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

Abstract Petersson A, Axelsson S, Davidson T, Frisk F, HakebergM, Kvist T, Norlund A, Meja`re I, Portenier I, Sandberg H,Tranaeus S, Bergenholtz G. Radiological diagnosis of peri-apical bone tissue lesions in endodontics: a systematic review.International Endodontic Journal, 45, 783–801, 2012. This systematic review evaluates the diagnostic accu-racy of radiographic methods employed to indicatepresence/absence and changes over time of periapicalbone lesions. Also investigated were the leads radio-graphic images may give about the nature of the processand the condition of the pulp in nonendodonticallytreated teeth. Electronic literature search included thedatabases PubMed, Embase and CENTRAL from Janu-ary 1950 to June 2011. All languages were acceptedprovided there was an abstract in English. The MeSHterms were ‘Cone beam computed tomography (CBCT)’,‘Radiography, panoramic’, ‘Periapical diseases’, ‘Dentalpulp diseases’, ‘Sensitivity and specificity’, ‘receiveroperating characteristics (ROC) curve’, ‘Cadaver’,‘Endodontics’ and ‘Radiography dental’. Two reviewersindependently assessed abstracts and full text articles.An article was read in full text if at least one of the tworeviewers considered an abstract to be potentiallyrelevant. Altogether, 181 articles were read in full text.The GRADE approach was used to assess the quality ofevidence of each radiographic method based on studiesof high or moderate quality. Twenty-six studies fulfilledcriteria set for inclusion. None was of high quality; 11were of moderate quality. There is insufficient evidencethat the digital intraoral radiographic technique isdiagnostically as accurate as the conventional filmtechnique. The same applies to CBCT. No conclusionscan be drawn regarding the accuracy of radiologicalexamination in identifying various forms of periapicalbone tissue changes or about the pulpal condition.Keywords: accuracy, diagnosis, periapical diseases,radiography, sensitivity, specificity.