Health  Vol.7 No.4 , April 2015
Evaluation of Diagnostic Efficacy of Digital Subtraction Radiography in the Diagnosis of Simulated External Root Resorption: An in Vitro Study
ABSTRACT
External root resorption can induce the degeneration of dental cementum and dentine and may extend towards the pulp reductive. Digital subtraction radiography can function as a useful tool in diagnosing degenerative carious lesions. This study investigated the diagnostic value of digital subtraction radiography in detecting external root resorption. This was a descriptive study conducted using the lab trial method. Artificially-induced external root resorption was created in different sizes at the coronal and apical aspects of 20 premolar teeth. Digital radiographs were obtained of each tooth under standard conditions and these radiographs were subtracted by imaging devices. The subtracted images and the digital radiographs were observed by three radiologists. Chi-square, Kappa test, and Z-test were used to analyze the data. The mean of general sensitivity of digital subtraction radiography and direct digital radiography was low in diagnosing 0.05 mm lesions (Sen = 35%), yet, the accuracy index was good for all lesions (Acc ≥ 65%). Other diagnostic parameters were also acceptable. Both types of radiography worked better in diagnosing coronal than apical lesions (P > 0.05). The interpreters (observers) showed a better performance in diagnosing external root resorption using digital subtraction radiography compared to digital radiography. Both modalities were exact and accurate in detecting 0.05 mm lesions as well as other lesions. However, the results of digital subtraction radiography were not significantly different from those of direct digital radiography.

Cite this paper
Goorabjavari, N. , Talaeipour, A. , Ezoddini-Ardakani, F. , Safi, Y. and Shamloo, N. (2015) Evaluation of Diagnostic Efficacy of Digital Subtraction Radiography in the Diagnosis of Simulated External Root Resorption: An in Vitro Study. Health, 7, 439-448. doi: 10.4236/health.2015.74051.
References
[1]   Bakland, L.K. (1992) Root Resorption. Dental Clinics of North America, 36, 491-507.

[2]   Freitas, A., Rosa, J.E. and Souza, I.F. (2000) Radiologia Odontologica. 5th Edition, Artes Medicas, Sao Paulo, 157.

[3]   Seltzre, S. and Kranser, P. (1998) Endodotology; Biologic Considerations in Endodontic Procedures. 2nd Edition, Lea and Sibiger, Philadelphia, 170-190, 527-543.

[4]   Cohen, S. and Hargreves, K. (2006) Pathway of the Pulp. 9th Edition, Mosby Co., St. Luis, So4-47, 704-727.

[5]   White, S.C. and Pharoah, M.J. (2014) Oral Radiology: Principles and Interpretation, 7th Edition, Elsevier, Health Sciences Division, Amsterdam, 41-63.

[6]   Lozano, A., Fomer, L. and Liena, C. (2002) In Vitro Comparison of Root Canal Measurements with Conventional and Digital Radiography. International Endodontic Journal, 35, 542-550.

[7]   Neena, I.E., Ananthraj, A., Praveen, P., Karthik, V. and Rani, P. (2011) Comparison of Digital Radiography and Apex Locator with the Conventional Method in Root Length Determination of Primary Teeth. Journal of Indian Society of Pedodontics and Preventive Dentistry, 29, 300-304.
http://dx.doi.org/10.4103/0970-4388.86371

[8]   Kamburoglu, K., TsesisI, K.A. and Kaffe, I. (2008) Diagnosis of Arthficially Induced External Root resoption Using Conventional Intraoral Film Radiography, CCD and PSP an ex Vivo Study. Oral Surg med Sral Pathol Pral Radiol Endod, 100, 885-891.

[9]   Kravitz, L.H., Tyndull, D.A., Bagnell, C.P. and Dove, S.B. (1992) Assessment of External Root Resorption Using Digital Subtraction Radiography. Journal of Endodontics, 18, 275-284.
http://dx.doi.org/10.1016/S0099-2399(06)80954-4

[10]   Reddy, M.S. and Jeffcoat, M.K. (1993) Digital Subtraction Radiography. Dental Clinics of North America, 37, 553-565.

