Comparison between Radiographic (2-dimensional and 3-dimensional) and Histologic Findings of Periapical Lesions Treated with Apical Surgery.

Bornstein, Michael; Bingisser, Andreas; Reichart, Peter; Sendi, Pedram; Bosshardt, Dieter; von Arx, Thomas (2015). Comparison between Radiographic (2-dimensional and 3-dimensional) and Histologic Findings of Periapical Lesions Treated with Apical Surgery. Journal of endodontics, 41(6), pp. 804-811. Elsevier 10.1016/j.joen.2015.01.015

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INTRODUCTION The aim of this study was to evaluate the concordance of 2- and 3-dimensional radiography and histopathology in the diagnosis of periapical lesions. METHODS Patients were consecutively enrolled in this study provided that preoperative periapical radiography (PR) and cone-beam computed tomographic imaging of the tooth to be treated with apical surgery were performed. The periapical lesional tissue was histologically analyzed by 2 blinded examiners. The final histologic diagnosis was compared with the radiographic assessments of 4 blinded observers. The initial study material included 62 teeth in the same number of patients. RESULTS Four lesions had to be excluded during processing, resulting in a final number of 58 evaluated cases (31 women and 27 men, mean age = 55 years). The final histologic diagnosis of the periapical lesions included 55 granulomas (94.8%) and 3 cysts (5.2%). Histologic analysis of the tissue samples from the apical lesions exhibited an almost perfect agreement between the 2 experienced investigators with an overall agreement of 94.83% (kappa = 0.8011). Radiographic assessment overestimated cysts by 28.4% (cone-beam computed tomographic imaging) and 20.7% (periapical radiography), respectively. Comparing the correlation of the radiographic diagnosis of 4 observers with the final histologic diagnosis, 2-dimensional (kappa = 0.104) and 3-dimensional imaging (kappa = 0.111) provided only minimum agreement. CONCLUSIONS To establish a final diagnosis of an apical radiolucency, the tissue specimen should be evaluated histologically and specified as a granuloma (with/without epithelium) or a cyst. Analysis of 2-dimensional and 3-dimensional radiographic images alike results only in a tentative diagnosis that should be confirmed with biopsy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > School of Dental Medicine > Department of Oral Surgery and Stomatology
04 Faculty of Medicine > School of Dental Medicine > School of Dental Medicine, Oral Surgery Research

UniBE Contributor:

Bornstein, Michael; Bingisser, Andreas; Reichart, Peter; Bosshardt, Dieter and von Arx, Thomas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0099-2399

Publisher:

Elsevier

Language:

English

Submitter:

Eveline Carmen Schuler

Date Deposited:

21 Oct 2015 08:38

Last Modified:

25 Jan 2017 12:15

Publisher DOI:

10.1016/j.joen.2015.01.015

PubMed ID:

25863407

Uncontrolled Keywords:

Apical surgery, cone-beam computed tomographic imaging, cyst, granuloma, periapical lesion, periapical radiography

BORIS DOI:

10.7892/boris.72298

URI:

https://boris.unibe.ch/id/eprint/72298

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