Diagnostic value of Cone beam computed tomography in determination of root canal obturation length versus digital radiography

Abstract

Background and aims. One of the keys to success of root canal therapy is to adequately obturate the prepared root canal space . Periapical radiography is the most commonly used method in clinical practice to evaluate the quality of RCO. Conventional radiography compresses three-dimensional structures on to a two-dimensional image.This may cause radiographic estimation of RCO is challenging for the difficulty of distinguishing super imposed features. Cone beam computed tomography is a contemporary ,radiological imaging system that produces three-dimensional images of the area under examination.These properties make this form of imaging particularly suitable for use in endodontics. Materials and methods. 130 single canal extracted human teeth by obturated root canals were enrolled to the study. Digital Periapical (PA) radiography and 3D cone-beam computed tomography(CBCT) were taken of all teeth and the distance between apical limit of root canal obturation (RCO) and radiographic apex was evaluated by measuring tool of the systems. Then a histologic mesiodistal section prepared of each teeth and the real distance between anatomic apex and RCO was evaluated by measuring tool of stereomicroscope.The accuracy of each methods was evaluated by measuring AUC(area under curve). Statistical analysis was performed with SPSS20. The significance level was set at 0.05. Results.The area under ROC curve of CBCT ,was 0.866.The specificity is 100 and the sensitivity is 81.8. PPV is %86 and NPV is %100. The AUC in PA technique is 0.71.The specificity is 98.1 and sensitivity is 63.6. PPV is% 88 and NPV is %93. Conclusion. The sensitivity and specificity of CBCT was higher than PA and the diagnostic value of CBCT is better than PA radiography