[11]   Hintze, H., Wenzel, A., Andreasen, F.M. and Swevin, I. (1992) Digital Subtraction Radiography for Assessment of Simulated Root Resorption Cavities. Performance of Conventional and Reverse Contrast Modes. Endodontics & Dental Traumatology, 8, 149-154.
http://dx.doi.org/10.1111/j.1600-9657.1992.tb00234.x

[12]   Ohki, M., Okano, T. and Yamada, N. (1988) A Contrast-Correction Method for Digital Subtraction Radiography. Journal of Periodontal Research, 23, 277-280.
http://dx.doi.org/10.1111/j.1600-0765.1988.tb01372.x

[13]   Wenzel, A., Anthonisen, P.N. and Juun, M.B. (2000) Reproducibility in the Assessment of Caries Lesion Behavior: A Comparison between Conventional Film and Subtraction Ra-diography. Caries Research, 34, 214-218.
http://dx.doi.org/10.1159/000016593

[14]   Jeffcoat, M.K., Reddy, M.S., Page, R., Wannawisute, A., Waite, P., Palcanis, K., et al. (1991) Use of Digital Radiography to Demonstrate the Potential of Naproxen as an Adjust in the Treatment of Rapidly Progressive Periodontitis. Journal of Periodontal Research, 26, 415-421.
http://dx.doi.org/10.1111/j.1600-0765.1991.tb01731.x

[15]   Wenzel, A. and Halse, A. (1992) Digital Subtraction Radiography after Stannous Fluoride Treatment for Occlusal Caries Diagnosis. Oral Surgery, Oral Medicine, Oral Pathology, 74, 824-828.
http://dx.doi.org/10.1016/0030-4220(92)90416-N

[16]   Grondahl, H.G., Grondahl, K. and Webber, R.L. (1983) A Digital Subtraction Technique for Dental Radiography. Oral Surgery, Oral Medicine, Oral Pathology, 55, 96-102.
http://dx.doi.org/10.1016/0030-4220(83)90314-6

[17]   Ono, E., Filho, E.M., Leite, H.F., Oshiro Tanaka, J.L., De Moraes, M.E.L. and De Melo Castilho, J.C. (2011) Evaluation of Simulated External Root Resorption with Digital Radiography and Digital Subtraction Radiography. American Journal of Orthodontics and Dentofacial Orthopedics, 139, 324-333.
http://dx.doi.org/10.1016/j.ajodo.2009.03.046

[18]   Georgios, S., Georgios, M. and Kleoniki, L. (2011) Assessment of Simulated Internal Resorption Cavities Using Digital and Digital Subtraction Radiography: A Comparative Study. Dental Traumatology, 27, 344-349.
http://dx.doi.org/10.1111/j.1600-9657.2011.01020.x

[19]   Borg, E., Kallqvist, A. and Grondahl, H.G. (1998) Film and Digital Radiography for Detection of Simulated Root Resorption Cavities. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 86, 110-114.
http://dx.doi.org/10.1016/S1079-2104(98)90159-7

[20]   Halse, A., Espelid, T., Veit, A.B. and White, S.C. (2005) Detection of Mineral Resorption in Approximal Enamel by Subtraction Radiography. Oral Surgery, Oral Medicine, Oral Pathology, 77, 177-132.

[21]   Holmes, J.P., Gulabivala, K. and Van Stelt, P.F. (2001) Detection of Simulated Internal Tooth Resorption Using Conventional Radiography and Subtraction Imaging. Dentomaxillofacial Radiology, 30, 249-254.
http://dx.doi.org/10.1038/sj.dmfr.4600626

[22]   Qaffari, R. and Keshavarzi, M. (2008) Evaluation of Accuracy of Digital Subtraction Radiography in Diagnosing in Vitro Artificially-induced External Root Rersorption. Journal of Isfahan Dental School, 4, 141-148.

[23]   Varshowsaz, M. and Ghattari, R. (2007) Evaluation of the Accuracy of Digital Subtraction Radiography in the Detection of Dental Demineralization (in Vitro). Journal of Dental School, 22, 332-340. (Persian)

[24]   Uprichard, K.K., Potter, B.J., Russell, C.M., Schafer, T.E., Adair, S. and Weller, R.N. (2000) Comparison of Direct Digital and Conventional Radiography for the Detection of Proximal Surface Caries in the Mixed Dentition. Pediatric Dentistry, 22, 9-15.

[25]   Alkurt, M.T., Peker, I., Bala, O. and Altunkaynak, B. (2007) In Vitro Comparison of Four Different Dental X-Ray Films and Direct Digital Radiography for Proximal Caries Detection. Operative Dentistry, 32, 504-509.
http://dx.doi.org/10.2341/06-148

[26]   Bernier-Rodriguez, J.A., Sidow, S.J., Joyce, A.P., McNally, K. and McPherson, J.C. (2008) Radiographic Interpretation of Experimental Lesions in Radicular Tooth Structure of Human Maxillary Anterior Teeth. Journal of Endodontics, 34, 1466-1469.
http://dx.doi.org/10.1016/j.joen.2008.09.009

 
 
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