Identification and classification of pulp calcifications in posterior teeth according to dental condition using digital panoramic radiography and cone beam computed tomography
Poliana Santos Gonçalves, Amanda Pelegrin Candemil, Igor Bassi Ferreira Petean, Alice Correa Silva Sousa, Cassiano Ricardo Ferreira Pires, Jardel Francisco Mazzi-Chaves, Manoel Damião de Sousa-Neto, Hugo Gaêta-Araujo- General Dentistry
- Radiology, Nuclear Medicine and imaging
- General Medicine
- Otorhinolaryngology
Abstract
Objective
To compare digital panoramic radiography (DPR) and cone beam computed tomography (CBCT) in the detection and classification of pulp calcifications in posterior teeth in relation to tooth condition and its location.
Methods
250 patients with simultaneous DPR and CBCT scans were selected from a dental image bank. For each posterior tooth, its condition was registered (healthy, restored, or decayed). The presence of calcifications was assessed and classified according to location (coronal or radicular) and type (total obliteration, partial obliteration, narrowing, and no calcification). Chi-square and McNemar tests were used to compare DPR and CBCT results, with a significance level of 5%. DPR diagnostic values were calculated using CBCT as reference.
Results
Decayed and restored teeth showed a significantly (p < 0.001) higher prevalence of pulp calcifications than healthy teeth in both imaging exams. There was a significant discrepancy between the imaging modalities in the identification of calcifications (p < 0.001), especially for radicular calcifications of maxillary teeth (DPR = 55.2%; CBCT = 30.9%). In the case of coronal calcifications, there was a greater discrepancy between CBCT and DPR in the mandibular teeth (10.7%) than in the maxillary teeth (7.7%). Overall, DPR presents higher sensitivity (0.855) than specificity (0.483) for pulp calcifications detection.
Conclusion
DPR considerably overestimates pulp calcifications in posterior teeth, as compared to CBCT. A higher prevalence of pulp calcifications is related to decayed and restored teeth.