A new periapical index based on cone beam computed tomography.

Area of Science:

• Dentistry
• Oral Radiology
• Endodontics

Background:

• Apical periodontitis (AP) diagnosis relies on radiographic interpretation, which can be limited.
• Cone Beam Computed Tomography (CBCT) offers higher resolution imaging for periapical assessment.
• A standardized index for CBCT-based AP evaluation is needed.

Purpose of the Study:

• To evaluate a novel periapical index utilizing CBCT imaging for diagnosing apical periodontitis.
• To introduce the Cone Beam Computed Tomography Periapical Index (CBCTPAI) for standardized assessment.
• To compare the diagnostic efficacy of CBCTPAI with traditional radiography.

Main Methods:

• Developed the CBCTPAI based on measurements of periapical radiolucency on CBCT scans.
• Measured lesion extension in three dimensions (buccopalatal, mesiodistal, diagonal) using Planimp software.
• Evaluated 1014 images from 596 patients using the CBCTPAI criteria by three observers.

Main Results:

• CBCT identified AP in 60.9% of cases, compared to 39.5% with radiography (P < .01).
• The CBCTPAI incorporates lesion size, cortical bone expansion, and destruction.
• The index demonstrated accuracy with high-resolution CBCT images.

Conclusions:

• The CBCTPAI is an accurate diagnostic tool for apical periodontitis.
• This index can reduce false-negative diagnoses and observer interference.
• CBCTPAI enhances the reliability of epidemiological studies on AP prevalence and severity.