Comparative Assessment of the Efficacy of Two-Dimensional Digital Intraoral Radiography to Three-Dimensional Cone Beam Computed Tomography in the Diagnosis of Periapical Pathologies

BACKGROUND: Periapical intraoral radiographs are useful in assessing periapical pathologies; essential information often is not extracted owing to difficult interpretation and two-dimensional presentation of three-dimensional structures focusing on using cone beam CT (CBCT) and other advanced imaging modalities. AIMS: The present study was conducted to comparatively assess the digital intraoral radiography to CBCT in the diagnosis of periapical pathologies. MATERIALS AND METHODS: In 50 teeth, CBCT and digital imaging were compared in assessing periapical pathologies using CBCTPA and six-point scoring. The scores obtained were assessed and compared with statistical evaluation. The data were expressed in percentage and number and mean and standard deviation. The level of significance was kept at P < 0.05. RESULTS: On comparing 3D CBCT and 2D digital imaging for assessing the study parameters, it was seen that resorption was seen in 33, 30, and 9 teeth, respectively, on 3, 2, and 1 rooted tooth on CBCT and 13, 16, and 7 teeth on digital radiography. The numbers of roots and root canals on CBCT were 45, 34, and 18 in 3, 2, and 1 rooted tooth and 50, 32, and 18 on digital imaging. Lesions were detected on CBCT in 16, 18, and 18 teeth on CBCT in 3, 2, and 1 rooted tooth, respectively, and in 14, 14, and 16 teeth on digital imaging. Comparing the five-point scale for lesions and CBPAI index for CBCT and digital imaging, the difference was statistically significant with P = 0.004 and <0.0001, respectively. CONCLUSION: The present study concludes that 3D CBCT is superior in accuracy to 2D imaging in diagnosing the periapical lesions, especially concerning multirooted teeth. Owing to its high radiation exposure and cost, 2D imaging can be incorporated in assessing periapical pathology for the single-rooted tooth.