Diagnostic Accuracy of CBCT Versus 2D Radiography for Various Dental Pathologies: A Systematic Review and...

Area of Science:

• Dentistry
• Radiology
• Medical Imaging

Background:

• Accurate diagnosis of dental pathologies is crucial for effective treatment planning.
• Cone-beam computed tomography (CBCT) offers 3D imaging, potentially surpassing traditional 2D radiography.
• However, CBCT involves higher radiation exposure and costs compared to 2D methods.

Purpose of the Study:

• To systematically review and compare the diagnostic accuracy of CBCT versus 2D radiography.
• To evaluate their effectiveness in diagnosing specific dental conditions: periapical lesions, root fractures, endodontic complications, root resorption, third molar issues, and root perforations.

Main Methods:

• Systematic review and meta-analysis following PRISMA 2020 guidelines.
• Searched major databases (PubMed, Scopus, Web of Science, Embase, Cochrane, Google Scholar) until September 2025.
• Included studies reporting sensitivity and specificity against histopathology or clinical references; pooled data using R.

Main Results:

• Analyzed 48 studies involving 5604 patients, selected from 3214 records.
• CBCT demonstrated superior diagnostic accuracy compared to 2D radiography (pooled sensitivity risk ratio: 1.53, specificity risk ratio: 1.08).
• CBCT showed particularly high accuracy for diagnosing root fractures (sensitivity risk ratio: 1.89).

Conclusions:

• CBCT significantly enhances diagnostic precision in dentistry.
• Its superior performance, especially for complex cases like root fractures, makes it a valuable tool.
• CBCT is recommended for complex dental diagnoses requiring detailed 3D visualization.