Sensibilidad y especificidad de la tomografía computarizada de haz cónico en el diagnostico de necrosis pulpar

Introduction: previous knowledge of the characteristics of apical periodontitis that are visible in computerized axial tomography images, but are not detected in periapical radiographs, is essential to improve the diagnostic certainty of various pathologies. Objective: to evaluate the diagnostic sensitivity and specificity of conventional periapical radiography in comparison with cone beam computerized tomography in the identification of periapical lesions. Metodology: Descriptive study of a diagnostic test in individuals who attended for an endodontic consultation at the School of Dentistry of the University of Cartagena in the period 2022-2. For the selection of individuals, the initial X-ray, the diagnosis of pulpal necrosis and that they accepted their participation in the project by signing an informed consent and clinical history form were considered. The evaluation of periapical radiographs and CBCTs were examined by a calibrated evaluator, following specific parameters. After the evaluation, an analysis of the diagnostic test is carried out considering a contingency table to determine the sensitivity, specificity, positive predictive value and negative predictive value. Results: In 57% of the tomographies a periapical lesion was observed while in the periapical radiograph it was only observed in 14%. The analysis showed that periapical radiography has only 25% diagnostic sensitivity, however, it has 100% specificity to rule out the presence of lesions. Conclusion: periapical radiography is not capable of providing the greatest certainty in the diagnosis of pulpal necrosis, for which CBCT provides better diagnostic results that can significantly contribute to the treatment and prognosis of periapical recovery.