DETAILED TOMOGRAPHY OF PERIAPICAL AND PERIODONTAL LESIONS - DIAGNOSTIC-ACCURACY COMPARED WITH PERIAPICAL RADIOGRAPHY

Objective. To compare the diagnostic accuracy of detailed tomography u sing the Scanora(R) system with that of conventional periapical radiog raphy for detecting periapical and periodontal lesions. Methods. We se lected for comparison 243 periapical and 322 periodontal sites in 177 patients. Five observers independently assessed radiographs for the pr esence or absence of the following lesions: periapical bone changes, w idening of apical and marginal ligament space, crestal erosion, vertic al bone loss, furcation involvement and calculus. Results. ROC analysi s demonstrated no significant differences in the overall interpretatio n of either disease. Periapical radiography was superior (p < 0.05) to tomography for the detection of calculus. The sensitivity of tomograp hy for periapical pathology was 87%, and 70% for periapical radiograph y. Sensitivities for periodontal diseases were 84% and 77%. Specificit ies were 81%, 90%, 77% and 79%, respectively. Differences for sensitiv ity and specificity were significant (p < 0.05) in relation to periapi cal pathology. The energy imparted during tomography was 0.92 mJ. Conc lusion. Detailed tomography and periapical radiography performed equal ly well for the overall diagnosis of periapical and periodontal lesion s. Tomograms differed substantially from periapical radiographs in bot h sensitivity and specificity for detecting periapical lesions in post erior regions. The energy imparted during detailed tomography is simil ar to that from two D-speed films.