Radiographic and CBCT Study of Apical Inflammatory Root Resorption

Objectives: This study aimed to detect apical inflammatory root resorption (AIRR) in teeth with apical periodontitis by using conventional periapical radiographic (CPR) and cone-beam computed tomographic (CBCT) imaging methods.
Methods: The study sample consisted of 14 patients, 6 males and 8 females, aged between 18-64 years, and referred to dental emergency service for tooth extraction. A total of 52 permanent teeth were extracted, 6 anterior, 23 premolars, and 23 molars, which allowed the analysis of 88 root apexes for the presence or absence of AIRR. Two previously calibrated examiners evaluated all conventional periapical radiographs (CPR) and CBCT images. When no agreement has been reached between both observers as to the diagnosis of AIRR, they would re-assess the images together to attain a consensus. Comparative statistical analysis between the different methods for detection of AIRR was performed using the Chi-square test, and the level of statistical significance was set at 5%. The Kappa coefficient was used to assess the inter-observer agreement.
Results: The Kappa coefficient for the inter-observer agreement was 0.83. Apical inflammatory root resorption was observed in 11.4% (n=10) and 23.9% (n=21) of the root apexes analyzed using CPR and CBCT, respectively (P<0.05). Statistical analysis revealed no significant difference between imaging methods in the detection of AIRR regarding tooth position (anterior, premolar, and molar teeth) and root type (mesiobuccal, palatal, distobuccal, mesial, distal, buccal, single and fused) (P>0.05).
Conclusions: Apical inflammatory root resorption may be present but not radiographically visible. Despite the diagnostic performance of CBCT to detect AIRR, improvements are needed to increase the diagnostic power of this imaging method.