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Clinical Oral Investigations

Published in:

01-01-2018 | Original Article

Ultrasound examination with color power Doppler to assess the early response of apical periodontitis to the endodontic treatment

Authors: Elisabetta Cotti, Stefano Andrea Esposito, Davide Musu, Girolamo Campisi, Hagay Shemesh

Published in: Clinical Oral Investigations | Issue 1/2018

Abstract

Objectives

The purpose of this study was to assess the possibility to detect early vascular changes in apical periodontitis (AP) using ultrasound examination with color power Doppler (US-CPD) and to establish a correlation between the early response of AP to treatment and its potential healing.

Materials and methods

Twenty-one apical lesions were visualized with US-CPD before endodontic treatment, 1 week after the first access to endodontic system and 4 weeks after root canal obturation. A differential diagnosis between cystic lesions (CLs) and granulomatous lesions (GLs) was attempted. The vascular modifications were then correlated with long-term radiographic follow-up using Fisher’s exact test.

Results

The decrease or disappearance of vascular flow observed in AP 4 weeks after root canal obturation was significantly related to a healing trend (p = 0.0206) of the lesions. Combining the data with preoperative US-CPD diagnosis showed a reproducibility for GLs only (p = 0.0022).

Conclusions

This study showed the possibility to detect early vascular changes in AP using US-CPD, correlating them with a healing trend after endodontic treatment. Future investigations should be conducted and more attention should be dedicated to the potential of this alternative and biologically safe imaging technique.

Clinical relevance

US-CPD in endodontics may be a helpful tool to identify healing processes after endodontic treatment and to understand the behavior of different forms of AP.

Moore CL, Copel JA (2011) Point-of-care ultrasonography. N Engl J Med 364:749–757. doi:10.1056/NEJMra0909487 CrossRefPubMed

Duck FA (2001) Recent epidemiology papers: european committee for medical ultrasound safety. Ultraschall Med 13:227–231. doi:10.1016/S0929-8266(01)00133-1

Salvesen KA (2002) Epidemiology of diagnostic ultrasound exposure during pregnancy. Ultraschall Med 15:165–171. doi:10.1016/S0929-8266(02)00038-1

Cotti E, Campisi G, Garau V, Puddu G (2002) A new technique for the study of periapical bone lesions: ultrasound real time imaging. Int Endod J 35:148–152. doi:10.1046/j.1365-2591.2002.00458.x CrossRefPubMed

McDicken WN, Anderson T (2002) The difference between colour Doppler velocity imaging and power Doppler imaging. Eur J of Echocardiogr 3:240–244. doi:10.1053/euje.2002.0150 CrossRef

Martin K (2011) Basic equipment, components and image production. In: Allan PL, Baxter GM, Weston M (eds) Clinical ultrasound, 3rd edn. Churchill Livingstone, Edinburg, pp 16–30CrossRef

Cotti E, Campisi G, Ambu R, Dettori C (2003) Ultrasound real-time imaging in the differential diagnosis of periapical lesions. Int Endod J 36:556–563. doi:10.1046/j.1365-2591.2003.00690.x CrossRefPubMed

Gundappa M, Ng SY, Whaites EJ (2006) Comparison of ultrasound, digital and conventional radiography in differentiating periapical lesions. Dentomaxillofac Radiol 35:326–333. doi:10.1259/dmfr/60326577 CrossRefPubMed

Sumer AP, Danaci M, Sandikci EO, Sumer M, Celenk P (2009) Ultrasonography and Doppler ultrasonography in the evaluation of intraosseus lesios of the jaws. Dentomaxillofac Radiol 38:23–27. doi:10.1259/dmfr/20664232 CrossRefPubMed

10.

Sandhu SS, Singh S, Arora S, Sandhu AK, Dhingra R (2015) Comparative evaluation of advanced and conventional diagnostic aids for endodontic management of periapical lesions, an in vivo study. J Clin Diagn Res 9:1–4. doi:10.7860/JCDR/2015/9301.5360 CrossRef

11.

