A comparison of four CBCT machines in the diagnostic efficacy of early external cervical resorption and apical periodontitis: an ex vivo study
Abstract
ABSTRACT
Many CBCT machines are available in the market with different characteristics. This
study aims to compare the accuracy of scans of four cone beam computed tomography
(CBCT) scanners in assessing signs of disease at early stages; external cervical
resorption and apical periodontitis. Two dry dentate human mandibles with thirteen teeth
were obtained and used in this experiment. Simulated ECR and AP lesions were created
on root surfaces and the base of the socket of extracted teeth, respectively. CBCT scans
were taken before and after the creation of the lesions using four different CBCT units;
Accuitomo (Morita), Orthophos (Sirona), CS9300(Carestream) and
CS9600(Carestream)). Receiving Operator Characteristic (ROC) analysis, Kappa tests,
sensitivity, and specificity were calculated for each CBCT scanner. The overall area
under ROC curve for the four CBCT machines for ECR detection were 0.996
(Accuitomo), 0.992 (Orthophos), 0.979 (CS9300) and 0.985 (CS9600), and there was no
significant difference (p<0.05). While the overall area under ROC curve for AP detection
were 0.824 (Accuitomo), 0.801 (Orthophos), 0.762 (CS9300) and 0.779 (CS9600).
Sensitivity, Specificity, PPV and NPV values were high for all four CBCT machines in
detecting ECR (0.993, 0.977, 0.929 and 0.998, respectively). While sensitivity, specificity
and NPV values were high (0.767, 0.792, 0.934), the PPV were less (0.467) when
detecting AP. There was no significant difference between the different machines when
detecting ECR. Within the limitations of this ex vivo study, no differences were found
between the four CBCT units when detecting ECR and AP at early stages. All machines
displayed better efficiency when detecting ECR than when detecting AP at early stages.