DOI QR코드

DOI QR Code

Detection of furcation involvement using periapical radiography and 2 cone-beam computed tomography imaging protocols with and without a metallic post: An animal study

  • Received : 2016.06.15
  • Accepted : 2016.10.31
  • Published : 2017.03.31

Abstract

Purpose: The purpose of this study was to assess the accuracy, sensitivity, and specificity of the diagnosis of incipient furcation involvement with periapical radiography (PR) and 2 cone-beam computed tomography (CBCT) imaging protocols, and to test metal artifact interference. Materials and Methods: Mandibular second molars in 10 macerated pig mandibles were divided into those that showed no furcation involvement and those with lesions in the furcation area. Exams using PR and 2 different CBCT imaging protocols were performed with and without a metallic post. Each image was analyzed twice by 2 observers who rated the absence or presence of furcation involvement according to a 5-point scale. Receiver operating characteristic (ROC) curves were used to evaluate the accuracy, sensitivity, and specificity of the observations. Results: The accuracy of the CBCT imaging protocols ranged from 67.5% to 82.5% in the images obtained with a metallic post and from 72.5% to 80% in those without a metallic post. The accuracy of PR ranged from 37.5% to 55% in the images with a metallic post and from 42.5% to 62.5% in those without a metallic post. The area under the ROC curve values for the CBCT imaging protocols ranged from 0.813 to 0.802, and for PR ranged from 0.503 to 0.448. Conclusion: Both CBCT imaging protocols showed higher accuracy, sensitivity, and specificity than PR in the detection of incipient furcation involvement. Based on these results, CBCT may be considered a reliable tool for detecting incipient furcation involvement following a clinical periodontal exam, even in the presence of a metallic post.

