Root Resorption Detection by Multiple Radiographs versus Cone-Beam Computed Tomography

Abstract

Purpose: To determine sensitivity and specificity of root resorption detection caused by impacted teeth using multiple traditional two-dimensional radiographs and cone-beam computed tomography (CBCT). Methods: A convenience sample was utilized to identify pediatric patients with impacted teeth who have both CBCT imaging and multiple traditional radiographs (N = 34). Graduate dental residents specializing in pediatric dentistry or radiology reviewed the traditional radiographs and CBCT images and were asked if root resorption was present. Identification of resorption was compared to a benchmark (CBCT images reviewed by an experienced oral and maxillofacial radiologist –JA-). Results: Five (15%) cases presented with root resorption (benchmark). When comparing 2D to 3D images, the expert reviewer had a sensitivity of 40% and a specificity of 100%. Compared to the benchmark, traditional radiographs had mean sensitivity and specificity of 47% and 85%, respectively, whereas CBCT images had mean of sensitivity and specificity 73% and 87%, respectively. Conclusion: Root resorption with tooth impaction is not common. Multiple traditional radiographs have similar specificity as CBCT and should still initially be utilized for root resorption detection. CBCT should only be obtained if additional information, such as clarifying detailed location, is needed. This approach fits the Image Gently Campaign spirit.