The Diagnostic Yield of Dental Radiography and Cone-Beam Computed Tomography for the Identification of Dentoalveolar Lesions in Cats

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Abstract

The objective of this study was to evaluate the diagnostic yield of dental radiography (DR) and 3 cone-beam computed tomography (CBCT) software modules for the identification of 32 pre-defined dentoalveolar lesions in cats. For 5 feline cadaver heads and 22 client-owned cats admitted for evaluation and treatment of dental disease, 32 predefined dentoalveolar lesions were evaluated separately and scored by use of dental radiography and 3 CBCT software modules [multiplanar reconstructions (MPR), tridimensional (3-D) rendering, and reconstructed panoramic views]. A qualitative scoring system was used. Dentoalveolar lesions were grouped into 14 categories for statistical analysis. Point of reference for presence or absence of a dentoalveolar lesion was determined as the method that could be used to clearly identify the disorder as being present. Accuracy, sensitivity, specificity, and positive and negative predictive values were calculated with the McNemar χ ² test of marginal homogeneity of paired data. When all 3 CBCT software modules were used in combination, the diagnostic yield of CBCT was significantly higher than that of dental radiography for 4 of 14 categories (missing teeth, horizontal bone loss, loss of tooth integrity, feline resorptive lesions), and higher, although not significantly so, for 9 categories (supernumerary teeth, supernumerary roots, abnormally shaped roots, vertical bone loss, buccal bone expansion, periapical disease, inflammatory root resorption, and external replacement root resorption). In conclusion, we found that CBCT provided more clinically relevant detailed information as compared to dental radiography. Therefore, CBCT should be considered better suited for use in diagnosing dentoalveolar lesions in cats.

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Most cited references 45

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Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis.

Carlos Estrela, Liane Azevedo, Mirela Azevedo … (2008)

The aim of this study was to evaluate the accuracy of imaging methods for detection of apical periodontitis (AP). Imaging records from a consecutive sample of 888 imaging exams of patients with endodontic infection (1508 teeth), including cone beam computed tomography (CBCT) and panoramic and periapical radiographs, were selected. Sensitivity, specificity, predictive values, and accuracy of periapical and panoramic radiographs were calculated. Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic accuracy of the panoramic and periapical images. Prevalence of AP was significantly higher with CBCT. Overall sensitivity was 0.55 and 0.28 for periapical and panoramic radiographs, respectively. ROC curves and area under curve (AUC) with periapical radiography showed a high accuracy for the cutoff value of 5 for both periapical (AUC, 0.90) and panoramic (AUC, 0.84) radiographs. AP was correctly identified with conventional methods when showed advanced status. CBCT was proved to be accurate to identify AP.

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Accuracy of periapical radiography and cone-beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard.

Francisco Paula-Silva, Min-Kai Wu, Mário Leonardo … (2009)

The aim of this study was to evaluate the accuracy of two imaging methods in diagnosing apical periodontitis (AP) using histopathological findings as a gold standard. The periapex of 83 treated or untreated roots of dogs' teeth was examined using periapical radiography (PR), cone-beam computed tomography (CBCT) scans, and histology. Sensitivity, specificity, predictive values, and accuracy of PR and CBCT diagnosis were calculated. PR detected AP in 71% of roots, a CBCT scan detected AP in 84%, and AP was histologically diagnosed in 93% (p = 0.001). Overall, sensitivity was 0.77 and 0.91 for PR and CBCT, respectively. Specificity was 1 for both. Negative predictive value was 0.25 and 0.46 for PR and CBCT, respectively. Positive predictive value was 1 for both. Diagnostic accuracy (true positives + true negatives) was 0.78 and 0.92 for PR and CBCT (p = 0.028), respectively. A CBCT scan was more sensitive in detecting AP compared with PR, which was more likely to miss AP when it was still present.

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Cone-beam CT diagnostic applications: caries, periodontal bone assessment, and endodontic applications.

Joel Tyndall, Saurabh Rathore (2008)

Cone-beam CT (CBCT) is useful for many maxillofacial applications, such as implant site imaging and diagnosis and treatment planning for orthodontics and craniofacial surgery. Dentoalveolar applications, such as carious lesion detection and characterization, assessment of the three-dimensional nature of periodontal bone topography, and various endodontic applications are less known and not as thoroughly studied. This article explores and assesses in vivo and in vitro efforts to apply CBCT imaging to these more common dentoalveolar tasks. CBCT imaging, like its medical counterpart, can be seen as a highly useful and, in some instances, indispensable part of the dental imaging armamentarium.

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Author and article information

Contributors

Colleen M. Heney: URI : http://loop.frontiersin.org/people/575370/overview

Boaz Arzi: URI : http://loop.frontiersin.org/people/185285/overview

Philip H. Kass: URI : http://loop.frontiersin.org/people/461891/overview

David C. Hatcher: URI : http://loop.frontiersin.org/people/188409/overview

Frank J. M. Verstraete: URI : http://loop.frontiersin.org/people/142479/overview

Journal

Journal ID (nlm-ta): Front Vet Sci

Journal ID (iso-abbrev): Front Vet Sci

Journal ID (publisher-id): Front. Vet. Sci.

Title: Frontiers in Veterinary Science

Publisher: Frontiers Media S.A.

ISSN (Electronic): 2297-1769

Publication date (Electronic): 21 February 2019

Publication date Collection: 2019

Volume: 6

Electronic Location Identifier: 42

Affiliations

[1] ¹Dentistry and Oral Surgery Service, School of Veterinary Medicine, William Pritchard Veterinary Medical Teaching Hospital, University of California, Davis , Davis, CA, United States

[2] ²Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis , Davis, CA, United States

[3] ³Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis , Davis, CA, United States

[4] ⁴Diagnostic Dental Imaging Center , Sacramento, CA, United States

Author notes

Edited by: Padraic Martin Dixon, University of Edinburgh, United Kingdom

Reviewed by: Norman W. Johnston, DentalVets, United Kingdom; Leen Verhaert, Dierenarts Leen Verhaert, Belgium

*Correspondence: Frank J. M. Verstraete fjverstraete@ 123456ucdavis.edu

This article was submitted to Veterinary Dentistry and Oromaxillofacial Surgery, a section of the journal Frontiers in Veterinary Science

Article

DOI: 10.3389/fvets.2019.00042

PMC ID: 6393352

PubMed ID: 30847347

SO-VID: 44fb05a3-ad9f-4aa8-86d9-c74c59cda51f

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 19 October 2018

Date accepted : 01 February 2019

Page count

Figures: 7, Tables: 12, Equations: 0, References: 56, Pages: 15, Words: 10275

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