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Feasibility of Cone-beam Computed Tomography in Detecting Lateral Canals before and after Root Canal Treatment: An Ex Vivo Study

Published:April 14, 2017DOI:https://doi.org/10.1016/j.joen.2017.01.025

      Abstract

      Introduction

      The study objective was to evaluate the effectiveness of cone-beam computed tomographic (CBCT) imaging for the detection of lateral canals (LCs) in endodontically treated premolars.

      Methods

      Two evaluators classified 80 extracted premolars into 2 groups based on the absence (n = 40) or presence (n = 40) of LCs according to micro–computed tomographic analysis. The extracted teeth were fixated in a human mandible and scanned with CBCT imaging. Subsequently, each tooth was endodontically treated, and CBCT scans were repeated. Three experienced examiners evaluated all images randomly. Receiver operating characteristic curves were compared using the McNemar test, and sensitivity, specificity, positive predictive value, and negative predictive value (NPV) were obtained.

      Results

      The area under the receiver operating characteristic curve values were 0.58 and 0.49 before and after root canal treatment, respectively. These values were statistically significantly different (P < .001). Before root canal treatment sensitivity, specificity, positive predictive value, and negative predictive value were 55%, 52%, 55%, and 56%, whereas after root canal treatment the values were 33%, 61%, 46%, and 48%, respectively.

      Conclusions

      LC detection in nontreated teeth presented low accuracy, whereas among treated teeth CBCT imaging showed no efficacy. The results suggest that CBCT imaging is not an effective diagnostic tool for LC detection.

