A COMPARATIVE STUDY TO EVALUATE THE ACCURACY OF CBCT, DIGITAL RADIOGRAPHY AND INTRA ORAL PERIAPICAL RADIOGRAPHY FOR THE ASSESSMENT OF THE ANATOMY OF THE MAXILLARY SECOND PREMOLAR ROOT CANALS: AN INVITRO STUDY.

Abstract

Aim: To compare the accuracy of CBCT, Digital Radiography and Intra Oral Periapical Radiography in evaluating the root canal morphology of the maxillary second premolar teeth.
Methodology: 76 freshly extracted maxillary second premolars obtained without any cracks, fractures or external root resorption was selected. The peripheral part of samples was covered with modeling wax to simulate soft tissue Samples are then subjected to intra oral periapical radiography, digital radiography and CBCT. All the stages were performed by a trained operator. Exposure parameters were set at 65 kVp, 7.5 mA and an exposure time of 0.80 seconds for conventional radiographs and 0.40 seconds for digital radiographs. The distance between the buccal surface and the focal spot was 20 inches. The E-speed film (Kodak) was used in the conventional method. The films were developed in the same day Digital image were taken by direct system using CCD receptor of 23w14%4mm size. The images were prepared with Adstra software. CBCT scans were carried out using Planmeca Promax 3D (Planmeca, Helsinki,). The images were taken at 84 kVp, 6 mA and 12 sec exposure. The field of view (FOV) was set at 5%5 cm with the pixel size of 0.16 mm and bit depth of 15. The images were analyzed by Planmeca Romexis Viewer
Results: Type ll configuration (35.59%) according to vertucci's classification was most prevalent in 1OPAR group followed by Type IV configuration (31.6%), Type (28.9%), Type V(2.6%), Type lll (1.3%). In RVG group Type I configuration (34.2%) according to vertucci’s classification was most prevalent followed by Type II configuration (31.6%), Type IV (30.6%), Type V(2.6%), Type III (1.3%). In CBCT group 1ype ll configuration (35.5%) according to vertucci’s classification was most prevalent followed by Type lV configuration (32.9%), Type I (28.9%), Type V (1.3%), Type III (1.3%).
In general, according to the kappa statistical test, the agreement between 1OPAR and digital radiographic imaging in canal configuration was 924 (P-0.001). On the other hand, in terms of canal configuration based on Vertucci's classifications, the agreement between CBCT and lOPAR is .942 (P=0.001). Totally, in terms of canal counts, the agreement between CBCT and 1OPAR 1s .866 (P=0.001). On comparing the groups, statistically significant results obtained with Group III (CBCT) Suggesting a better efficiency for CBCT in evaluating the root canal morphology than Group I (RVG) & II (1OPAR).
Interpretation & Conclusion: Within the limitations of this study, it is concluded that ,the accuracy in determining the root canal morphology was increased by use of CBCT scan in comparison with Digital Radiography, Intra Oral Periapical Radiography.
Keywords: Root Canal Morphology,