Comparison of non-contrast-enhanced dental magnetic resonance imaging and cone-beam computed tomography in assessing the horizontal and vertical components of furcation defects in maxillary molars: An in vivo feasibility study.

AIM: To compare non-contrast-enhanced dental magnetic resonance imaging (NCE-dMRI) and cone-beam computed tomography (CBCT) in assessing horizontal and vertical furcation defects in maxillary molars in vivo. MATERIALS AND METHODS: (NCE-dMRI) and CBCT were performed in 23 patients with severe periodontitis. Sixty-five first/second maxillary molars (195 furcation entrances) were analysed by two independent observers on both modalities to assess the horizontal and vertical components of furcation defects. Reliability of defect classification was evaluated using weighted kappa (κ) statistics. Agreement between NCE-dMRI and CBCT was determined by the Bland-Altman analysis. Sensitivity and specificity of NCE-dMRI were calculated using CBCT as the reference. RESULTS: Inter-radicular bone loss was observed in 94 furcation entrances. Intra- and inter-rater κ-values were ≥0.9 for both NCE-dMRI and CBCT. The Bland-Altman analysis showed mean differences (95% limits of agreement) of 0.12 mm (-0.67 to 0.90) for horizontal and 0.12 mm (-1.27 to 1.50) for vertical measurements. For the detection of furcation defects, sensitivity/specificity of NCE-dMRI was 98%/100% for horizontal and 99%/99% for vertical components. For defect classification, sensitivity values of NCE-dMRI were 88%/89%/100% (horizontal degree I/II/III) and 95%/91%/80% (vertical subclass A/B/C), respectively. CONCLUSIONS: Non-contrast-enhanced dental magnetic resonance imaging demonstrated high reliability and high agreement with CBCT for the assessment of furcation defects in maxillary molars.

In vivo accuracy of dental magnetic resonance imaging in assessing maxillary molar furcation involvement: A feasibility study in humans.

AIM: To investigate the accuracy and reliability of dental magnetic resonance imaging (dMRI) in assessing maxillary molar furcation involvement (FI). MATERIAL AND METHODS: In this prospective study, 22 patients with severe periodontitis underwent cone-beam computed tomography (CBCT) and dMRI. For 192 furcation entrances, the degree of horizontal FI was assessed by two independent observers on both modalities. Results of dMRI were compared with CBCT (reference modality) to assess the accuracy of dMRI. Cohen's kappa (κ), sensitivity and specificity were calculated for FI classification. Bland-Altman analysis and the Kruskal-Wallis test were used to evaluate measurement accuracy of dMRI. RESULTS: Based on CBCT findings, 93 furcation entrances revealed FI (degree I/II/III: 35/19/39). Intra- and inter-reader agreement was excellent for both modalities (κ-range: 0.884 to 0.933). dMRI measurements showed high agreement with CBCT (bias: 0.17 mm; 95% limits of agreement: -1.05 to 1.38 mm), and measurement accuracy did not differ among different degrees of FI (p = .67). For FI detection, sensitivity and specificity of dMRI were 98% and 99%. For FI classification, sensitivity values of dMRI were 89%/84%/100% for degree I/II/III. CONCLUSIONS: Compared to CBCT (non-invasive gold standard), dMRI demonstrates high accuracy and reliability in evaluating the degree of FI in maxillary molars.