The aim of this study was to compare treatment plans for external cervical resorption (ECR) developed from periapical (PA) radiographs and cone-beam computed tomographic (CBCT) imaging. The secondary aim of this study was to test a new classification system for ECR based on CBCT axial slice analysis.
ECR was identified in 56 teeth (47 patients) from a database of 928 CBCT images. Strict exclusion criteria resulted in a sample of 30 ECR teeth (25 patients) and 10 ECR-free control teeth. Six examiners evaluated CBCT and matched PA images in separate sessions. Examiners classified ECR according to the Heithersay classification system and the novel Rohde classification system and provided a treatment plan.
All 30 ECR cases were identified by CBCT imaging and 29 by PA radiography. Interrater agreement was uniformly higher with CBCT imaging, and treatment plans developed from CBCT scans differed from those developed with PA radiographs in 56.7% of the cases. Examiners recommended ECR repair in the majority of cases (59.8% of CBCT images and 56.7% of PA radiographs). The Heithersay classification was dependent on the method of imaging with a greater prevalence of class 4 reported with CBCT imaging (P = .0016). The Rohde classification system significantly predicted the recommended treatment plan (P = .002 for Rohde class 2 and P = .043 for Rohde class 3). All Heithersay classifications failed to statistically predict treatment plans.
Treatment plans changed between PA and CBCT imaging in the majority of cases evaluated. If CBCT imaging is available, the Rohde classification system may help guide treatment planning for cases of ECR.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Endodontics
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- External cervical resorption: a review.J Endod. 2009; 35: 616-624
- External resorption associated with bleaching of pulpless teeth.J Endod. 1979; 5: 344-348
- Invasive cervical resorption: an analysis of potential predisposing factors.Quintessence Int. 1999; 30: 83-95
- Understanding external cervical resorption in vital teeth.J Endod. 2016; 42: 1737-1751
- Differential diagnosis of internal and external root resorption.J Endod. 1976; 11: 329-334
- Use of cone beam computed tomography in endodontics 2015 update.J Endod. 2015; 41: 1393-1396
- Diagnostic accuracy of small volume cone beam computed tomography and intraoral periapical radiography for the detection of simulated external inflammatory root resorption.Int Endod J. 2011; 44: 136-147
- Observer ability to detect ex vivo simulated internal or external cervical root resorption.J Endod. 2011; 37: 168-175
- The diagnostic efficacy of cone-beam computed tomography in endodontics: a systematic review and analysis by a hierarchical model of efficacy.J Endod. 2015; 41: 1008-1014
- Comparison of endodontic diagnosis and treatment planning decisions using cone-beam volumetric tomography versus periapical radiography.J Endod. 2014; 40: 910-916
- The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics.Dentomaxillofac Radiol. 2014; 43: 20130137
- The assessment and management of external cervical resorption with periapical radiographs and cone-beam computed tomography.J Endod. 2016; 42: 1435-1440
- Clinical, radiologic and histopathologic features of invasive cervical resorption.Quintessence Int. 1999; 30: 27-37
- Treatment of invasive cervical resorption: an analysis of results using topical application of trichloracetic acid, curettage, and restoration.Quintessence Int. 1999; 30: 96-110
- Invasive cervical resorption.Endod Topics. 2004; 7: 73-92
- Conservative management of class 4 invasive cervical root resorption using calcium-enriched mixture cement.J Endod. 2016; 42: 1291-1294
- Conservative nonsurgical treatment of class 4 invasive cervical resorption:a case series.J Endod. 2015; 41: 1907-1912
- Use of the microscope in endodontics: results of a questionnaire.J Endod. 2008; 34: 804-807
- Resistance to vertical fracture of MTA-filled roots.Dent Traumatol. 2014; 30: 36-42
- Root perforations: classification and treatment choices based on prognostic factors.Dent Traumatol. 1996; 12: 255-264
- OsiriX: an open-source software for navigating in multidimensional DICOM images.J Digit Imaging. 2004; 17: 205-216
- Accuracy of periapical radiography and cone beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard.J Endod. 2009; 35: 1009-1012
- Detection of the apical lesion and the mandibular canal in conventional radiography and computed tomography.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 92: 682-688
Published online: December 08, 2017
Published by Elsevier Inc. on behalf of American Association of Endodontists.