Research Article
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Comparison of the accuracy of different cone beam computed tomography systems in measuring the volume of external root resorption

Year 2025, Volume: 59 Issue: 2, 77 - 83, 21.05.2025

Ayşe Gül Öner Talmaç , Alaettin Koç

https://doi.org/10.26650/eor.20241247459

Abstract

Purpose: The aim of this study is to compare the accuracy of root resorption volume measurements among three cone-beam computed tomography (CBCT) devices using various imaging parameters.

Materials and Methods: A total of 42 external root resorption (ERR) defects were mechanically created on the buccal and palatinal surfaces of the roots of seven extracted human teeth. Volume measurements of the defects were performed using three CBCT devices and six different imaging protocols. CBCT measurements were then compared with those calculated from micro-computed tomography (micro-CT) images.

Results: The mean absolute error values indicated that the rate of measurement accuracies from best to worst was obtained with KaVo 3D eXam (0.125 mm voxel, 0.2 mm voxel, respectively), Orthophos XG 3D (0.1 mm voxel, 0.16 mm voxel, respectively), and Rainbow CT (0.2 mm voxel, 0.3 mm voxel, respectively). No statistically significant difference was found between any of the CBCT measurements in comparison to the micro-CT evaluations.

Conclusion: Although external root resorption is a small object to evaluate using CBCT, larger voxel sizes (e.g., 0.3 mm) of CBCT systems can be employed during scanning without compromising image quality.

Keywords

Cone-beam computed tomography external root resorption micro computed tomography imaging parameters

Thanks

I would like to thank my esteemed professor Prof Dr Pelin Güneri for reviewing the article and making suggestions

