Ultrasound Imaging In Endodontic Diagnosis-Literature Review and Current Practices

Abstract

Imaging always plays a very important part in the diagnosis of various orofacial diseases, especially various periapical lesions that are diagnosed and treated based on radiological findings. The diagnosis of a periapical cyst or granuloma is important because literature reveals that prevalence of apical cyst is 15% of which 9% are true cyst and 6% are periapical pocket cyst. It is suggested that true cyst may sustain apical periodontitis and thus it becomes important to differentiate the lesions as it can affect treatment outcome. The only reliable diagnostic method, to date is the histologic sectioning of the whole lesion, which is not possible in all cases. Traditional radiographs help in the detection of the lesion but is unable to differentiate them, also the 3 D coordinates of the lesion cannot be assessed. Advanced imaging techniques need to be applied in cases where more information on size, content,healing patterns are to be estimated. Ultrasound with Color Power Doppler is one such advanced imaging technique widely used in the field of medicine with potential applications in endodontics. The ability to estimate the content of the lesion (solid, fluid or mixed) and vascularity helps in differentiating lesions of endodontic origin. Other exciting applications include detecting pulpal blood flow in teeth through intact enamel and dentin, monitoring post treatment healing.However the thickness of overlying bone can decrease its diagnostic validity. Other limitations include the need for expertise of operator, smaller probe for endodontic use.