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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

Three-dimensional Pattern of Inflammatory Periapical Lesion Extension in the Premolar’s Region: An Application of K-means Clustering

Author(s): Maryam Kazemipoor, Fatemeh Valizadeh* and Sara Jambarsang

Volume 17, Issue 9, 2021

Published on: 25 February, 2021

Page: [1151 - 1158] Pages: 8

DOI: 10.2174/1573405617666210225090213

Price: $65

Abstract

Background: Cone-Beam Computed Tomography (CBCT) provides a better diagnosis of endodontic lesions.

Introduction: The present study would assess the pattern of periapical lesion extension in premolar teeth using CBCT.

Methods: In this descriptive study‚ 330 roots in the regions of maxillary and mandibular premolars have been evaluated. Maximum periapical lesion extensions in the three orthogonal planes (axial, coronal, and sagittal) were measured and recorded in millimeters. Measurements were compared based on gender‚ dental arch, tooth type, and root. Statistical analysis was performed using repeated measure ANOVA, Bonferroni, Chi-square tests, and clustering data analysis (K-means method). The significant level was set at 0.05.

Results: There were significant differences between the lesion expansions in the three-dimensional planes (p-value<0.001). The highest average of lesion extension in the premolar regions of the examined population was reported in the vertical dimension (4.1± 1.3), followed by horizontal buccolingual dimension (3.4±1.1) and horizontal mesiodistal dimension (3.1±1.0), respectively. According to independent variables, in the premolar region, only tooth roots showed significant differences in the lesion extension (p-value=0.002). Clustering data analysis showed that the majority of the participants were categorized in a cluster with lower lesion extension. Based on clustering data analysis, the small lesions were significantly observed in the first premolar and buccal roots.

Conclusion: Since the periapical lesion extension in the buccolingual dimension, which could not be detected in the 2-D imaging techniques, was rather high in the region of premolar teeth, and CBCT, as a 3-D imaging technique, is a suitable option for the precise evaluation of periapical lesion extension. Also, the majority of the lesions in this tooth area are small and located in the buccal roots.

Keywords: Cone-beam Computed Tomography, diagnosis, endodontics, periapical disease, K-means, premolars.