References

  • Kamburoğlu K, Kurşun S, Yüksel S, Oztaş B. Observer ability to detect ex vivo simulated internal or external cervical root resorption. J Endod 2011;37:168-75. google scholar
  • Neves FS, Vasconcelos TV, Vaz SL, Freitas DQ, Haiter-Neto F. Evaluation of reconstructed images with different voxel sizes of acquisition in the diagnosis of simulated external root resorption using cone beam computed tomography. Int Endod J 2012;45:234-9. google scholar
  • Creanga AG, Geha H, Sankar V, Teixeira FB, McMahan CA, Noujeim M. Accuracy of digital periapical radiography and cone-beam computed tomography in detecting external root resorption. Imaging Sci Dent 2015;45:153-8. google scholar
  • Andreasen JO. Luxation of permanent teeth due to trauma. A clinical and radiographic follow-up study of 189 injured teeth. Scand J Dent Res 1970; 78: 273-86. google scholar
  • Heithersay GS. Invasive cervical resorption. Endod Topics 2004;7:73-92. google scholar
  • Makkes PC, Thoden van Velzen SK. Cervical external root resorption. J Dent 1975;3:217-22. google scholar
  • Alqerban A, Jacobs R, Souza PC, Willems G. In-vitro comparison of 2 cone-beam computed tomography systems and panoramic imaging for detecting simulated canine impaction-induced external root resorption in maxillary lateral incisors. Am J Orthod Dentofacial Orthop 2009; 136:764-5. google scholar
  • Patel S, Foschi F, Condon R, Pimentel T, Bhuva B. External cervical resorption: part 2 - management. Int Endod J 2018;51:1224-38. google scholar
  • Dalili Z, Taramsari M, Mousavi Mehr SZ, Salamat F. Diagnostic value of two modes of cone-beam computed tomography in evaluation of simulated external root resorption: an in vitro study. Imaging Sci Dent 2012;42:19-24. google scholar
  • Bender IB. Factors influencing the radiographic appearance of bony lesions. J Endod 1982;8:161-70. google scholar
  • Goldberg F, De Silvio A, Dreyer C. Radiographic assessment of simulated external root resorption cavities in maxillary incisors. Endod Dent Traumatol 1998;14:133-6. google scholar
  • Saccomanno S, Passarelli PC, Oliva B, Grippaudo C. Comparison between Two Radiological Methods for Assessment of Tooth Root Resorption: An In Vitro Study. Hindawi BioMed Researc Int 2018:5152172. google scholar
  • Dudic A, Giannopoulou C, Leuzinger M, Kiliaridis S. Detection of apical root resorption after orthodontic treatment by using panoramic radiography and cone-beam computed tomography of super-high resolution. Am J Orthod Dentofacial Orthop 2009;135:434-7. google scholar
  • Andreasen JO. Experimental dental traumatology: development of a model for external root resorption. Dental Traumatology 1987;3:269-87. google scholar
  • Chapnick L. External root resorption: an experimental radiographic evaluation. Oral Surg Oral Med Oral Pathol 1989;67:578-82. google scholar
  • Nance RS, Tyndall D, Levin LG, Trope M. Diagnosis of external root resorption using TACT (tuned-aperture computed tomography). Endod Dent Traumatol 2000;16:24-8. google scholar
  • Bjorndal L, Carlsen O, Thuesen G, Darvann T, Kreiborg S. External and internal macromorphology in 3D-reconstructed maxillary molars using computerized X-ray microtomography. Int Endod J 1999;32:3-9. google scholar
  • Kamburoglu K, Barenboim SF, Kaffe I. Comparison of conventional film with different digital and digitally filtered images in the detection of simulated internal resorption cavities: an ex vivo study in human cadaver jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:790-7. google scholar
  • Patel S, Dawood A, Whaites E, Pitt Ford T. New dimensions in endodontic imaging: part 1-conventional and alternative radiographic systems. Int Endod J 2009;42:447-62. google scholar
  • Friedland B, Faiella RA, Bianchi J. Use of rotational tomography for assessing internal resorption. J Endod 2001;27:797-9. google scholar
  • Lima TF, Gamba TO, Zaia AA, Soares AJ. Evaluation of cone beam computed tomography and periapical radiography in the diagnosis of root resorption. Aust Dent J 2016;61:425-31. google scholar
  • White SC, Pharoah MJ. The Evolution and Application of Dental Maxillofacial Imaging Modalities. Dent Clin North Am. 2008;52:689-705. google scholar
  • Scarfe WC, Farman AG. What is Cone-Beam CT and How Does it Work? Dent Clin North Am. 2008;52:707-30. google scholar
  • Farman AG, Scarfe WC. The Basics of Maxillofacial Cone Beam Computed Tomography. Semin Orthod 2009;15:2-13. google scholar
  • Scarfe WC, Farman A. Cone-Beam Computed Tomography: White S.C., Pharoah M.J. Oral Radiology: Principles and Interpretation. 2009;Mosby 225-43. google scholar
  • Scarfe WC, Farman AG, Sukovic P. Clinical Applications of Cone-Beam Computed Tomography in Dental Practice. J Can Dent Assoc 2006;72:75-80. google scholar
