An uncovered extensive fusion of two separated periapical lesions in CBCT imaging: the importance of multiplanar radiographic appraisal
Abstract
Objectives: This report is aimed to present a case of an uncovered fusion of two seemingly separated periapical rarefying osteitis lesions on two adjacent teeth through Cone Beam Computed Tomography (CBCT) imaging and to describe the significance of a comprehensive multiplanar appraisal in interpreting CBCT radiographs.Case Report: An 18-year-old female patient came to Universitas Airlangga Dental Hospital for a CBCT examination of her right central maxillary incisor (tooth 11) as referred by her dentist. Based on the clinical report provided, the patient had a slight palpable swelling of the labial gingival anterior maxilla with sign of crepitus. Caries lesions were found on teeth 11 and 12 in which the vitality tests showed negative responses. Thus, it was provisionally suspected as a periapical inflammatory lesion. CBCT was done and the 3D-reconstructed images of the bone showed there were two neighboring radiolucent ovoid lesions attached on one-third apical of teeth 11 and 12, separated by a firm-apparent cortex. It was later discovered that the two lesions were actually fused as one elongated and extensive lesion through the multiplanar appraisal of three orthogonal views provided in CBCT application.
Conclusion: CBCT 3D-reconstructed and panoramic reformatted images should be used with caution, either for linear measurement or diagnostic purposes, as they should only be used to illustrate the diagnosis and/or provide a better understanding of the problem to the patients and their treatment plans. A comprehensive multiplanar appraisal is required to provide a diagnostically complete interpretation.
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Patel S, Harvey S. Guidelines for reporting on CBCT scans. Int Endod J. 2021;54(4):628–33.
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Kim M, Huh KH, YI WJ, Heo MS, Lee SS, Choi SC. Evaluation of accuracy of 3D reconstruction images using multi-detector CT and cone-beam CT. Imaging Sci Dent. 2012;42(1):25–33.
Sitorus RP. Pengetahuan Mahasiswa Pendidikan Dokter Gigi Spesialis dan Dokter Gigi Spesialis tentang Penggunaan Cone Beam Computed Tomography (CBCT) di Kota Medan. Universitas Sumatera Utara; 2021.
Sathawane R, Bhakte K, Chandak R, Lanjekar A, Bagde L. Awareness, Knowledge and Attitude of Dental Students and General Dental Practitioners of Nagpur towards CBCT: A Questionnaire Based Analytical study. Int J Res Rev. 2020;7(6):398–403.
Kamburoǧlu K, Kurşun Ş, Akarslan ZZ. Dental students’ knowledge and attitudes towards cone beam computed tomography in Turkey. Dentomaxillofacial Radiol. 2011;40(7):439–43.
Sangar S, Vadivel JK. Awareness of dental students towards CBCT: A cross sectional study. J Indian Acad Oral Med Radiol. 2020;32(4):366–70.
Almohiy H, Alshahrani I. Cone Beam Computed Tomography (CBCT) in dentistry- students’ and interns’ perspective in Abha, Saudi Arabia. Ann Trop Med Public Heal. 2019;22(Special Issue 5).
Pauwels R, Araki K, Siewerdsen JH, Thongvigitmanee SS. Technical aspects of dental CBCT: State of the art. Dentomaxillofacial Radiol. 2015;44(1):1–20.
Bouwens DG, Cevidanes L, Ludlow JB, Phillips C. Comparison of mesiodistal root angulation with posttreatment panoramic radiographs and cone-beam computed tomography. Am J Orthod Dentofac Orthop [Internet]. 2011;139(1):126–32.
Hol C, Hellén-Halme K, Torgersen G, Nilsson M, Moystad A. How do dentists use CBCT in dental clinics? A Norwegian nationwide survey. Acta Odontol Scand. 2015;73(3):195–201.
Braz-Silva PH, Bergamini ML, Mardegan AP, De Rosa CS, Hasseus B, Jonasson P. Inflammatory profile of chronic apical periodontitis: a literature review. Acta Odontol Scand [Internet]. 2019 Apr 3;77(3):173–80.
Bagheri SCBT-CR of O and MS (Second E, editor. Chapter 1 - Oral and Maxillofacial Radiology. In St. Louis (MO): Mosby; 2014. p. 1–27.
Venkatesh E, Elluru SV. CBCT: Basics and Applications in Dentistry. J Istanbul Univ Fac Dent. 2017;51:102–21.
Pavan Kumar T, Sujatha S, Yashodha Devi B, Nagaraju R, Shwetha V. Basics of CBCT Imaging. J Dent Oro-facial Res. 2017;13(01):49–55.
Subbulakshmi AC, Bharathi S, Naveen S. CBCT report of three intresting cases of cysts and its radiographic presentations. J Oral Med Oral Surgery, Oral Pathol Oral Radiol. 2021;7(3):176–81.
Fernandes TMF, Adamczyk J, Poleti ML, Henriques JFC, Friedland B, Garib DG. Comparison between 3D volumetric rendering and multiplanar slices on the reliability of linear measurements on CBCT images: An in vitro study. J Appl Oral Sci. 2015;23(1):56–63.
Hassan B, Van Der Stelt P, Sanderink G. Accuracy of three-dimensional measurements obtained from cone beam computed tomography surface-rendered images for cephalometric analysis: Influence of patient scanning position. Eur J Orthod. 2009;31(2):129–34.
Sang YH, Hu HC, Lu SH, Wu YW, Li WR, Tang ZH. Accuracy assessment of three‑dimensional surface reconstructions of in vivo teeth from cone‑beam computed tomography. Chin Med J (Engl). 2016;129(12):1464–70.
Patel S, Harvey S. Guidelines for reporting on CBCT scans. Int Endod J. 2021;54(4):628–33.
Ganguly R, Ramesh A. Systematic interpretation of CBCT scans: why do it? J Mass Dent Soc. 2014;62(4):68–70.
Kim IH, Singer SR, Mupparapu M. Review of cone beam computed tomography guidelines in North America. Quintessence Int (Berl). 2019;50(2):136–45.
Friedland B, Miles DA. Liabilities and risks of using cone beam computed tomography. Dent Clin North Am [Internet]. 2014;58(3):671–85.
Temur KT, HATİPOĞLU Ö. Awareness and Use of Cone-Beam Computed Tomography (CBCT) of Turkish Dentist. J Dent Fac Atatürk Uni. 2019;29(2):169–75.
Chagas MM, Silva MAG, Cavalcanti MGP. Evaluation of cone beam computed tomography imaging in placed dental implants: comparison between multiplanar reconstruction and parasagittal images / Avaliação de imagens de tomografia computadorizada de feixe cônico em implantes instalados: comparação e. Brazilian J Dev. 2021;7(4):34811–22.
Published
2022-04-30
How to Cite
NURRACHMAN, Aga Satria; SARIFAH, Norlaila; ASTUTI, Eha Renwi.
An uncovered extensive fusion of two separated periapical lesions in CBCT imaging: the importance of multiplanar radiographic appraisal.
Jurnal Radiologi Dentomaksilofasial Indonesia (JRDI), [S.l.], v. 6, n. 1, p. 21-26, apr. 2022.
ISSN 2686-1321.
Available at: <http://jurnal.pdgi.or.id/index.php/jrdi/article/view/751>. Date accessed: 19 apr. 2024.
doi: https://doi.org/10.32793/jrdi.v6i1.751.
Section
Case Report
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
