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- Huumonen, S, et al.
(author)
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Diagnostic value of computed tomography in re-treatment of root fillings in maxillary molars
- 2006
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In: Int Endod J. ; 39:10, s. 827-833
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Journal article (peer-reviewed)abstract
- Aim To compare the diagnostic information and radiation dose between intraoral radiography and computed tomography (CT) in re-treatment decision making concerning root fillings in maxillary molars. Methodology Thirty-nine root-filled maxillary molars with suspected apical periodontitis were examined with two intraoral periapical radiographs and CT. Presence of periapical lesion/s per tooth and root were analysed for both techniques. In addition, in the CT images, the number of root canals, erosion, or perforation of cortical bone plates, and the distance between palatal root and cortical bone plates were evaluated. Radiation dose for CT was registered and calculated; and that of periapical radiographs used as reported previously (Ekestubbe et al. 2004). Results Periapical radiographs revealed periapical lesions in 33 teeth compared with 38 on CT images. A lesion of any root was detected more often with CT. The mesiobuccal root had two root canals in 30 teeth of which 27 of the MB2 canals were not filled, and 22 roots with an unfilled canal were associated a periapical lesion. Distances to palatal root, from the buccal and palatal cortex were measured in CT and varied between 5.0–12.0 mm and 0–4.0 mm, respectively. Based on the radiographic information, a variety of treatment alternatives were suggested. Mean effective dose of periapical radiographs was 0.02 mSv and that of CT 0.055 mSv. Conclusions Computed tomography may give important information in re-treatment decision when considering root fillings in maxillary molars. The radiation dose should be considered individually.
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- Lofthag-Hansen, Sara, 1956, et al.
(author)
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Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology
- 2007
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In: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. ; 103:1, s. 114-119
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Journal article (peer-reviewed)abstract
- Objective To compare intraoral periapical radiography with 3D images for the diagnosis of periapical pathology. Study design Maxillary molars and premolars and mandibular molars with endodontic problems and examined with periapical radiographs and a 3D technique (3D Accuitomo) were retrospectively selected and evaluated by 3 oral radiologists. Numbers of roots and root canals, presence and location of periapical lesions, and their relation to neighboring structures were studied. Results Among 46 teeth, both techniques demonstrated lesions in 32 teeth, and an additional 10 teeth were found in the Accuitomo images. As regards individual roots, 53 lesions were found in both techniques, and 33 more roots were found to have lesions in Accuitomo images. Artefacts were sometimes a problem in Accuitomo images. In 32 of the 46 cases, all observers agreed that additional clinically relevant information was obtained with Accuitomo images. Conclusions A high-resolution 3D technique can be of value for diagnosis of periapical problems.
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- Mota de Almeida, Fernando José, et al.
(author)
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Computed tomography (CT) in the selection of treatment for root-filled maxillary molars with apical periodontitis
- 2016
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In: Dentomaxillofacial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 45:5
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Journal article (peer-reviewed)abstract
- Objectives: The aims of this study were to evaluate whether the use of CT facilitates agreement among endodontists in selecting treatments for root-filled maxillary molars with apical periodontitis and to assess the efficacy of CT in choosing a treatment for such teeth. Methods: 39 root-filled maxillary molars from 34 patients with suspected apical periodontitis were independently evaluated by 4 endodontists and 1 postgraduate student (decision-makers). Treatment decisions were made based on intra-oral radiographs and a fictive clinical history. After 1-3 months, the same decision-makers repeated the examination of the same teeth but with additional information from a CT examination. Agreement between decision-makers with or without the availability of the CT results was measured with Cohen's kappa coefficient. Differences in selected treatments with or without accessibility to the CT results were plotted for the same endodontists using descriptive statistics. Results: The agreement in assessments among endodontists was slight or fair before the CT results were available (range: 0.081-0.535). No increase was observed after reviewing the CT results (range: 0.116-0.379). After the use of CT, the treatment plan was changed 38-76% of the time by all decision-makers, and the changes affected 57.8% of the cases in the study. Conclusions: The endodontists in this study exhibited a low degree of agreement when choosing a treatment for root-filled maxillary molars with apical periodontitis. A CT examination of the investigated teeth did not result in a significantly higher degree of agreement, and CT frequently contributed to a shift in the selected therapy.
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