Unveiling the Hidden Truths of Root Resorption: High-Resolution CBCT as the Gold Standard for Predictive Diagnostics and Risk Management in Orthodontics - An In Vitro Study

Abstract

Background: Root resorption, a frequent complication in orthodontic treatment, poses a challenge for early detection and assessment. Traditional periapical radiographs often fall short in identifying and evaluating root resorption, potentially leading to delayed intervention. High- Resolution Cone-Beam Computed Tomography (CBCT) provides advanced 3D imaging capabilities, which could enhance the accuracy and detail of root resorption diagnosis.

Materials and Methods: This in vitro study aimed to compare the effectiveness of CBCT and periapical radiography in detecting root resorption. Thirty extracted human premolars were subjected to controlled mechanical forces to induce resorption. Both imaging modalities were used to assess the presence, severity, and volume of resorption. Diagnostic performance metrics, including sensitivity and specificity, were calculated and compared.

Results: CBCT identified root resorption in 90% of the specimens, while periapical radiography detected resorption in 60% of cases. CBCT also provided superior diagnostic performance, with higher sensitivity (96%) and specificity (95%) compared to periapical radiography (68% and 85%, respectively). Additionally, CBCT offered more detailed insights into resorption severity and volumetric changes.

Conclusion: CBCT significantly improves the detection and evaluation of root resorption compared to traditional periapical radiography. The enhanced diagnostic accuracy and comprehensive 3D imaging capabilities of CBCT enable better assessment of resorption severity and volume, making it a valuable tool in orthodontic diagnostics, despite its higher cost and radiation exposure.