Abstract
External cervical resorption is a pathological condition affecting the cervical margins of teeth. Due to the increased prevalence and the area it affects, it can be easily misdiagnosed. The ability of clinicians to diagnose ECR and subcategorise the lesions using periapical radiographs and cone beam-CT scans has not been investigated in-depth. This study aims to assess if diagnostic ability to detect ECR lesions with the two modalities was different and if there was a change in the diagnosis when CBCT was used. A human skull, including the mandible was used for this study. The teeth were randomly allocated to the different subcategories, then pre and post-preparation radiographs with CBCT were taken. Statistical analysis was done using IBM SPSS version 16.0 (SPSS Inc., Chicago, IL, USA). The study sample was composed of 60 participants, the overall sensitivity of intraoral radiographs was significantly lower than CBCT. When the participants were told the radiograph and the CBCT were of the same tooth 60% said they would change their diagnosis. The use of intraoral radiographs alone might not be enough to identify and correctly diagnose ECR lesions. CBCT can give a better idea about the nature and the extent of the lesion.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Heithersay G. Management of tooth resorption. Aust Dent J. 2007;52:S105–21.
Mavridou AM, et al. Is hypoxia related to external cervical resorption? A case report. J Endodont. 2019;45(4):459–70.
Von Arx T, et al. Human and feline invasive cervical resorptions: the missing link? Presentation of four cases. J Endodont. 2009;35(6):904–13.
Heithersay GS. Invasive cervical resorption: an analysis of potential predisposing factors. Quintessence Int. 1999;30(2):83–95.
Patel S, et al. External cervical resorption: a three-dimensional classification. Int Endod J. 2018;51(2):206–14.
Goodell KB, Mines P, Kersten DD. Impact of cone-beam computed tomography on treatment planning for external cervical resorption and a Novel Axial Slice-based Classification System. J Endodont. 2018;44(2):239–44.
de Souza DV, et al. External cervical resorption: a comparison of the diagnostic efficacy using 2 different cone-beam computed tomographic units and periapical radiographs. J Endodont. 2017;43(1):121–5.
Bossuyt PM, et al. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. Clin Chem. 2015;61(12):1446–52.
Shelley AM, Brunton P, Horner K. Subjective image quality assessment of cross sectional imaging methods for the symphyseal region of the mandible prior to dental implant placement. J Dent. 2011;39(11):764–70.
Beertsen W, et al. Generalized cervical root resorption associated with periodontal disease. J Clin Periodontol. 2001;28(11):1067–73.
Schroeder HE, Scherle WF. Cemento-enamel junction–revisited. J Periodontal Res. 1988;23(1):53–9.
Mavridou AM, et al. Understanding external cervical resorption in vital teeth. J Endodont. 2016;42(12):1737–51.
Yi J, et al. Cone-beam computed tomography versus periapical radiograph for diagnosing external root resorption: a systematic review and meta-analysis. Angle Orthod. 2017;87(2):328–37.
McCaul L, McHugh S, Saunders W. The influence of specialty training and experience on decision making in endodontic diagnosis and treatment planning. Int Endod J. 2001;34(8):594–606.
Patel K, Mannocci F, Patel S. The assessment and management of external cervical resorption with periapical radiographs and cone-beam computed tomography: a clinical study. J Endodont. 2016;42(10):1435–40.
Durack C, et al. Diagnostic accuracy of small volume cone beam computed tomography and intraoral periapical radiography for the detection of simulated external inflammatory root resorption. Int Endod J. 2011;44(2):136–47.
Özen T, et al. Interpretation of chemically created periapical lesions using 2 different dental cone-beam computerized tomography units, an intraoral digital sensor, and conventional film. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2009;107(3):426–32.
Kamburoğlu K, et al. Detection of vertical root fracture using cone-beam computerized tomography: an in vitro assessment. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2010;109(2):e74–81.
Kamburoğlu K, et al. Observer ability to detect ex vivo simulated internal or external cervical root resorption. J Endodont. 2011;37(2):168–75.
Fryback DG, Thornbury JR. The efficacy of diagnostic imaging. Med Decis Making. 1991;11(2):88.
Kim I, et al. Clinical research and diagnostic efficacy studies in the oral and maxillofacial radiology literature: 1996–2005. Dentomaxillofac Radiol. 2011;40(5):274.
Scarfe WC et al. Use of cone beam computed tomography in endodontics. Int J Dentistry. 2009;634567. https://doi.org/10.1155/2009/634567.
E.S.o.E.d., et al. European Society of Endodontology position statement: external cervical resorption. Int Endodont J. 2018;51(12):1323–6.
Acknowledgements
The authors deny any conflicts of interest related to this study. This research project received no specific grant from any funding organisation or any other source.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict Of Interest
All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. No funds, grants, or other support was received.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Cunliffe, J., Al-Hadidi, A., Sawair, F.A. et al. Comparison of imaging modalities in the diagnosis of external cervical resorption (ECR): an in-vitro study. Odontology 110, 157–163 (2022). https://doi.org/10.1007/s10266-021-00651-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10266-021-00651-y