Comparative evaluation to determine the efficacy of conventional radiography, digital radiography and ultrasound imaging in the diagnosis of periapical lesions

In recent time several imaging modalities have been implicated for diagnosing periapical lesion. The present study is carried out to determine and compare the nature and extent of periapical lesions using conventional radiography, digital radiography and ultrasound imaging and to confirm the diagnosis with histopathological examination. Thirty patients aged between 15 and 45 years with well-defined periapical radiolucency associated with anterior maxillary or mandibular teeth requiring endodontic surgery or extraction were selected. The pre-operative intraoral periapical radiographs and digital images and were diagnosed by three observers. Ultrasound examination was performed and the images were assessed by an ultrasonographer. The periapical tissues were obtained to enable histopathological investigation. The data was statistically analysed using the kappa procedure, Kruskal Wallis Anova & Mann-Whitney U test. Results showed that the percentage accuracy of diagnosing periapical lesions using conventional radiography, digital radiography and ultrasound was – 86.67%, 93.33% & 93.33% respectively. Thus, we conclude that ultrasound helps in distinguishing between periapical granuloma and cyst which is of importance in predicting the treatment outcome. So, ultrasound can be used as an adjunct to conventional or digital radiography in diagnosing periapical lesions.