ABSTRACT
Objetivos: La radiolucidez apical, signo común de la periodontitis apical, se puede detectar mediante radiografías periapicales (RP) o cortes obtenidos a partir de la tomografía computarizada de haz cónico (TCHC). El objetivo de este estudio clínico fue comparar la prevalencia de lesiones periapicales en raíces individuales de dientes tratados endodónticamente evaluados mediante RP digitales y TCHC. Material y métodos: Se evaluaron un total de 135 dientes (131 pacientes) mediante RP digitales y TCHC. Los dientes fueron clasificados según su diagnóstico en: tejidos apicales normales, periodontitis apical sintomática, periodontitis apical asintomática, absceso apical agudo y absceso apical crónico. Dos examinadores calibrados determinaron la presencia o ausencia de lesión periapical. En caso de desacuerdo, la lectura se discutía hasta alcanzar un consenso. Resultados: Se analizaron 290 raíces emparejadas con RP digitales y TCHC, y se detectaron 159 (54,8%) lesiones periapicales mediante RP digitales. En cambio, se detectaron 204 (70,3%) lesiones periapicales cuando estas mismas 290 raíces fueron observadas mediante TCHC. Además, se observaron 4 raíces accesorias solo identificadas mediante TCHC. Conclusiones: El análisis de las imágenes obtenidas mediante TCHC revelaron un 15,5% más de lesiones periapicales que las obtenidas mediante RP digitales en dientes endodonciados habiendo diferencias estadísticamente significativas (P < .05) en los dientes clasificados como tejidos apicales normales, periodontitis apical sintomática y absceso apical agudo
Objective: Periapical radiolucency, detected on a periapical (PA) radiograph or by reconstructed scans obtained using cone beam computed tomography (CBCT), is a common sign of apical periodontitis. The aim of this study was to compare the prevalence of PA lesions on individual roots viewed with digital PA radiographs and CBCT of endodontically treated teeth. Material and methods: One hundred and thirty-five paired roots (in 131 patients) were evaluated with both radiological systems, digital PA radiographs and CBCT. The teeth were classified according to their diagnosis in cases of normal apical tissues, symptomatic apical periodontitis, asymptomatic apical periodontitis, acute apical abscess and chronic apical abscess. Two calibrated examiners determined the presence of absence of periapical lesion. A consensus agreement was reached if there was any disagreement. Results: Two hundred and ninety paired roots were assessed with PA radiographs and CBCT; periapical lesions were present in 159 (54.8%) roots assessed with digital PA radiographs. When the same 290 sets of roots were assessed with CBCT, lesions were present in 204 (70.3%). Four additional roots were detected with CBCT. Conclusions: The analysis of the images obtained by CBCT revealed 15.5% more PA lesions than those obtained by digital PA radiographs. Statistically significant difference (P <.05) was observed between digital PA radiographs and CBCT for teeth classified as having normal apical tissues, symptomatic apical periodontitis and acute apical abscess
