Imaging diagnosis of external root resorption in replanted permanent teeth

Area of Science:

• Dentistry
• Oral and Maxillofacial Radiology
• Endodontics

Background:

• External root resorption (ERR) is a common complication following traumatic dental avulsion and replantation.
• Accurate diagnosis of ERR is crucial for treatment planning and prognosis.
• Cone beam computed tomography (CBCT) and digital periapical radiographs (PR) are common imaging modalities used in endodontics.

Purpose of the Study:

• To compare the diagnostic performance of CBCT and PR in identifying the type and extent of ERR in human permanent teeth after traumatic avulsion and replantation.
• To evaluate the agreement between CBCT and PR in assessing ERR characteristics.

Main Methods:

• 39 human permanent maxillary incisors replanted after traumatic avulsion were included.
• Digital PR and CBCT images were acquired for each tooth.
• Two calibrated examiners independently assessed ERR type and extension on both imaging modalities.

Main Results:

• Significant divergence was observed between CBCT and PR in diagnosing ERR type, with CBCT identifying more inflammatory ERR and PR identifying more replacement ERR.
• Discordance in ERR type diagnosis reached 69.2% (MD surfaces) and 61.5% (MD/BL surfaces) between the methods.
• PR classified most cases as moderate/severe ERR (69.2%), while CBCT indicated mild ERR in 41.4% (MD) and 51.3% (MD/BL) of cases.

Conclusions:

• There is a notable discrepancy in the diagnostic capabilities of CBCT and digital PR for evaluating external root resorption in replanted teeth.
• The choice of imaging modality influences the classification of ERR type and severity.
• Further research is needed to establish standardized protocols for imaging ERR in post-traumatic avulsed and replanted teeth.