Differential Diagnosis of Large Periapical Lesions Using Cone-Beam Computed Tomography Measurements and Biopsy

This study compared the differential diagnosis of large periapical lesions (granuloma versus cyst) to traditional biopsy using Cone Beam Computed Tomography (CBCT), the NewTom 3G. Large lesions were scanned and a preoperative diagnosis based on gray value measurements of the imaged lesion area was made. After surgery a biopsy report was obtained and compared to the CBCT diagnosis. In 13 out of 17 cases, the diagnosis coincided. In 4 out of 17 cases, the CBCT read cyst with the oral pathologist’s diagnosis being granuloma. Thus, the CBCT may provide a more accurate diagnosis than biopsy and histology providing a diagnosis without invasive surgery and/or waiting a year to see if nonsurgical therapy is effective.