The detection and management of root resorption lesions using intraoral radiography and cone beam computed tomography - an in vivo investigation

Aim To compare the accuracy of intraoral periapical radiography with cone beam computed tomography (CBCT) for the detection and management of resorption lesions. Methodology Digital intraoral radiographs and CBCT scans were taken of patients with internal resorption (n = 5), external cervical resorption (n = 5) and no resorption (controls) (n = 5). A 'reference standard' diagnosis and treatment plan was devised for each tooth. Sensitivity, specificity, positive predictive values, negative predictive values and receiver operator characteristic (ROC) curves, as well as the reproducibility of each technique were determined for diagnostic accuracy and treatment option chosen. Results The intraoral radiography ROC Az values were 0.780 and 0.830 for diagnostic accuracy of internal and external cervical resorption respectively. The CBCT ROC Az values were 1.000 for both internal and external cervical resorption. There was a significantly higher prevalence (P = 0.028) for the correct treatment option being chosen with CBCT (%) compared with intraoral radiographs (%). Conclusion CBCT was effective and reliable in detecting the presence of resorption lesions. Although digital intraoral radiography resulted in an acceptable level of accuracy, the superior accuracy of CBCT may result in a review of the radiographic techniques used for assessing the type of resorption lesion present. CBCT's superior diagnostic accuracy also resulted in an increased likelihood of correct management of resorption lesions. © 2009 International Endodontic Journal.