Comparison of Ultrasonography and Cone Beam Computed Tomography in the Differential Diagnosis of Periapical Lesions: A Prospective Radiopathological Study
Objective: The aim of this study is to evaluate the correlation between ultrasonography (USG) and cone beam computed tomography (CBCT) and the accuracy between histopathological diagnosis and preliminary diagnosis in the diagnosis of periapical lesion. Methods: 20 patients with periapical lesion in the jaw, were included in the study. The presence of expansion or perforation and dimensions of the lesion were performed with CBCT. In the examination of the lesion with USG, shape, echogenicity, vascularization of the lesion and the presence of buccal expansion and perforation, were determined. Subsequently, a biopsy was taken from the lesion for histopathological examination and the final result was compared with the accuracy of the preliminary diagnoses. Results: Kolmogorov-Smirnov test, Wilcoxon test (w) and Cohen’s kappa coefficient (κ) was used to analyze the data. Three of the 4 lesions diagnosed as periapical granuloma as a preliminary diagnosis were confirmed as periapical granuloma in histopathological examination. Periapical cyst was confirmed in histopathological examination of 14 of 16 lesions diagnosed as periapical cyst as a preliminary diagnosis. Mesiodistal (MD) measurements in CBCT measurements were significantly higher than the USG group (p <0.05). There was 100% agreement (p = 0.000) between the evaluation of buccal expansion, buccal perforation, and palatal-lingual perforation between CBCT and USG. Conclusion: It was concluded that the combined use of USG and CBCT can provide the clinician with important information in the diagnosis of periapical lesion.
1. Chuenchompoonut V, Ida M, Honda E, Kurabayashi T, Sasaki T. Accuracy of panoramic radiography in assessing the dimensions of radiolucent jaw lesions with distinct or indistinct borders. Dentomaxillofac Radiol. 2003; 32(2):80-6.
2. Nair PN. New perspectives on radicular cysts: Do they heal? Int Endod J. 1998; 31(3):155-60.
3. Boeddinghaus R, Whyte A. Current concepts in maxillofacial imaging. Eur J Radiol. 2008; 66(3):396-418.
4. Shumway BS, Foster TS. Pathology of the jaw: The importance of radiographs. J Can Dent Assoc. 2011; 77:b132.
5. De Vos W, Casselman J, Swennen GR. Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: A systematic review of the literature. Int J Oral Maxillofac Surg. 2009; 38(6):609-25.
6. Ahmad M, Freymiller E. Cone beam computed tomography: Evaluation of maxillofacial pathology. J Calif Dent Assoc. 2010; 38(1):41-7.
7. Scarfe WC, Farman AG. What is cone-beam CT and how does it work? Dent Clin North Am. 2008; 52(4):707-30.
8. Gumussoy I, Miloglu O, Bayrakdar IS, Dagistan S, Caglayan F. Ultrasonography in the evaluation of the mid-palatal suture in rapid palatal expansion. Dentomaxillofac Radiol. 2014; 43(8):20140167.
9. Wakasugi-Sato N, Kodama M, Matsuo K, Yamamoto N, Oda M, Ishikawa A, Tanaka T, Seta Y, Habu M, Kokuryo S, Ichimiya H, Miyamoto I, Kito S, Matsumoto-Takeda S, Wakasugi T, Yamashita Y, Yoshioka I, Takahashi T, Tominaga K, Morimoto Y. Advanced clinical usefulness of ultrasonography for diseases in oral and maxillofacial regions. Int J Dent. 2010; 2010:639382.
10. Bayrakdar IS, Yilmaz AB, Caglayan F, Ertas U, Gundogdu C, Gumussoy I. Cone beam computed tomography and ultrasonography imaging of benign intraosseous jaw lesion: A prospective radiopathological study. Clin Oral Investig. 2018; 22(3):1531-9.
