Comparison of CBCT and Digital Periapical Radiography in Detection of Pulpal Exposure in External Cervical Root Resorption: an in-vitro study

pulpal exposures originated from the external cervical root resorptions have major effects, on the treatment and prognosis, that could result in tooth loss. This study was performed to compare two different imaging systems-digital periapical radiography with PSP Sensor in three horizontal different views and CBCT images- to assess pulpal exposure in simulated cavity of external cervical root resorptions.

Method and material:

Eighty maxilla central incisor teeth  with straight roots were included. Teeth were randomly divided to two groups (40 teeth with and 40 without pulpal exposures). Each sample was assessed digital radiography with PSP Sensor (in 3 horizontal angles) and CBCT image system, to detect the presence of pulpal exposures. False Negative and False Positive results in 2 imaging procedures were judged with ratio test.

The results showed in CBCT (P.P.V = 85/7) and (N.P.V = 89/5) and in digital intraoral radiography (P.P.V = 80) and (N.P.V = 80) in proximal defects and in CBCT (P.P.V = 93 / 3) and (N.P.V = 100) and intraoral digital radiography (P.P.V = 77/8) and (N.P.V = 75) in buccal defects. In buccal defects, ratio test showed that there is a significant difference between CBCT and intraoral digital radiography technique (0/03>P) but is not significant in proximal defects (0/4>P), (Significance level was 0/05).

The results showed that despite the higher resolution CBCT images than digital intraoral radiography, there were no significant differences in detection of exposure in proximal surfaces between two imaging systems. The differences in detection of buccal defects was significant, the accuracy of CBCT images in detection of buccal defects was significantly higher than PSP digital radiographies.