  • Carter L, Farman AG, Geist J, Scarfe WC, Angelopoulos C, Nair MK, Hildebolt CF, Tyndall D, Shrout M. American Academy of Oral and Maxillofacial Radiology executive opinion statement on performing and interpreting diagnostic cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:561-2. google scholar
  • Patel S, Lambrechts P, Shemesh H, Mavridou A. European Society of Endodontology position statement: External Cervical Resorption. Int Endod J 2018;51:1323-6. google scholar
  • Parrales-Bravo C, Friedrichsdorf SP, Costa C, Paiva JB, Iglesias-Linares A. Does endodontics influence radiological detection of external root resorption? an in vitro study. BMC Oral Health. 2023;23:221. google scholar
  • Saoud TM, Mistry S, Kahler B, Sigurdsson A, Lin LM. Regenerative Endodontic Procedures for Traumatized Teeth after Horizontal Root Fracture, Avulsion, and Perforating Root Resorption. J Endod 2016;42:1476-82. google scholar
  • Matny LE, Ruparel NB, Levin MD, Nouj eim M, Diogenes A. A Volumetric Assessment of External Cervical Resorption Cases and Its Correlation to Classification, Treatment Planning, and Expected Prognosis. J Endod 2020;46:1052-8. google scholar
  • Saoud TM, Mistry S, Kahler B, Sigurdsson A, Lin LM. Regenerative Endodontic Procedures for Traumatized Teeth after Horizontal Root Fracture, Avulsion, and Perforating Root Resorption. J Endod 2016;42:1476-82. google scholar
  • Nosrat A, Dianat O, Verma P, Levin MD, Price JB, Aminoshariae A, Rizzante FAP. External Cervical Resorption: A Volumetric Analysis on Evolution of Defects over Time. J Endod 2023;49:36-44. google scholar
  • Pauwels R, Silkosessak O, Jacobs R, Bogaerts R, Bosmans H, Panmekiate S. A pragmatic approach to determine the optimal kVp in cone beam CT: balancing contrast-to-noise ratio and radiation dose. Dentomaxillofac Radiol 2014;43:20140059. google scholar
  • Katkar R, Steffy DD, Noujeim M, Deahl ST, Geha H. The effect of milliamperage, number of basis images, and export slice thickness on contrast-to-noise ratio and detection of mandibular canal on cone beam computed tomography scans: an in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol 2016;122:646-53. google scholar
  • Special Committee to Revise the Joint AAE/AAOMR Position Statement on use of CBCT in Endodontics. AAE and AAOMR Joint Position Statement: Use of Cone Beam Computed Tomography in Endodontics 2015 Update. Oral Surg Oral Med Oral Pathol Oral Radiol 2015;120:508-12. google scholar
  • White SC, Pharoah MJ. Oral Radiology: Principles and Interpretation. 8th Edition. 2018 google scholar
  • Hatcher DC. Operational principles for cone-beam computed tomography. J Am Dent Assoc 2010;141:3-6. google scholar
  • Hirsch E, Wolf U, Heinicke F, Silva MA. Dosimetry of the cone beam computed tomography Veraviewepocs 3D compared with the 3D Accuitomo in different field of views. Dentomaxillofac Radiol 2008;37:268-73. google scholar
  • Freitas DQ, Nascimento EHL, Vasconcelos TV, Noujeim M. Diagnosis of external root resorption in teeth close and distant to zirconium implants: influence of acquisition parameters and artefacts produced during cone beam computed tomography. Int Endod J 2019;52: 866-73. google scholar
  • Liedke GS, da Silveira HE, Silveira HL, Dutra V, de Figueiredo JA. influence of voxel size in the diagnostic ability of cone beam tomography to evaluate simulated external root resorption. J Endod 2009;35:233-5. google scholar
  • Koç A, Sezgin ÖS, Kayıpmaz S. Comparing different planimetric methods on volumetric estimations by using cone beam computed tomography. Radiol Med 2020;125:398-405. google scholar
  • Tsaousoglou P, Markou E, Efthimiades N, Vouros I. Characteristics and treatment of invasive cervical resorption in vital teeth. A narrative review and a report of two cases. Br Dent J 2017;222:423-8. google scholar
  • Heithersay GS. Clinical, radiologic, and histopathologic features of invasive cervical resorption. Quintessence Int 1999;30:27-37. google scholar
  • Patel S, Foschi F, Mannocci F, Patel K. External cervical resorption: a three-dimensional classification. Int Endod J 2018;51:206-14. google scholar
  • 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 Endod 2018;44:239-44. google scholar
  • Kolsuz ME, Eren H, Çelikten B, Dalgali Evli P, Demirtürk Kocasaraç H, Orhan K. influence of Cone-Beam Computed Tomography Voxel Sizes in the Detection of Chemically Induced External Root Resorptions. Med Sci Monit 2022;28:e936160. google scholar
  • Sönmez G, Koç C, Kamburoğlu K. Accuracy of linear and volumetric measurements of artificial ERR cavities by using CBCT images obtained at 4 different voxel sizes and measured by using 4 different software: an ex vivo research. Dentomaxillofac Radiol 2018;47:20170325. ~ google scholar
  • Deliga Schröder ÂG, Westphalen FH, Schröder JC, Fernandes Â, Westphalen VPD. Accuracy of Digital Periapical Radiography and Cone-beam Computed Tomography for Diagnosis of Natural and Simulated External Root Resorption. J Endod 2018;44;1151-8. google scholar