Keywords

References

  1. American Academy of Periodontology. Glossary of periodontal terms. 4th ed. Chicago: American Academy of Periodontology; 2001.
  2. Hamp SE, Nyman S, Lindhe J. Periodontal treatment of multirooted teeth. Results after 5 years. J Clin Periodontol 1975; 2: 126-35. https://doi.org/10.1111/j.1600-051X.1975.tb01734.x
  3. Dannewitz B, Zeidler A, Husing J, Saure D, Pfefferle T, Eickholz P, et al. Loss of molars in periodontally treated patients: results 10 years and more after active periodontal therapy. J Clin Periodontol 2016; 43: 53-62. https://doi.org/10.1111/jcpe.12488
  4. Graetz C, Schutzhold S, Plaumann A, Kahl M, Springer C, Salzer S, et al. Prognostic factors for the loss of molars - an 18-years retrospective cohort study. J Clin Periodontol 2015; 42: 943-50. https://doi.org/10.1111/jcpe.12460
  5. Bower RC. Furcation morphology relative to periodontal treatment. Furcation entrance architecture. J Periodontol 1979; 50: 23-7. https://doi.org/10.1902/jop.1979.50.1.23
  6. Svardstrom G, Wennstrom JL. Furcation topography of the maxillary and mandibular first molars. J Clin Periodontol 1988; 15: 271-5. https://doi.org/10.1111/j.1600-051X.1988.tb01583.x
  7. Mol A. Imaging methods in periodontology. Periodontol 2000 2004; 34: 34-48. https://doi.org/10.1046/j.0906-6713.2003.003423.x
  8. Cimbaljevic MM, Spin-Neto RR, Miletic VJ, Jankovic SM, Aleksic ZM, Nikolic-Jakoba NS. Clinical and CBCT-based diagnosis of furcation involvement in patients with severe periodontitis. Quintessence Int 2015; 46: 863-70.
  9. Cavalcanti MG. Cone beam computed tomographic imaging: perspective, challenges, and the impact of near-trend future applications. J Craniofac Surg 2012; 23: 279-82. https://doi.org/10.1097/SCS.0b013e318241ba64
  10. 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: 609-25. https://doi.org/10.1016/j.ijom.2009.02.028
  11. Salineiro FC, Pinheiro LR, dos Santos Junior O, Cavalcanti MG. Detection of horizontal root fracture using four different protocols of cone-beam computed tomography. Braz Oral Res 2015; 29. pii: S1806-83242015000100264.
  12. Costa FF, Gaia BF, Umetsubo OS, Cavalcanti MG. Detection of horizontal root fracture with small-volume cone-beam computed tomography in the presence and absence of intracanal metallic post. J Endod 2011; 37: 1456-9. https://doi.org/10.1016/j.joen.2011.05.040
  13. Pinheiro LR, Scarfe WC, Augusto de Oliveira Sales M, Gaia BF, Cortes AR, Cavalcanti MG. Effect of cone-beam computed tomography field of view and acquisition frame on the detection of chemically simulated peri-implant bone loss in vitro. J Periodontol 2015; 86: 1159-65. https://doi.org/10.1902/jop.2015.150223
  14. Mohammadpour M, Bakhshalian N, Shahab S, Sadeghi S, Ataee M, Sarikhani S. Effect of titanium and stainless steel posts in detection of vertical root fractures using NewTom VG cone beam computed tomography system. Imaging Sci Dent 2014; 44: 89-94. https://doi.org/10.5624/isd.2014.44.2.89
  15. Ferreira RI, Bahrami G, Isidor F, Wenzel A, Haiter-Neto F, Groppo FC. Detection of vertical root fractures by cone-beam computerized tomography in endodontically treated teeth with fiber-resin and titanium posts: an in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115: e49-57.
  16. Takeshita WM, Iwaki LC, da Silva MC, Sabio S, Albino PR. Comparison of periapical radiography with cone beam computed tomography in the diagnosis of vertical root fractures in teeth with a metallic post. J Conserv Dent 2014; 17: 225-9. https://doi.org/10.4103/0972-0707.131781
  17. Santos Junior O, Pinheiro LR, Umetsubo OS, Cavalcanti MG. CBCT-based evaluation of integrity of cortical sinus close to periapical lesions. Braz Oral Res 2015; 29. pii: S1806-83242015000100216.
  18. Umetsubo OS, Gaia BF, Costa FF, Cavalcanti MG. Detection of simulated incipient furcation involvement by CBCT: an in vitro study using pig mandibles. Braz Oral Res 2012; 26: 341-7. https://doi.org/10.1590/S1806-83242012000400010
  19. Glickman I. Clinical periodontology: the periodontium in health and disease. 2nd ed. Philadelphia, PA: W.B. Saunders; 1958. p. 694-6.
  20. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-74. https://doi.org/10.2307/2529310
  21. Laky M, Majdalani S, Kapferer I, Frantal S, Gahleitner A, Moritz A, et al. Periodontal probing of dental furcations compared with diagnosis by low-dose computed tomography: a case series. J Periodontol 2013; 84: 1740-6. https://doi.org/10.1902/jop.2013.120698
  22. Walter C, Weiger R, Zitzmann NU. Periodontal surgery in furcation-involved maxillary molars revisited - an introduction of guidelines for comprehensive treatment. Clin Oral Investig 2011; 15: 9-20. https://doi.org/10.1007/s00784-010-0431-9
  23. Bowers GM, Schallhorn RG, McClain PK, Morrison GM, Morgan R, Reynolds MA. Factors influencing the outcome of regenerative therapy in mandibular Class II furcations: Part I. J Periodontol 2003; 74: 1255-68. https://doi.org/10.1902/jop.2003.74.9.1255
  24. Stembirek J, Kyllar M, Putnova I, Stehlik L, Buchtova M. The pig as an experimental model for clinical craniofacial research. Lab Anim 2012; 46: 269-79. https://doi.org/10.1258/la.2012.012062
  25. Wang S, Liu Y, Fang D, Shi S. The miniature pig: a useful large animal model for dental and orofacial research. Oral Dis 2007; 13: 530-7. https://doi.org/10.1111/j.1601-0825.2006.01337.x
  26. Aljehani YA. Diagnostic applications of cone-beam CT for periodontal diseases. Int J Dent 2014; 2014: 865079.
  27. Costa FF, Gaia BF, Umetsubo OS, Pinheiro LR, Tortamano IP, Cavalcanti MG. Use of large-volume cone-beam computed tomography in identification and localization of horizontal root fracture in the presence and absence of intracanal metallic post. J Endod 2012; 38: 856-9. https://doi.org/10.1016/j.joen.2012.03.011
  28. Barbat J, Messer HH. Detectability of artificial periapical lesions using direct digital and conventional radiography. J Endod 1998; 24: 837-42. https://doi.org/10.1016/S0099-2399(98)80014-9
  29. Qiao J, Wang S, Duan J, Zhang Y, Qiu Y, Sun C, et al. The accuracy of cone-beam computed tomography in assessing maxillary molar furcation involvement. J Clin Periodontol 2014; 41: 269-74. https://doi.org/10.1111/jcpe.12150
  30. Costa FF, Pinheiro LR, Umetsubo OS, dos Santos O Jr, Gaia BF, Cavalcanti MG. Influence of cone-beam computed tomographic scan mode for detection of horizontal root fracture. J Endod 2014; 40: 1472-6. https://doi.org/10.1016/j.joen.2014.03.001
  31. Benic GI, Sancho-Puchades M, Jung RE, Deyhle H, Hammerle CH. In vitro assessment of artifacts induced by titanium dental implants in cone beam computed tomography. Clin Oral Implants Res 2013; 24: 378-83. https://doi.org/10.1111/clr.12048

Cited by

  1. Accuracy of Cone Beam Computed Tomography in the Assessment of Mandibular Molar Furcation Defects vol.20, pp.None, 2017, https://doi.org/10.1590/pboci.2020.022
  2. Reliability Assessment of the Clinical and Radiographic Diagnosis of Furcation Involvement vol.14, pp.1, 2017, https://doi.org/10.2174/1874210602014010403
  3. The effects of orthodontic materials on the accuracy of periapical radiography-based caries detection vol.36, pp.4, 2020, https://doi.org/10.1007/s11282-019-00412-2
  4. Diagnostic accuracy of periapical radiograph, cone beam computed tomography, and intrasurgical linear measurement techniques for assessing furcation defects: a longitudinal randomised controlled trial vol.25, pp.3, 2017, https://doi.org/10.1007/s00784-020-03380-8