Musu D, Rossi-Fedele G, Campisi G, Cotti E (2016) Ultrasonography in the diagnosis of bone lesions of the jaws: a systematic review of the literature. Oral Med Oral Surg Oral Pathol Oral Radiol 122:e19–e29. doi:10.1016/j.oooo.2016.03.022 CrossRef

12.

Rajendran N, Sundaresan B (2007) Efficacy of ultrasound and color power Doppler as a monitoring tool in the healing of endodontic periapical lesions. J Endod 33:181–186. doi:10.1016/j.joen.2006.07.020 CrossRefPubMed

13.

Maity I, Kumari A, Shukla AK, Usha HL, Naveen DN (2011) Monitoring of healing by ultrasound with color power doppler after root canal treatment of maxillary anterior teeth with periapical lesions. J Conserv Dent 14:252–257. doi:10.4103/0972-0707.85804 CrossRefPubMedPubMedCentral

14.

Tikku AP, Kumar S, Loomba K, Chandra A, Verma P, Aggarwal R (2010) Use of ultrasound, color Doppler imaging and radiography to monitor periapical healing after endodontic surgery. J Oral Sci 52:411–416. doi:10.2334/josnusd.52.411 CrossRefPubMed

15.

Dessi C, Demartis P, Campisi G, Cotti E (2009) Use of ultrasound real-time examination and colour –doppler to evaluate initial response to root canal treatment (Abstract). Int Endod J 42:1139

16.

Jafarzadeh H, Abbott PV (2010) Review of pulp sensibility tests. Part I: general information and thermal tests. Int Endod J 43:738–762. doi:10.1111/j.1365-2591.2010.01754.x CrossRefPubMed

17.

Bhaskar SN (1966) Periapical lesions-types, incidence, and clinical features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 21:657–671CrossRef

18.

Goldman M, Pearson A, Darzenta N (1974) Reliability of radiographic interpretations. Oral Surg Oral Med Oral Pathol 38:287–293CrossRefPubMed

19.

Ramfjord SP (1967) The Periodontal Disease Index (PDI). J Periodontol 38:602–610. doi:10.1902/jop.1967.38.6.602 CrossRef

20.

AAE & AAOM (2015) AAE and AAOM joint position statement American Association of Endodontists/American Academy of Oral and Maxillofacial Radiology (online). Use of cone beam computed tomography in endodontics. https://www.aae.org/uploadedfiles/clinical_resources/guidelines_and_position_statements/cbctstatement_2015update.pdf. Accessed August 17 2016

21.

Kim S, Kratchman S (2006) Modern endodontic surgery concepts and practice: a review. J Endod 32:601–623. doi:10.1016/j.joen.2005.12.010 CrossRefPubMed

22.

Ng YL, Mann V, Gulabivala K (2011) A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. Int Endod J 44:583–609. doi:10.1111/j.1365-2591.2011.01872.x CrossRefPubMed

23.

Nair PNR (2006) On the cause of persistent apical periodontitis: a review. Int Endod J 39:246–281. doi:10.1111/j.1365-2591.2006.01099.x CrossRef

24.

Lin L, Chen MYH, Ricucci D, Rosenberg PA (2010) Guided tissue regeneration in periapical surgery. J Endod 36:618–625. doi:10.1016/j.joen.2009.12.012 CrossRefPubMed

25.

Saran U, Gemini Piperni S, Chatterjee S (2014) Role of angiogenesis in bone repair. Arch Biochem Biophys 561:109–107. doi:10.1016/j.abb.2014.07.006 CrossRefPubMed

26.

Marton IJ, Kiss C (2014) Overlapping protective and destructive regulatory pathaways in apical periodontitis. J Endod 40:155–163. doi:10.1016/j.joen.2013.10.036 CrossRefPubMed

27.

Bender IB, Seltzer S (1961) Roentgenographic and direct observation of experimental lesions in bone. J Am Dent Assoc 87:708–716CrossRef

28.