Year 2025, Volume: 59 Issue: 2, 77 - 83, 21.05.2025

Ayşe Gül Öner Talmaç , Alaettin Koç

https://doi.org/10.26650/eor.20241247459

Abstract

References

  • Kamburoğlu K, Kurşun S, Yüksel S, Oztaş B. Observer ability to detect ex vivo simulated internal or external cervical root resorption. J Endod 2011;37:168-75. google scholar
  • Neves FS, Vasconcelos TV, Vaz SL, Freitas DQ, Haiter-Neto F. Evaluation of reconstructed images with different voxel sizes of acquisition in the diagnosis of simulated external root resorption using cone beam computed tomography. Int Endod J 2012;45:234-9. google scholar
  • Creanga AG, Geha H, Sankar V, Teixeira FB, McMahan CA, Noujeim M. Accuracy of digital periapical radiography and cone-beam computed tomography in detecting external root resorption. Imaging Sci Dent 2015;45:153-8. google scholar
  • Andreasen JO. Luxation of permanent teeth due to trauma. A clinical and radiographic follow-up study of 189 injured teeth. Scand J Dent Res 1970; 78: 273-86. google scholar
  • Heithersay GS. Invasive cervical resorption. Endod Topics 2004;7:73-92. google scholar
  • Makkes PC, Thoden van Velzen SK. Cervical external root resorption. J Dent 1975;3:217-22. google scholar
  • Alqerban A, Jacobs R, Souza PC, Willems G. In-vitro comparison of 2 cone-beam computed tomography systems and panoramic imaging for detecting simulated canine impaction-induced external root resorption in maxillary lateral incisors. Am J Orthod Dentofacial Orthop 2009; 136:764-5. google scholar
  • Patel S, Foschi F, Condon R, Pimentel T, Bhuva B. External cervical resorption: part 2 - management. Int Endod J 2018;51:1224-38. google scholar
  • Dalili Z, Taramsari M, Mousavi Mehr SZ, Salamat F. Diagnostic value of two modes of cone-beam computed tomography in evaluation of simulated external root resorption: an in vitro study. Imaging Sci Dent 2012;42:19-24. google scholar
  • Bender IB. Factors influencing the radiographic appearance of bony lesions. J Endod 1982;8:161-70. google scholar
  • Goldberg F, De Silvio A, Dreyer C. Radiographic assessment of simulated external root resorption cavities in maxillary incisors. Endod Dent Traumatol 1998;14:133-6. google scholar
  • Saccomanno S, Passarelli PC, Oliva B, Grippaudo C. Comparison between Two Radiological Methods for Assessment of Tooth Root Resorption: An In Vitro Study. Hindawi BioMed Researc Int 2018:5152172. google scholar
  • Dudic A, Giannopoulou C, Leuzinger M, Kiliaridis S. Detection of apical root resorption after orthodontic treatment by using panoramic radiography and cone-beam computed tomography of super-high resolution. Am J Orthod Dentofacial Orthop 2009;135:434-7. google scholar
  • Andreasen JO. Experimental dental traumatology: development of a model for external root resorption. Dental Traumatology 1987;3:269-87. google scholar
  • Chapnick L. External root resorption: an experimental radiographic evaluation. Oral Surg Oral Med Oral Pathol 1989;67:578-82. google scholar
  • Nance RS, Tyndall D, Levin LG, Trope M. Diagnosis of external root resorption using TACT (tuned-aperture computed tomography). Endod Dent Traumatol 2000;16:24-8. google scholar
  • Bjorndal L, Carlsen O, Thuesen G, Darvann T, Kreiborg S. External and internal macromorphology in 3D-reconstructed maxillary molars using computerized X-ray microtomography. Int Endod J 1999;32:3-9. google scholar
