A Clinical Evaluation of Cone Beam Computed Tomography: Implications for Endodontic Microsurgery
Abstract
Introduction: Cone-Beam Computed Tomography (CBCT) has become a valuable diagnostic tool for endodontics. Although the literature generally supports the accuracy of this imaging modality, some studies report that CBCT images may have limitations in representing the true clinical presentation. Purpose: This prospective, in vivo study compared limited field of view (LFOV) CBCT measurements to clinical measurements made during endodontic surgery. Methods: Patients requiring endodontic surgery with a LFOV CBCT were asked to enroll in the study. Data collection, during the surgical and radiographic assessment, involved answering standardized questions evaluating multiple factors including the presence and dimensions of bony defects. During surgery, clinical data was collected and photographically documented. During the radiographic assessment, CBCT scans were evaluated by three calibrated, board certified specialists; two endodontists and one oral and maxillofacial radiologist. The clinical data was compared to data from CBCT interpretations and statistically analyzed. Results: The sample size of 83 teeth included 58 maxillary and 25 mandibular teeth from 77 subjects: 20 females and 57 males with an average age of 41 years old. The CBCT evaluators correctly identified the presence or absence of buccal plate fenestrations 92.2 percent of the time and had a kappa value of 0.84. The area of buccal plate fenestrations had to be at least 20.5 mm^2 in order to be visible on CBCT at least 90 percent of the time. This data was most reliable when the interval between scan and surgery is less than 100 days. Conclusion: Though useful in endodontic surgical treatment planning, based on the findings of this study, the LFOV CBCT overestimates the presence of bone and underestimates the size of fenestrations.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 01, 2019
- Accession Number
- AD1127953
Entities
People
- Molly E. Kopacz
Organizations
- Uniformed Services University of the Health Sciences