Kruse C, Spin-Neto R, Wenzel A, Kirkevang LL (2015) Cone beam computed tomography and periapical lesions: a systematic review analysing studies on diagnostic efficacy by a hierarchical model. Int Endod J 48:815–828. doi:10.1111/iej.12388 CrossRefPubMed

29.

Estrela C, Bueno MR, Azevedo BC, Azevedo JR, Pècora JD (2008) A new periapical index based on cone beam computed tomography. J Endod 34:1325–1331. doi:10.1016/j.joen.2008.08.013 CrossRefPubMed

30.

Delano EO, Ludlow J, Ørstavick D, Tyndall D, Trope M (2001) Comparison between PAI and quantitative digital radiographic assessment of apical healing after endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 92:108–115. doi:10.1067/moe.2001.115466 CrossRefPubMed

31.

Kirkevang LL, Ørstavik D, Wenzel A, Væth M (2015) Prognostic value of the full-scale periapical index. Int Endod J 48:1051–1058. doi:10.1111/iej.12402 CrossRefPubMed

32.

Ørstavik D, Kerekes K, Eriksen HM (1986) The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol 2:20–24. doi:10.1111/j.1600-9657.1986.tb00119.x CrossRefPubMed

33.

Guo J, Simon JH, Sedghizadeh P, Soliman ON, Chapman T, Enciso R (2013) Evaluation of the reliability and accuracy of using cone-beam computed tomography for diagnosing periapical cysts from granulomas. J Endod 39:1485–1490. doi:10.1016/j.joen.2013.08.019 CrossRefPubMed

34.

Folestad A, Alund M, Asteberg S et al (2015) Offloading treatment is linked to activation of proinflammatory cytokines and start of bone repair in Charcot arthropathy patients. J Foot Ankle Res 72:1–12. doi:10.1186/s13047-015-0129-y2015

35.

Raghav N, Reddy SS, Giridhar AG et al (2010) Comparison of the efficacy of conventional radiography, digital radiography and ultrasound in diagnosis of periapical lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110:379–385. doi:10.1016/j.tripleo.2010.04.039 CrossRefPubMed

36.

Cotti E, Simbola V, Dettori C, Campisi G (2006) Echographic evaluation of bone lesions of endodontic origin: report of two cases in the same patient. J Endod 32:901–905. doi:10.1016/j.joen.2006.01.013 CrossRefPubMed

37.

Patel S, Dawood A, Whaites E, Pitt Ford T (2009) New dimensions in endodontic imaging: part 1. Conventional and alternative radiographic systems. Int Endod J 42:447–462. doi:10.1111/j.1365-2591.2008.01530.x CrossRefPubMed

38.

Hayashi T (2012) Application of ultrasonography in dentistry. Jpn Dent Sci Rev 48:5–13. doi:10.1016/j.jdsr.2011.05.001 CrossRef

39.

Sakuma K, Ikarugi Y, Tanaka R, Hayashi T (2007) Ultrasonography of periapical lesion: comparison with CT. Dental Radiol 47:53–64

40.

van der Stelt PF (1985) Experimentally produced bone lesions. Oral Surg Oral Med Oral Pathol 59:306–312CrossRefPubMed

41.

Marmary Y, Koter T, Heling I (1999) The effect of periapical rarefying osteitis on cortical and cancellous bone. A study comparing conventional radiographs with computed tomography. Dentomaxillofac Radiol 28:267–271. doi:10.1038/sj/dmfr/4600453 CrossRefPubMed

Title: Ultrasound examination with color power Doppler to assess the early response of apical periodontitis to the endodontic treatment
Authors: Elisabetta Cotti
Stefano Andrea Esposito
Davide Musu
Girolamo Campisi
Hagay Shemesh
Publication date: 01-01-2018
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 1/2018
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-017-2089-z

At a glance: The STEP trials

Springer Medicine

Ultrasound examination with color power Doppler to assess the early response of apical periodontitis to the endodontic treatment

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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