  • Kamburoglu K, Barenboim SF, Kaffe I. Comparison of conventional film with different digital and digitally filtered images in the detection of simulated internal resorption cavities: an ex vivo study in human cadaver jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:790-7. google scholar
  • Patel S, Dawood A, Whaites E, Pitt Ford T. New dimensions in endodontic imaging: part 1-conventional and alternative radiographic systems. Int Endod J 2009;42:447-62. google scholar
  • Friedland B, Faiella RA, Bianchi J. Use of rotational tomography for assessing internal resorption. J Endod 2001;27:797-9. google scholar
  • Lima TF, Gamba TO, Zaia AA, Soares AJ. Evaluation of cone beam computed tomography and periapical radiography in the diagnosis of root resorption. Aust Dent J 2016;61:425-31. google scholar
  • White SC, Pharoah MJ. The Evolution and Application of Dental Maxillofacial Imaging Modalities. Dent Clin North Am. 2008;52:689-705. google scholar
  • Scarfe WC, Farman AG. What is Cone-Beam CT and How Does it Work? Dent Clin North Am. 2008;52:707-30. google scholar
  • Farman AG, Scarfe WC. The Basics of Maxillofacial Cone Beam Computed Tomography. Semin Orthod 2009;15:2-13. google scholar
  • Scarfe WC, Farman A. Cone-Beam Computed Tomography: White S.C., Pharoah M.J. Oral Radiology: Principles and Interpretation. 2009;Mosby 225-43. google scholar
  • Scarfe WC, Farman AG, Sukovic P. Clinical Applications of Cone-Beam Computed Tomography in Dental Practice. J Can Dent Assoc 2006;72:75-80. google scholar
  • Carter L, Farman AG, Geist J, Scarfe WC, Angelopoulos C, Nair MK, Hildebolt CF, Tyndall D, Shrout M. American Academy of Oral and Maxillofacial Radiology executive opinion statement on performing and interpreting diagnostic cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:561-2. google scholar
  • Patel S, Lambrechts P, Shemesh H, Mavridou A. European Society of Endodontology position statement: External Cervical Resorption. Int Endod J 2018;51:1323-6. google scholar
  • Parrales-Bravo C, Friedrichsdorf SP, Costa C, Paiva JB, Iglesias-Linares A. Does endodontics influence radiological detection of external root resorption? an in vitro study. BMC Oral Health. 2023;23:221. google scholar
  • Saoud TM, Mistry S, Kahler B, Sigurdsson A, Lin LM. Regenerative Endodontic Procedures for Traumatized Teeth after Horizontal Root Fracture, Avulsion, and Perforating Root Resorption. J Endod 2016;42:1476-82. google scholar
  • Matny LE, Ruparel NB, Levin MD, Nouj eim M, Diogenes A. A Volumetric Assessment of External Cervical Resorption Cases and Its Correlation to Classification, Treatment Planning, and Expected Prognosis. J Endod 2020;46:1052-8. google scholar
  • Saoud TM, Mistry S, Kahler B, Sigurdsson A, Lin LM. Regenerative Endodontic Procedures for Traumatized Teeth after Horizontal Root Fracture, Avulsion, and Perforating Root Resorption. J Endod 2016;42:1476-82. google scholar
  • Nosrat A, Dianat O, Verma P, Levin MD, Price JB, Aminoshariae A, Rizzante FAP. External Cervical Resorption: A Volumetric Analysis on Evolution of Defects over Time. J Endod 2023;49:36-44. google scholar
  • Pauwels R, Silkosessak O, Jacobs R, Bogaerts R, Bosmans H, Panmekiate S. A pragmatic approach to determine the optimal kVp in cone beam CT: balancing contrast-to-noise ratio and radiation dose. Dentomaxillofac Radiol 2014;43:20140059. google scholar
  • Katkar R, Steffy DD, Noujeim M, Deahl ST, Geha H. The effect of milliamperage, number of basis images, and export slice thickness on contrast-to-noise ratio and detection of mandibular canal on cone beam computed tomography scans: an in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol 2016;122:646-53. google scholar
