Abstract
Introduction
Cone-beam computed tomographic (CBCT) imaging is a valuable diagnostic tool for endodontics.
Some studies report that CBCT images have limitations in representing the true clinical
presentation. This prospective, in vivo study compared limited field of view (LFOV) CBCT measurements with clinical measurements
made during endodontic surgery.
Methods
Eighty-seven subjects requiring endodontic surgery and LFOV CBCT acquisition of the
surgical site were enrolled. Data collection involved clinicians answering standardized
questions during the radiographic and surgical assessment. Intraoperatively, data
were collected and photographically documented. Postoperatively, CBCT scans were evaluated
by 3 calibrated, board-certified specialists: 2 endodontists and 1 oral and maxillofacial
radiologist. The 2 subsets of data were compared through statistical analysis to quantify
their relationship.
Results
The subjects included 65 maxillary and 29 mandibular teeth from 87 subjects: 25 women
and 62 men with an average age of 42 years old. The CBCT evaluators correctly identified
the presence or absence of buccal plate fenestrations with 91.0% accuracy (95% confidence
interval, 83.1–96.0) with 89.4% sensitivity and 92.9% specificity. The area of fenestrations
measured clinically (mean = 19.6 ± 33.4 mm2) was generally larger than the area measured by CBCT imaging (mean across CBCT evaluators
= 12.2 ± 19.1 mm2). Fenestration size in the maxillary arch was more likely to be underestimated than
in the mandibular arch (P < .0001). Vertical bone height was also underestimated when measured on CBCT imaging.
Conclusions
Based on the findings of this study, LFOV CBCT imaging accurately identifies the presence
or absence of buccal plate fenestrations, yet, when a fenestration is present, underestimates
its area.
Key Words
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Article info
Publication history
Published online: March 30, 2021
Identification
Copyright
Published by Elsevier Inc. on behalf of American Association of Endodontists.
