Available online 8 November 2022, 101803

This review analyses the diagnostic performance of cone-beam computed tomography (CBCT) for the in vivo/in vitro detection of external root resorption (ERR) and critically analyses current and past methods of measuring or classifying ERR in vivo/in vitro in terms of radiation doses and cumulative radiation risks.

A diagnostic test accuracy (DTA) protocol was used for a systematic review of diagnostic methods following PRISMA guidelines. The protocol was registered with PROSPERO (ID: CRD42019120513). A thorough and exhaustive electronic search of six core electronic databases was performed, applying the ISSG Search Filter Resource. The eligibility criteria were designed [PICO statement: Population, Index test, Comparator, Outcome] and methodological quality was assessed by QUADAS-2.

Seventeen papers were selected from a total of 7.841 articles. Six in vivo studies were assessed as having a low risk of bias. The overall sensitivity and specificity of CBCT for diagnosis of ERR was 78.12% and 79.25%, respectively. The highest and lowest sensitivity and specificity of CBCT for diagnosis of external root resorption are 42%–98% and 49.3%–96.3%.

Most of the selected studies reported quantitative diagnoses with single linear measurements of ERR even though multi-slice radiographs were available. The cumulative radiation dose (µS) to radiation-sensitive structures, such as the bone marrow, brain and thyroid, was observed to increase using the three-dimensional (3D) radiography methods reported.

The highest and lowest sensitivity and specificity of CBCT for diagnosis of external root resorption are 42%–98% and 49.3%–96.3%. The minimum and maximum effective doses of dental CBCT for external root resorption diagnosis are 34 μSv and 1073 μSv.

Accuracy

diagnostic

external root resorption

cone-beam computed tomography

radiation dose

© 2022 The Author(s). Published by Elsevier Inc.