radiographs were evaluated using the PAI scoring system, which uses a scale from 1 to 5 with an increasing radiographic periapical status degree. CBCT images were evaluated using the CBCT-PAI scoring system, which includes two additional variables that indicate any possible expansion or destruction of the cortical bone. During statistical evaluation, the relationship between PAI and CBCT-PAI was investigated by Spearman's rho correlation analysis. Results: In our study, there was no significant difference between the mean ages according to gender (p>0.05). Moreover, there was no significant difference between the numbers of teeth with lesions according to gender (p>0.05). A significant and positive correlation was found between PAI and CBCT-PAI scores in all samples in coronal, sagittal, and axial planes (p<0.01). Conclusion: It was confirmed that CBCT provides more accurate information about the extension and dimensions of periapical lesions.