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Radiological diagnosis of periapical bone tissue lesions in endodontics: a systematic review

Journal article
Authors A. Petersson
S. Axelsson
T. Davidson
Fredrik Frisk
Magnus Hakeberg
Thomas Kvist
A. Norlund
I. Mejare
I. Portenier
H. Sandberg
S. Tranaeus
Gunnar Bergenholtz
Published in International Endodontic Journal
Volume 45
Issue 9
Pages 783-801
ISSN 0143-2885
Publication year 2012
Published at Institute of Odontology
Pages 783-801
Language en
Keywords accuracy, diagnosis, periapical diseases, radiography, sensitivity, specificity, beam computed-tomography, digital dental radiography, conventional, radiography, subtraction radiography, differential-diagnosis, intraoral, radiography, apical periodontitis, film radiography, ultrasound, accuracy, mmisalo t, 1995, dentomaxillofacial radiology, v24, p114, mmisalo t, 1993, dentomaxillofacial radiology, v22, p183
Subject categories Dentistry


Petersson A, Axelsson S, Davidson T, Frisk F, Hakeberg M, Kvist T, Norlund A, Mejare I, Portenier I, Sandberg H, Tranaeus S, Bergenholtz G. Radiological diagnosis of periapical bone tissue lesions in endodontics: a systematic review. International Endodontic Journal, 45, 783801, 2012. Abstract This systematic review evaluates the diagnostic accuracy of radiographic methods employed to indicate presence/absence and changes over time of periapical bone lesions. Also investigated were the leads radiographic images may give about the nature of the process and the condition of the pulp in nonendodontically treated teeth. Electronic literature search included the databases PubMed, Embase and CENTRAL from January 1950 to June 2011. All languages were accepted provided there was an abstract in English. The MeSH terms were Cone beam computed tomography (CBCT), Radiography, panoramic, Periapical diseases, Dental pulp diseases, Sensitivity and specificity, receiver operating characteristics (ROC) curve, Cadaver, Endodontics and Radiography dental. Two reviewers independently assessed abstracts and full text articles. An article was read in full text if at least one of the two reviewers considered an abstract to be potentially relevant. Altogether, 181 articles were read in full text. The GRADE approach was used to assess the quality of evidence of each radiographic method based on studies of high or moderate quality. Twenty-six studies fulfilled criteria set for inclusion. None was of high quality; 11 were of moderate quality. There is insufficient evidence that the digital intraoral radiographic technique is diagnostically as accurate as the conventional film technique. The same applies to CBCT. No conclusions can be drawn regarding the accuracy of radiological examination in identifying various forms of periapical bone tissue changes or about the pulpal condition.

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