11. Shahidi S, Shakibafard A, Zamiri B, Mokhtare MR, Houshyar M, Mahdian S. The feasibility of ultrasonography in defining the size of jaw osseous lesions. J Dent (Shiraz). 2015; 16(4):335-40.
12. Cotti E, Campisi G, Garau V, Puddu G. A new technique for the study of periapical bone lesions: Ultrasound real time imaging. Int Endod J. 2002; 35(2):148-52.
13. Cotti E, Campisi G, Ambu R, Dettori C. Ultrasound real-time imaging in the differential diagnosis of periapical lesions. Int Endod J. 2003; 36(8):556-63.
14. Gundappa M, Ng SY, Whaites EJ. Comparison of ultrasound, digital and conventional radiography in differentiating periapical lesions. Dentomaxillofac Radiol. 2006; 35(5):326-33.
15. Lauria L, Curi MM, Chammas MC, Pinto DS, Torloni H. Ultrasonography evaluation of bone lesions of the jaw. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996; 82(3):351-7.
16. Sumer AP, Danaci M, Ozen Sandikçi E, Sumer M, Celenk P. Ultrasonography and Doppler ultrasonography in the evaluation of intraosseous lesions of the jaws. Dentomaxillofac Radiol. 2009; 38(1):23-7.
17. Çelik K, Belli S. Periapikal kistler ve kök kanal tedavisi ile ilişkileri (Periapical Cysts and Relationships with Root Canal Therapy: Review). Turkiye Klinikleri J Dental Sci. 2012; 18(1):64-9.
18. Barbakow FH, Cleaton-Jones PE, Friedman D. Endodontic treatment of teeth with periapical radiolucent areas in a general dental practice. Oral Surg Oral Med Oral Pathol. 1981; 51(5):552-9.
19. Bhaskar SN. Oral surgery--oral pathology conference No. 17, Walter Reed Army Medical Center. Periapical lesions--types, incidence, and clinical features. Oral Surg Oral Med Oral Pathol. 1966; 21(5):657-71.
20. Eversole LR. Clinical outline of oral pathology: Diagnosis and treatment. 2nd ed. Philadelphia: Lea & Febiger; 1984.
21. Etöz M, Avcı F, Canger EM, Taşdemir Z. Periapikal Lezyonların Yüksek Çözünürlüklü Ultrasonografi ile Görüntülenmesinde Etkili Faktörlerin Belirlenmesi (Determination of effective factors in imaging of periapical lesions with high resolution ultrasonography). Selcuk Dent J. 2020; 7(2):213-9.
22. Arslan ZB, Demir H, Berker Yıldız D, Yaşar F. Diagnostic accuracy of panoramic radiography and ultrasonography in detecting periapical lesions using periapical radiography as a gold standard. Dentomaxillofac Radiol. 2020; 49(6):20190290.
23. Bansal TK, Konidena A, Bansal R, Khursheed I, Reddy J, Khursheed O. Comparison of diagnostic accuracy of conventional radiography, digital radiography, and ultrasound imaging in the detection of periapical lesions. J Indian Acad Oral Med Radiol. 2015; 27(4):520-6.
24. Goel S, Nagendrareddy SG, Raju MS, Krishnojirao DR, Rastogi R, Mohan RP, Gupta S. Ultrasonography with color Doppler and power Doppler in the diagnosis of periapical lesions. Indian J Radiol Imaging. 2011; 21(4):279-83.
25. Raghav N, Reddy SS, Giridhar AG, Murthy S, Yashodha Devi BK, Santana N, Rakesh N, Kaushik A. Comparison of the efficacy of conventional radiography, digital radiography, and ultrasound in diagnosing periapical lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 110(3):379-85.
Serindere, G., Aktuna Belgin, C., Bulte, M., Gursoy, D., & Salimov, F. Comparison of Ultrasonography and Cone Beam Computed Tomography in the Differential Diagnosis of Periapical Lesions: A Prospective Radiopathological Study. J Dent Indones. 2022;29(3): 194-201
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