      Key Words

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      References

        • Song M.
        • Kim H.C.
        • Lee W.
        • Kim E.
        Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic inspection during endodontic microsurgery.
        J Endod. 2011; 37: 1516-1519
        • Wu M.K.
        • Shemesh H.
        • Wesselink P.R.
        Limitations of previously published systematic reviews evaluating the outcome of endodontic treatment.
        Int Endod J. 2009; 42: 656-666
        • De Deus Q.D.
        Frequency, location, and direction of the lateral, secondary, and accessory canals.
        J Endod. 1975; 1: 361-366
        • Carvalho-Sousa B.
        • Almeida-Gomes F.
        • Carvalho P.R.
        • et al.
        Filling lateral canals: evaluation of different filling techniques.
        Eur J Dent. 2010; 4: 251-256
        • AAE
        Glossary of Endodontic Terms.
        9th ed. AAE, Chicago2015
        • Ricucci D.
        • Siqueira J.F.
        Fate of the tissue in lateral canals and apical ramifications in response to pathologic conditions and treatment procedures.
        J Endod. 2010; 36: 1-15
        • Schilder H.
        • Hargreaves K.M.
        Filling root canals in three dimensions.
        J Endod. 2006; 32: 281-290
        • Vertucci F.J.
        Root canal morphology and its relationship to endodontic procedures.
        Endod Topics. 2005; 10: 3-29
        • Scarfe W.C.
        • Levin M.D.
        • Gane D.
        • et al.
        Use of cone beam computed tomography in endodontics.
        Int J Dent. 2009; 2009: 634567
        • Neelakantan P.
        • Subbarao C.
        • Subbarao C.V.
        Comparative evaluation of modified canal staining and clearing technique, cone-beam computed tomography, peripheral quantitative computed tomography, spiral computed tomography, and plain and contrast medium-enhanced digital radiography in studying root canal morphology.
        J Endod. 2010; 36: 1547-1551
        • Baratto Filho F.
        • Zaitter S.
        • Haragushiku G.A.
        • et al.
        Analysis of the internal anatomy of maxillary first molars by using different methods.
        J Endod. 2009; 35: 337-342
        • Matherne R.P.
        • Angelopoulos C.
        • Kulild J.C.
        • et al.
        Use of cone-beam computed tomography to identify root canal systems in vitro.
        J Endod. 2008; 34: 87-89
        • Soares De Toubes K.M.
        • Côrtes M.I.
        • Valadares M.A.
        • et al.
        Comparative analysis of accessory mesial canal identification in mandibular first molars by using four different diagnostic methods.
        J Endod. 2012; 38: 436-441
        • Mirmohammadi H.
        • Mahdi L.
        • Partovi P.
        • et al.
        Accuracy of cone-beam computed tomography in the detection of a second mesiobuccal root canal in endodontically treated teeth: an ex vivo study.
        J Endod. 2015; 41: 1678-1681
        • Neves F.S.
        • Freitas D.Q.
        • Campos P.S.
        • et al.
        Evaluation of cone-beam computed tomography in the diagnosis of vertical root fractures: the influence of imaging modes and root canal materials.
        J Endod. 2014; 40: 1530-1536
        • Junqueira R.B.
        • Verner F.S.
        • Campos C.N.
        • et al.
        Detection of vertical root fractures in the presence of intracanal metallic post: a comparison between periapical radiography and cone-beam computed tomography.
        J Endod. 2013; 39: 1620-1624
        • Landis J.R.
        • Koch G.G.
        The measurement of observer agreement for categorical data.
        Biometrics. 2008; 33: 159-174
        • Mandrekar J.N.
        Receiver operating characteristic curve in diagnostic test assessment.
        J Thorac Oncol. 2010; 5: 1315-1316
        • Helvacioglu-Yigit D.
        • Demirturk Kocasarac H.
        • Bechara B.
        • et al.
        Evaluation and reduction of artifacts generated by 4 different root-end filling materials by using multiple cone-beam computed tomography imaging settings.
        J Endod. 2016; 42: 307-314
        • Schulze R.
        • Heil U.
        • Groß D.
        • et al.
        Artefacts in CBCT: a review.
        Dentomaxillofac Radiol. 2011; 40: 265-273
        • Hassan B.
        • Metska M.E.
        • Ozok A.R.
        • et al.
        Detection of vertical root fractures in endodontically treated teeth by a cone beam computed tomography scan.
        J Endod. 2009; 35: 719-722
        • Bechara B.
        • McMahan C.A.
        • Noujeim M.
        • et al.
        Comparison of cone beam CT scans with enhanced photostimulated phosphor plate images in the detection of root fracture of endodontically treated teeth.
        Dentomaxillofac Radiol. 2013; 42: 20120404
        • Liedke G.S.
        • Spin-Neto R.
        • Vizzotto M.B.
        • et al.
        Diagnostic accuracy of cone beam computed tomography sections with various thicknesses for detecting misfit between the tooth and restoration in metal-restored teeth.
        Oral Surg Oral Med Oral Pathol Oral Radiol. 2015; 120: 131-137
        • Park J.B.
        • Kim N.
        • Park S.
        • et al.
        Evaluation of root anatomy of permanent mandibular premolars and molars in a korean population with cone-beam computed tomography.
        Eur J Dent. 2013; 7: 94-101
        • Ok E.
        • Altunsoy M.
        • Nur B.G.
        • et al.
        A cone-beam computed tomography study of root canal morphology of maxillary and mandibular premolars in a Turkish population.
        Acta Odontol Scand. 2014; 8: 1-6
        • Estrela C.
        • Bueno M.R.
        • Couto G.S.
        • et al.
        Study of root canal anatomy in human permanent teeth in a subpopulation of Brazil's center region using cone-beam computed tomography - part 1.
        Braz Dent J. 2015; 26: 530-536
        • da Silva E.J.
        • de Castro R.W.
        • Nejaim Y.
        • et al.
        Evaluation of root canal configuration of maxillary and mandibular anterior teeth using cone beam computed tomography: an in-vivo study.
        Quintessence Int. 2016; 47: 19-24
        • Yang H.
        • Tian C.
        • Li G.
        • et al.
        A cone-beam computed tomography study of the root canal morphology of mandibular first premolars and the location of root canal orifices and apical foramina in a Chinese subpopulation.
        J Endod. 2013; 39: 435-438
        • Jaju P.P.
        • Jaju S.P.
        Cone-beam computed tomography: time to move from ALARA to ALADA.
        Imaging Sci Dent. 2015; 45: 263-265
        • Spin-Neto R.
        • Gotfredsen E.
        • Wenzel A.
        Impact of voxel size variation on CBCT-based diagnostic outcome in dentistry: a systematic review.
        J Digit Imaging. 2013; 26: 813-820
        • Kamburoğlu K.
        • Murat S.
        • Kolsuz E.
        • et al.
        Comparative assessment of subjective image quality of cross-sectional cone-beam computed tomography scans.
        J Oral Sci. 2011; 53: 501-508
        • Thönissen P.
        • Ermer M.A.
        • Schmelzeisen R.
        • et al.
        Sensitivity and specificity of cone beam computed tomography in thin bony structures in maxillofacial surgery – a clinical trial.
        J Craniomaxillofac Surg. 2015; 43: 1284-1288
        • Bechara B.
        • McMahan C.A.
        • Moore W.S.
        • et al.
        Contrast-to-noise ratio difference in small field of view cone beam computed tomography machines.
        J Oral Sci. 2012; 54: 227-232
        • Celikten B.
        • Uzuntas C.F.
        • Orhan A.I.
        • et al.
        Micro-CT assessment of the sealing ability of three root canal filling techniques.
        J Oral Sci. 2015; 57: 361-366