Graphical Abstract

[1]
Liapatas S, Nakou M, Rontogianni D. Inflammatory infiltrate of chronic periradicular lesions: an immunohistochemical study. Int Endod J 2003; 36(7): 464-71.
[http://dx.doi.org/10.1046/j.1365-2591.2003.00627.x] [PMID: 12823701]
[2]
Ricucci D, Mannocci F, Ford TRP. A study of periapical lesions correlating the presence of a radiopaque lamina with histological findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101(3): 389-94.
[http://dx.doi.org/10.1016/j.tripleo.2005.08.026] [PMID: 16504874]
[3]
Bender I, Seltzer S. Roentgenographic and direct observation of experimental lesions in bone: I. J Am Dent Assoc 1961; 62(2): 152-60.
[http://dx.doi.org/10.14219/jada.archive.1961.0030]
[4]
Bender IB, Seltzer S. Roentgenographic and direct observation of experimental lesions in bone: II. 1961. J Endod 2003; 29(11): 707-12.
[http://dx.doi.org/10.1097/00004770-200311000-00006] [PMID: 14651275]
[5]
van der Stelt PF. Experimentally produced bone lesions. Oral Surg Oral Med Oral Pathol 1985; 59(3): 306-12.
[http://dx.doi.org/10.1016/0030-4220(85)90172-0] [PMID: 3856825]
[6]
White SC, Atchison KA, Hewlett ER, Flack VF. Efficacy of FDA guidelines for prescribing radiographs to detect dental and intraosseous conditions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995; 80(1): 108-14.
[http://dx.doi.org/10.1016/S1079-2104(95)80026-3] [PMID: 7552849]
[7]
Patel S, Dawood A. The use of cone beam computed tomography in the management of external cervical resorption lesions. Int Endod J 2007; 40(9): 730-7.
[http://dx.doi.org/10.1111/j.1365-2591.2007.01247.x] [PMID: 17608680]
[8]
Christell H, Birch S, Hedesiu M, et al. Variation in costs of cone beam CT examinations among healthcare systems. Dentomaxillofac Radiol 2012; 41(7): 571-7.
[http://dx.doi.org/10.1259/dmfr/22131776] [PMID: 22499131]
[9]
Tsurumachi T, Honda K. A new cone beam computerized tomography system for use in endodontic surgery. Int Endod J 2007; 40(3): 224-32.
[http://dx.doi.org/10.1111/j.1365-2591.2006.01198.x] [PMID: 17305699]
[10]
Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc 2006; 72(1): 75-80.
[PMID: 16480609]
[11]
Patel S, Durack C, Abella F, Shemesh H, Roig M, Lemberg K. Cone beam computed tomography in Endodontics - a review. Int Endod J 2015; 48(1): 3-15.
[http://dx.doi.org/10.1111/iej.12270] [PMID: 24697513]
[12]
De Vos W, Casselman J, Swennen GR. Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature. Int J Oral Maxillofac Surg 2009; 38(6): 609-25.
[http://dx.doi.org/10.1016/j.ijom.2009.02.028] [PMID: 19464146]
[13]
Uraba S, Ebihara A, Komatsu K, Ohbayashi N, Okiji T. Ability of cone-beam computed tomography to detect periapical lesions that were not detected by periapical radiography: a retrospective assessment according to tooth group. J Endod 2016; 42(8): 1186-90.
[http://dx.doi.org/10.1016/j.joen.2016.04.026] [PMID: 27372162]
[14]
Song D, Zhang L, Zhou W, et al. Comparing cone-beam computed tomography with periapical radiography for assessing root canal obturation in vivo using microsurgical findings as validation. Dentomaxillofac Radiol 2017; 46(5): 20160463.
[http://dx.doi.org/10.1259/dmfr.20160463] [PMID: 28332866]
[15]
Caputo BV, Noro Filho GA, de Andrade Salgado DMR, Moura-Netto C, Giovani EM, Costa C. Evaluation of the root canal morphology of molars by using cone-beam computed tomography in a Brazilian population: part I. J Endod 2016; 42(11): 1604-7.
[http://dx.doi.org/10.1016/j.joen.2016.07.026] [PMID: 27625147]
[16]
Ezzodini Ardakani F, Razavi SH, Tabrizizadeh M. Diagnostic value of cone-beam computed tomography and periapical radiography in detection of vertical root fracture. Iran Endod J 2015; 10(2): 122-6.
[PMID: 25834597]
[17]
Choudhary AB, Motwani MB, Degwekar SS, et al. Utility of digital volume tomography in maxillofacial trauma. J Oral Maxillofac Surg 2011; 69(6): e135-40.
[http://dx.doi.org/10.1016/j.joms.2010.07.081] [PMID: 21277069]
[18]
Lofthag-Hansen S, Huumonen S, Gröndahl K, Gröndahl H-G. Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103(1): 114-9.
[http://dx.doi.org/10.1016/j.tripleo.2006.01.001] [PMID: 17178504]
[19]
Cheung GS, Wei WL, McGrath C. Agreement between periapical radiographs and cone-beam computed tomography for assessment of periapical status of root filled molar teeth. Int Endod J 2013; 46(10): 889-95.
[http://dx.doi.org/10.1111/iej.12076] [PMID: 23442122]
[20]
Patel S, Wilson R, Dawood A, Mannocci F. The detection of periapical pathosis using periapical radiography and cone beam computed tomography - part 1: pre-operative status. Int Endod J 2012; 45(8): 702-10.
[http://dx.doi.org/10.1111/j.1365-2591.2011.01989.x] [PMID: 22188219]
[21]
Abella F, Patel S, Duran-Sindreu F, Mercadé M, Bueno R, Roig M. Evaluating the periapical status of teeth with irreversible pulpitis by using cone-beam computed tomography scanning and periapical radiographs. J Endod 2012; 38(12): 1588-91.
[http://dx.doi.org/10.1016/j.joen.2012.09.003] [PMID: 23146642]
[22]
Christiansen R, Kirkevang L-L, Gotfredsen E, Wenzel A. Periapical radiography and cone beam computed tomography for assessment of the periapical bone defect 1 week and 12 months after root-end resection. Dentomaxillofac Radiol 2009; 38(8): 531-6.
[http://dx.doi.org/10.1259/dmfr/63019695] [PMID: 20026710]
[23]
