Accurate assessment of intraosseous lesion dimensions is useful in determining strategies for treatment of periradicular pathoses of dental causation.
Objectives: To compare the efficacy of digital versus analog imaging for the measurement of mesiodistal and vertical dimensions of periapical lesions in patients that require apical surgery.
Methods: Fourteen examiners assessed the dimensions of 28 lesions with a millimeter ruler and Ektaspeed Plus radiographs (Eastman Kodak, Rochester, N.Y.), and with the Visualix-2 (Gendex/Dentsply, Milan, Italy) in unenhanced, contrast-stretched and equalized modes with proprietary software mouse-driven measurement algorithm. Impregum F (Premier Dental Products) impressions at surgery were used as the "gold standard." Ten randomly chosen images were reread 2 weeks later to assess intra-operator reliability. As the Mauchly sphericity test was significant for all tests, a multivariate analysis of variance was used to assess accuracy. To explain the exact difference between means, the Bonferroni test was applied. Intra-observer reliability was assessed with Friedman's two-way analysis of variance; inter-observer effects were determined with Cronbach's alpha.
Results: For accuracy in measurement, the closest to the "gold standard" were achieved with the Visualix-2 with image equalization. The contrast-stretched Visualix-2 and unenhanced Visualix-2 measurements were less accurate; conventional film was consistently the least accurate (p < 0.002). On the other hand, subjective preference placed film radiographs above the unenhanced Visualix-2 images; contrast-stretched Visualix-2 images were preferred over all other modalities.
Conclusions: Charge-coupled device-based images with the Visualix-2 are preferable to film-based radiographs for measuring periapical lesion dimensions.