Accuracy of digital periapical radiography and cone-beam computed tomography in detecting external root resorption

Adriana Gabriela Creanga, Hassem Geha, Vidya Sankar, Fabricio B. Teixeira, Clyde Alex McMahan, Marcel Noujeim

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


Purpose: The purpose of this study was to evaluate and compare the efficacy of cone-beam computed tomography (CBCT) and digital intraoral radiography in diagnosing simulated small external root resorption cavities. Materials and Methods: Cavities were drilled in 159 roots using a small spherical bur at different root levels and on all surfaces. The teeth were imaged both with intraoral digital radiography using image plates and with CBCT. Two sets of intraoral images were acquired per tooth: orthogonal (PA) which was the conventional periapical radiograph and mesioangulated (SET). Four readers were asked to rate their confidence level in detecting and locating the lesions. Receiver operating characteristic (ROC) analysis was performed to assess the accuracy of each modality in detecting the presence of lesions, the affected surface, and the affected level. Analysis of variation was used to compare the results and kappa analysis was used to evaluate interobserver agreement. Results: A significant difference in the area under the ROC curves was found among the three modalities (P=0.0002), with CBCT (0.81) having a significantly higher value than PA (0.71) or SET (0.71). PA was slightly more accurate than SET, but the difference was not statistically significant. CBCT was also superior in locating the affected surface and level. Conclusion: CBCT has already proven its superiority in detecting multiple dental conditions, and this study shows it to likewise be superior in detecting and locating incipient external root resorption.

Original languageEnglish (US)
Pages (from-to)153-158
Number of pages6
JournalImaging Science in Dentistry
Issue number3
StatePublished - 2015


  • Cone-Beam Computed Tomography
  • Dental Digital Radiography
  • Root Resorption

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • General Dentistry
  • Radiology Nuclear Medicine and imaging


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