Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
권호 표지
DOI QR코드

DOI QR Code

Evaluation of ultrasonography as a diagnostic tool in the management of periapical cysts and granulomas: A clinical study

  • Avci, Fatma (Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Erciyes) ;
  • Etoz, Meryem (Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Erciyes) ;
  • Ustun, Yakup (Department of Endodontics, Faculty of Dentistry, University of Erciyes) ;
  • Arslan, Tugrul (Department of Endodontics, Faculty of Dentistry, University of Erciyes)
  • Received : 2021.09.22
  • Accepted : 2022.12.27
  • Published : 2022.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The aim of this study was, firstly, to determine the concordance of ultrasonographic and histopathological diagnoses in patients in whom apical resection was already indicated. Secondly, this study aimed to determine whether lesions were periapical granulomas or cysts, and to compare them after root canal treatment using ultrasonography and periapical radiographs. Materials and Methods: In the first stage of the study, ultrasonographic and histopathologic diagnoses of 10 lesions were compared. Secondly, the periapical radiographs and ultrasonographic images of 44 lesions were measured. The presence of internal vascularity was determined by ultrasonographic color and power Doppler modes. Follow-up examinations of healing after root canal treatment were performed using ultrasonography and periapical radiographs, and these modalities were compared. Results: In the periapical granuloma and cyst groups, the measurement values decreased for all variables. There was no significant difference in the dimensional changes of lesions between the 2 groups, and ultrasonography and periapical radiographs were compatible. The pre-diagnoses were compared with histopathological diagnoses and were found to be compatible. Conclusion: The ultrasonographic color and power Doppler techniques could be an effective method for diagnosing periapical lesions as cysts or granulomas. After root canal treatment of granulomas and cysts, the dimensional shrinkage and healing patterns appear to be similar. Ultrasonography and periapical radiographs were consistent in terms of dimensional comparisons, and ultrasonography may be an alternative method for follow-up of the healing of periapical lesions.