Estrela C, Bueno MR, Leles CR, Azevedo B, Azevedo JR. Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. J Endod 2008; 34(3): 273-9.
[http://dx.doi.org/10.1016/j.joen.2007.11.023] [PMID: 18291274]
[24]
Patel S, Brady E, Wilson R, Brown J, Mannocci F. The detection of vertical root fractures in root filled teeth with periapical radiographs and CBCT scans. Int Endod J 2013; 46(12): 1140-52.
[http://dx.doi.org/10.1111/iej.12109] [PMID: 23617242]
[25]
de Paula-Silva FWG, Wu M-K, Leonardo MR, da Silva LAB, Wesselink PR. Accuracy of periapical radiography and cone-beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard. J Endod 2009; 35(7): 1009-12.
[http://dx.doi.org/10.1016/j.joen.2009.04.006] [PMID: 19567324]
[26]
Cayo-Rojas CF, Begazo-Jiménez LA, Romero-Solórzano LB, Nicho-Valladares MK, Gaviria-Martínez A, Cervantes-Ganoza LA. Periapical lesions and their relationship to schneider’s membrane in cone-beam computed tomography. Int J Dent 2020; 2020: 8450315.
[http://dx.doi.org/10.1155/2020/8450315] [PMID: 32211047]
[27]
Setzer FC, Shi KJ, Zhang Z, et al. Artificial intelligence for the computer-aided detection of periapical lesions in cone-beam computed tomographic images. J Endod 2020; 46(7): 987-93.
[http://dx.doi.org/10.1016/j.joen.2020.03.025] [PMID: 32402466]
[28]
Orhan K, Bayrakdar IS, Ezhov M, Kravtsov A, Özyürek T. Evaluation of artificial intelligence for detecting periapical pathosis on cone-beam computed tomography scans. Int Endod J 2020; 53(5): 680-9.
[http://dx.doi.org/10.1111/iej.13265] [PMID: 31922612]
[29]
Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. Int Endod J 2011; 44(7): 610-25.
[http://dx.doi.org/10.1111/j.1365-2591.2011.01873.x] [PMID: 21366627]
[30]
Kim CS, Choi SH, Chai JK, et al. Periodontal repair in surgically created intrabony defects in dogs: influence of the number of bone walls on healing response. J Periodontol 2004; 75(2): 229-35.
[http://dx.doi.org/10.1902/jop.2004.75.2.229] [PMID: 15068110]
[31]
Antony DP, Thomas T, Nivedhitha MS. Two-dimensional periapical, panoramic radiography versus three-dimensional cone-beam computed tomography in the detection of periapical lesion after endodontic treatment: A systematic review. Cureus 2020; 12(4): e7736.
[PMID: 32440383]
[32]
Kazemipoor M, Sabaghzadegan F. Pattern of endodontic periapical lesion extension in anterior teeth: A CBCT study in an iranian population. Iran Endod J 2019; 14(4): 259-64.
[33]
Hargreaves KM. Cohen’s Pathways of the Pulp. 11th. St. Louis, Mo, USA: Mosby 2016.
[34]
Abbott PV. Classification, diagnosis and clinical manifestations of apical periodontitis. Endod Topics 2004; 8(1): 36-54.
[http://dx.doi.org/10.1111/j.1601-1546.2004.00098.x]
[35]
Vier FV, Figueiredo JA. Prevalence of different periapical lesions associated with human teeth and their correlation with the presence and extension of apical external root resorption. Int Endod J 2002; 35(8): 710-9.
[http://dx.doi.org/10.1046/j.1365-2591.2002.00554.x] [PMID: 12196225]
[36]
Vier FV. Figueiredo JAPd. Prevalence regarding the type of periapical pathology in 102 human teeth extracted with associated periapical lesion. ECLER Endod 2000; 2(2): 1-18.
[37]
Ramachandran Nair PN, Pajarola G, Schroeder HE. Types and incidence of human periapical lesions obtained with extracted teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996; 81(1): 93-102.
[http://dx.doi.org/10.1016/S1079-2104(96)80156-9] [PMID: 8850492]
[38]
Huumonen S, Ørstavik D. Radiological aspects of apical periodontitis. Endod Topics 2002; 1(1): 3-25.
[http://dx.doi.org/10.1034/j.1601-1546.2002.10102.x]
[39]
Saidi A, Naaman A, Zogheib C. Accuracy of cone-beam computed tomography and periapical radiography in endodontically treated teeth evaluation: A five-year retrospective study. J Int Oral Health 2015; 7(3): 15-9.
[PMID: 25878472]
[40]
Santos O Junior, Pinheiro LR, Umetsubo OS, Cavalcanti MGP. CBCT-based evaluation of integrity of cortical sinus close to periapical lesions. Braz Oral Res 2015; 29(1): 1-7.
[http://dx.doi.org/10.1590/1807-3107BOR-2015.vol29.0080] [PMID: 26398110]
[41]
Esposito S, Cardaropoli M, Cotti E. A suggested technique for the application of the cone beam computed tomography periapical index. Dentomaxillofac Radiol 2011; 40(8): 506-12.
[http://dx.doi.org/10.1259/dmfr/78881369] [PMID: 22065800]
[42]
Tsai P, Torabinejad M, Rice D, Azevedo B. Accuracy of cone-beam computed tomography and periapical radiography in detecting small periapical lesions. J Endod 2012; 38(7): 965-70.
[http://dx.doi.org/10.1016/j.joen.2012.03.001] [PMID: 22703662]
[43]
Yamasaki M, Kumazawa M, Kohsaka T, Nakamura H, Kameyama Y. Pulpal and periapical tissue reactions after experimental pulpal exposure in rats. J Endod 1994; 20(1): 13-7.
[http://dx.doi.org/10.1016/S0099-2399(06)80020-8] [PMID: 8182380]
[44]
Yu SM, Stashenko P. Identification of inflammatory cells in developing rat periapical lesions. J Endod 1987; 13(11): 535-40.
[http://dx.doi.org/10.1016/S0099-2399(87)80033-X] [PMID: 3482098]
[45]
Sakhdari S, Talaeipour AR, Talaeipour M, Pazhutan M, Tehrani SH, Kharazifard MJ. Diagnostic accuracy of CBCT with different voxel sizes and intraoral digital radiography for detection of periapical bone lesions: an ex-vivo study. J Dent (Tehran) 2016; 13(2): 77-84.
[PMID: 27928235]

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