Comparative Detection and Inter-Modality Agreement of Pulp Stones Using Digital Periapical Radiography and CBCT at...

Area of Science:

• Endodontics
• Dental Radiology
• Oral Pathology

Background:

• Pulp stones are calcifications in dental pulp, potentially complicating endodontic treatment.
• Cone beam computed tomography (CBCT) shows promise for detecting pulp stones, but direct comparisons with digital periapical radiography (DPR) are limited.
• Understanding detection differences across imaging modalities and resolutions is crucial for clinical application.

Purpose of the Study:

• To compare pulp stone detection rates between DPR and CBCT at different voxel sizes (0.1 mm and 0.2 mm).
• To evaluate inter-modality agreement for pulp stone identification using location-based analysis in extracted teeth.

Main Methods:

• Fifty-two extracted human teeth were imaged using DPR and CBCT (0.1 mm and 0.2 mm voxel sizes).
• Pulp stones were assessed in coronal and radicular regions using a binary scoring system.
• Detection rates and inter-modality agreement were statistically analyzed, stratified by location.

Main Results:

• CBCT at 0.1 mm yielded the highest detection rate (63.5%), followed by CBCT at 0.2 mm (57.7%) and DPR (50%).
• No statistically significant differences in detection rates were found among the modalities (p > 0.05).
• CBCT at 0.2 mm showed higher agreement with CBCT at 0.1 mm than DPR, particularly in the coronal region.

Conclusions:

• CBCT demonstrated numerically higher pulp stone detection rates than DPR under standardized ex vivo conditions.
• Location-based agreement analysis revealed greater consistency between CBCT voxel sizes than between CBCT and DPR, especially in the radicular region.
• Findings highlight modality and resolution differences in pulp stone detectability, aiding understanding of radiographic variability.