Interpretation of Chemically Created Periapical Lesions Using Direct DigitalImaging

摘要

Dental radiographs often provide pivotal information in the diagnosis andtreatment of periapical pathosis. The quality of the images, however, is greatly affected by exposure and development techniques, tissue density, and lesion size, location and character. Despite these variables, the radiograph is an indispensable tool for the clinician. Radiographic detection of periapical pathology has been widely examined in the last few decades, but the results have been inconsistent. Researchers have still not conclusively determined what volume and character of bone (cortical versus medullary) must be lost before radiographic detection is possible. Seltzer and Bendersi,2 1961 studies suggested the cortical medullary junction must be involved. However, Lee and Messer3 concluded that 80 percent of lesions confined to medullary bone are detectable. These and other studies used surgical burs to create model lesions. A weakness of this mechanical approach is the production of a well-defined edge to the lesion border. True periapical breakdown stemming from pulpal pathology normally produces a ragged and more ill-defined border due to a host of immunologic, inflammatory and bacterial interactions. As noted by Tirrell,4 chemically created lesions provide a way around this modeling problem by eliminating the sharp border.