Diagnostic accuracy of cone-beam computed tomography scans with high- and low-resolution modes for the detection of root perforations
Purpose This study compared the diagnostic accuracy of cone-beam computed tomography (CBCT) scans obtained with 2 CBCT systems with high- and low-resolution modes for the detection of root perforations in endodontically treated mandibular molars. Materials and Methods The root canals of 72 mandibular molars were cleaned and shaped. Perforations measuring 0.2, 0.3, and 0.4 mm in diameter were created at the furcation area of 48 roots, simulating strip perforations, or on the external surfaces of 48 roots, simulating root perforations. Forty-eight roots remained intact (control group). The roots were filled using gutta-percha (Gapadent, Tianjin, China) and AH26 sealer (Dentsply Maillefer, Ballaigues, Switzerland). The CBCT scans were obtained using the NewTom 3G (QR srl, Verona, Italy) and Cranex 3D (Soredex, Helsinki, Finland) CBCT systems in high- and low-resolution modes, and were evaluated by 2 observers. The chi-square test was used to assess the nominal variables. Results In strip perforations, the accuracies of low- and high-resolution modes were 75% and 83% for NewTom 3G and 67% and 69% for Cranex 3D. In root perforations, the accuracies of low- and high-resolution modes were 79% and 83% for NewTom 3G and was 56% and 73% for Cranex 3D. Conclusion The accuracy of the 2 CBCT systems was different for the detection of strip and root perforations. The Cranex 3D had non-significantly higher accuracy than the NewTom 3G. In both scanners, the high-resolution mode yielded significantly higher accuracy than the low-resolution mode. The diagnostic accuracy of CBCT scans was not affected by the perforation diameter.
Efficacy of Periapical Radiography and Three Cone-Beam Computed Tomography Systems for Detection of Peri-Implant Dehiscence Defects: An in- Vitro Study
Background: Early detection of peri-implant bone defects is highly important because these defects eventually lead to gingival recession, bone loss and implant failure. Objective: This study aimed to assess and compare the efficacy of periapical radiography and three CBCT systems for the detection of peri-implant dehiscence defects. Material and Methods: In this vitro study, 124 titanium implants were placed in bovine ribs. The bone pieces were then mounted in boxes in the form of mandible and red dental wax was used to simulate the soft tissue. Crestal bone defects with 2, 3, and 4 mm depth were created in the ribs using a round bur. Periapical and CBCT images were then obtained. Images were investigated by two oral and maxillofacial radiologists twice with a two-week interval. The results were analyzed using chi-square, Kappa coefficient, Cochrane’s Q and McNemar tests as well as the receiver operating characteristic (ROC) curve. Results: The two observers showed good agreement in detection of sound and defective samples on periapical radiographs and CBCT scans. The level of agreement was low in detection of two samples with 2 mm defects on CBCT scans taken with Planmeca and NewTom 3G systems at the time of second assessment. NewTom 3G had the highest sensitivity (68.9%, 74.2% and 86.3%, respectively) and specificity (100% for all three) compared to other systems for detection of 2, 3 and 4 mm crestal bone defects. Conclusion: The inter-observer agreement increased with increase in depth of defects. NewTom 3G had the highest accuracy for detection of crestal bone defects.
Solitary Orbital Paget Disease: A Case Report
Purpose: To describe the clinical findings in a patient who had developed painless supraorbital prominence. Methods: Clinical and histopathological findings of the case are reviewed and presented. Results: The patient had an isolated histologically confirmed Paget disease of the orbit. Local excision of the lesion was performed. Conclusion: Paget disease can present not only as a diffuse process but also as a painless, solitary lesion of the orbit.