[ comparison between digital panoramic view and cone-beam computed tomography [CBCT] images in diagnosis of apical radiolucent lesions]

ABSTRACT

Panoramic radiography is used extensively in the field of dentistry as a screening method. In endodontic treatment, the diagnosis and evaluation of periapical area is very important. However, using advanced imaging such as cone beam computed tomography [CBCT] has increased diagnostic ability, but it must be used precisely and in special condition. The aim of this study was to compare diagnostic value of digital panoramic view and CBCT in diagnosis of apical lucent lesion. In this cross-sectional study, digital panoramic view and CBCT of 47 patients [573 apical portions of root] who had referred to maxillofacial radiology clinic for maxillary and or mandibular CBCT procedures were assessed. All of the selected patients needed these images as their treatment protocol. According to order of CBCT [maxilla, mandible and both], the teeth of the same jaw in digital panoramic radiography by a maxillofacial radiologist were evaluated. After data enterance, agreement, Sensitivity, specificity and likelihood ratio [positive and negative] were assessed totally and for each jaw separately with 95 percent confidence interval. 0.05 was established as a level of significant. Periapical radiolucency in 15.9% of apical areas in CBCT and in digital panoramic view in 4.2% of them was detected. Overall, sensitivity and specificity of digital panoramic view were 26.4% and 100% respectively. Sensitivity of panoramic view in diagnosis of periapical lucency in mandible was higher than maxilla. According to kappa analysis, the agreement level between panoramic and CBCT was assigned low [kappa=0.374]. Although panoramic is a routine screening method in field of dentistry, it is not accurate in diagnosis of the presence of periapical lesions. This limitation in maxilla is more than mandible