Detectability of artificial periapical lesions using direct digital and conventional radiography

The ability of different radiographic techniques to detect the presence of artificially created periapical lesions in mandibles of human cadavers was investigated. Conventional radiography was compared with direct digital ima ging using the Digora system, Artificial lesions were created around the ro ots of molars in three stages: removal of lamina dura only, extension to ca ncellous bone, and involvement of cortical plate. Radiographs and digital i mages (gray scale, color, and reverse image) were obtained preoperatively a nd after each stage of bone removal. Images were scored on a 5-point scale by eight observers. For all image types, lesions were readily detectable af ter removal of lamina dura only, with increasing detectability associated w ith further bone removal (especially cortical plate involvement), Radiograp hs and gray-scale digital images were comparable at all stages, whereas col or and reverse images were associated with a greater spread of diagnostic s cores. Digital imaging did not enhance detectability of lesions.