  • Special Committee to Revise the Joint AAE/AAOMR Position Statement on use of CBCT in Endodontics. AAE and AAOMR Joint Position Statement: Use of Cone Beam Computed Tomography in Endodontics 2015 Update. Oral Surg Oral Med Oral Pathol Oral Radiol 2015;120:508-12. google scholar
  • White SC, Pharoah MJ. Oral Radiology: Principles and Interpretation. 8th Edition. 2018 google scholar
  • Hatcher DC. Operational principles for cone-beam computed tomography. J Am Dent Assoc 2010;141:3-6. google scholar
  • Hirsch E, Wolf U, Heinicke F, Silva MA. Dosimetry of the cone beam computed tomography Veraviewepocs 3D compared with the 3D Accuitomo in different field of views. Dentomaxillofac Radiol 2008;37:268-73. google scholar
  • Freitas DQ, Nascimento EHL, Vasconcelos TV, Noujeim M. Diagnosis of external root resorption in teeth close and distant to zirconium implants: influence of acquisition parameters and artefacts produced during cone beam computed tomography. Int Endod J 2019;52: 866-73. google scholar
  • Liedke GS, da Silveira HE, Silveira HL, Dutra V, de Figueiredo JA. influence of voxel size in the diagnostic ability of cone beam tomography to evaluate simulated external root resorption. J Endod 2009;35:233-5. google scholar
  • Koç A, Sezgin ÖS, Kayıpmaz S. Comparing different planimetric methods on volumetric estimations by using cone beam computed tomography. Radiol Med 2020;125:398-405. google scholar
  • Tsaousoglou P, Markou E, Efthimiades N, Vouros I. Characteristics and treatment of invasive cervical resorption in vital teeth. A narrative review and a report of two cases. Br Dent J 2017;222:423-8. google scholar
  • Heithersay GS. Clinical, radiologic, and histopathologic features of invasive cervical resorption. Quintessence Int 1999;30:27-37. google scholar
  • Patel S, Foschi F, Mannocci F, Patel K. External cervical resorption: a three-dimensional classification. Int Endod J 2018;51:206-14. google scholar
  • 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 Endod 2018;44:239-44. google scholar
  • Kolsuz ME, Eren H, Çelikten B, Dalgali Evli P, Demirtürk Kocasaraç H, Orhan K. influence of Cone-Beam Computed Tomography Voxel Sizes in the Detection of Chemically Induced External Root Resorptions. Med Sci Monit 2022;28:e936160. google scholar
  • Sönmez G, Koç C, Kamburoğlu K. Accuracy of linear and volumetric measurements of artificial ERR cavities by using CBCT images obtained at 4 different voxel sizes and measured by using 4 different software: an ex vivo research. Dentomaxillofac Radiol 2018;47:20170325. ~ google scholar
  • Deliga Schröder ÂG, Westphalen FH, Schröder JC, Fernandes Â, Westphalen VPD. Accuracy of Digital Periapical Radiography and Cone-beam Computed Tomography for Diagnosis of Natural and Simulated External Root Resorption. J Endod 2018;44;1151-8. google scholar
There are 49 citations in total.

Details

Primary Language English
Subjects Dentistry (Other)
Journal Section Original Research Articles
Authors

Ayşe Gül Öner Talmaç 0000-0002-0574-5779

Alaettin Koç 0000-0001-9984-6900

Publication Date May 21, 2025
Submission Date February 4, 2023
Published in Issue Year 2025 Volume: 59 Issue: 2

Cite

EndNote Öner Talmaç AG, Koç A (May 1, 2025) Comparison of the accuracy of different cone beam computed tomography systems in measuring the volume of external root resorption. European Oral Research 59 2 77–83.
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