Keywords

References

  1. Raghav N, Reddy SS, Giridhar AG, Murthy S, Yashodha Devi BK, Santana N, et al. Comparison of the efficacy of conventional radiography, digital radiography, and ultrasound in diagnosing periapical lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110: 379-85. https://doi.org/10.1016/j.tripleo.2010.04.039
  2. Lin LM, Ricucci D, Lin J, Rosenberg PA. Nonsurgical root canal therapy of large cyst-like inflammatory periapical lesions and inflammatory apical cysts. J Endod 2009; 35: 607-15. https://doi.org/10.1016/j.joen.2009.02.012
  3. Nair PN. New perspectives on radicular cysts: do they heal? Int Endod J 1998; 31: 155-60. https://doi.org/10.1046/j.1365-2591.1998.00146.x
  4. Musu D, Rossi-Fedele G, Campisi G, Cotti E. Ultrasonography in the diagnosis of bone lesions of the jaws: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122: e19-29. https://doi.org/10.1016/j.oooo.2016.03.022
  5. Shahidi S, Shakibafard A, Zamiri B, Mokhtare MR, Houshyar M, Mahdian S. The feasibility of ultrasonography in defining the size of jaw osseous lesions. J Dent (Shiraz) 2015; 16: 335-40.
  6. Rajendran N, Sundaresan B. Efficacy of ultrasound and color power Doppler as a monitoring tool in the healing of endodontic periapical lesions. J Endod 2007; 33: 181-6. https://doi.org/10.1016/j.joen.2006.07.020
  7. Cotti E, Campisi G, Ambu R, Dettori C. Ultrasound real-time imaging in the differential diagnosis of periapical lesions. Int Endod J 2003; 36: 556-63. https://doi.org/10.1046/j.1365-2591.2003.00690.x
  8. Goel S, Nagendrareddy SG, Raju MS, Krishnojirao DR, Rastogi R, Mohan RP, et al. Ultrasonography with color Doppler and power Doppler in the diagnosis of periapical lesions. Indian J Radiol Imaging 2011; 21: 279-83. https://doi.org/10.4103/0971-3026.90688
  9. Aggarwal V, Singla M. Use of computed tomography scans and ultrasound in differential diagnosis and evaluation of nonsurgical management of periapical lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: 917-23. https://doi.org/10.1016/j.tripleo.2009.12.055
  10. Torabinejad M, Fouad AF, Walton RE. Endodontics: principles and practice. St. Louis: Elsevier; 2015. p. 51-67.
  11. Gulsahi A, Yuzugullu B, Imirzalioglu P, Genc Y. Assessment of panoramic radiomorphometric indices in Turkish patients of different age groups, gender and dental status. Dentomaxillofac Radiol 2008; 37: 288-92. https://doi.org/10.1259/dmfr/19491030
  12. Nobuhara WK, del Rio CE. Incidence of periradicular pathoses in endodontic treatment failures. J Endod 1993; 19: 315-8. https://doi.org/10.1016/S0099-2399(06)80464-4
  13. Ishii J, Nagasawa H, Wadamori T, Yamashiro M, Ishikawa H, Yamada T, et al. Ultrasonography in the diagnosis of palatal tumors. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 87: 39-43. https://doi.org/10.1016/S1079-2104(99)70292-1
  14. Lauria L, Curi MM, Chammas MC, Pinto DS, Torloni H. Ultrasonography evaluation of bone lesions of the jaw. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996; 82: 351-7. https://doi.org/10.1016/S1079-2104(96)80365-9
  15. Tiwari B, Krishnan M, Popli M, Iyer SR, Arora V. Ultrasonography and color Doppler in the differential diagnosis of periapical cyst and granuloma. J Contemp Dent 2014; 4: 17-21. https://doi.org/10.5005/jp-journals-10031-1062
  16. Sumer AP, Danaci M, Ozen Sandikci E, Sumer M, Celenk P. Ultrasonography and Doppler ultrasonography in the evaluation of intraosseous lesions of the jaws. Dentomaxillofac Radiol 2009; 38: 23-7. https://doi.org/10.1259/dmfr/20664232
  17. Tikku AP, Kumar S, Loomba K, Chandra A, Verma P, Aggarwal R. Use of ultrasound, color Doppler imaging and radiography to monitor periapical healing after endodontic surgery. J Oral Sci 2010; 52: 411-6. https://doi.org/10.2334/josnusd.52.411
  18. Adibi S, Shakibafard A, Karimi Sarvestani Z, Saadat N, Khojastepour L. Effect of cortical bone thickness on detection of intraosseous lesions by ultrasonography. Radiol Res Pract 2015: 2015; 797593. https://doi.org/10.1155/2015/797593
  19. Maity I, Kumari A, Shukla AK, Usha H, Naveen D. Monitoring of healing by ultrasound with color power doppler after root canal treatment of maxillary anterior teeth with periapical lesions. J Conserv Dent 2011; 14: 252-7. https://doi.org/10.4103/0972-0707.85804
  20. Tikku AP, Bharti R, Sharma N, Chandra A, Kumar A, Kumar S. Role of ultrasound and color doppler in diagnosis of periapical lesions of endodontic origin at varying bone thickness. J Conserv Dent 2016; 19: 147-51. https://doi.org/10.4103/0972-0707.178694
  21. Parvathy V, Kumar R, James EP, George S. Ultrasound imaging versus conventional histopathology in diagnosis of periapical lesions of endodontic origin: a comparative evaluation. Indian J Dent Res 2014; 25: 54-7. https://doi.org/10.4103/0970-9290.131124
  22. Cotti E, Campisi G, Garau V, Puddu G. A new technique for the study of periapical bone lesions: ultrasound real time imaging. Int Endod J 2002; 35: 148-52. https://doi.org/10.1046/j.1365-2591.2002.00458.x
  23. Gundappa M, Ng SY, Whaites EJ. Comparison of ultrasound, digital and conventional radiography in differentiating periapical lesions. Dentomaxillofac Radiol 2006; 35: 326-33. https://doi.org/10.1259/dmfr/60326577
  24. Gad K, Ellabban M, Sciubba J. Utility of transfacial dental ultrasonography in evaluation of cystic jaw lesions. J Ultrasound Med 2018; 37: 635-44. https://doi.org/10.1002/jum.14374
  25. Sonmez G, Kamburoglu K, Yilmaz F, Koc C, Baris E, Tuzuner A. Versatility of high resolution ultrasonography in the assessment of granulomas and radicular cysts: a comparative in vivo study. Dentomaxillofac Radiol 2019; 48: 20190082. https://doi.org/10.1259/dmfr.20190082
  26. Prince CN, Annapurna CS, Sivaraj S, Ali IM. Ultrasound imaging in the diagnosis of periapical lesions. J Pharm Bioallied Sci 2012; 4 (Suppl 2): S369-72.
  27. Fernandes M, De Ataide I. Non-surgical management of a large periapical lesion using a simple aspiration technique: a case report. Int Endod J 2010; 43: 536-42. https://doi.org/10.1111/j.1365-2591.2010.01719.x
  28. Ozan U, Er K. Endodontic treatment of a large cyst-like periradicular lesion using a combination of antibiotic drugs: a case report. J Endod 2005; 31: 898-900. https://doi.org/10.1097/01.don.0000164129.74235.8e
  29. Caliskan MK. Prognosis of large cyst-like periapical lesions following nonsurgical root canal treatment: a clinical review. Int Endod J 2004; 37: 408-16. https://doi.org/10.1111/j.1365-2591.2004.00809.x
  30. Nair P, Sjogren U, Schumacher E, Sundqvist G. Radicular cyst affecting a root-filled human tooth: a long-term post-treatment follow-up. Int Endod J 1993; 26: 225-33. https://doi.org/10.1111/j.1365-2591.1993.tb00563.x
  31. Ramachandran Nair PN, Pajarola G, Schroeder HE. Types and incidence of human periapical lesions obtained with extracted teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996; 81: 93-102. https://doi.org/10.1016/S1079-2104(96)80156-9
  32. Soares JA, Brito-Junior M, Silveira FF, Nunes E, Santos SM. Favorable response of an extensive periapical lesion to root canal treatment. J Oral Sci 2008; 50: 107-11. https://doi.org/10.2334/josnusd.50.107
  33. Franzen R, Gutknecht N, Falken S, Heussen N, Meister J. Bactericidal effect of a Nd: YAG laser on Enterococcus faecalis at pulse durations of 15 and 25 ms in dentine depths of 500 and 1,000 ㎛. Lasers Med Sci 2011; 26: 95-101. https://doi.org/10.1007/s10103-010-0826-5
  34. Ricucci D, Pascon EA, Ford TR, Langeland K. Epithelium and bacteria in periapical lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101: 239-49. https://doi.org/10.1016/j.tripleo.2005.03.038