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Gundappa M, Ng et al. Dentomaxillofac Radiol 2006; 35: 326–333

Apical surgery is not considered necessary for many endodontic lesions, but lesions which persist despite re-root treatment are often treated this way. One problem is diagnosis of periapical lesions, which depends on biopsy. In this study, 15 patients requiring endodontic surgery for anterior teeth were given conventional (CR) and digital (DR) periapical radiographs and an ultrasound scan of the teeth. Following surgery, tissue was examined histopathologically.

Radiographic lesion size was assessed by 3 observers who had good agreement for CR and weak agreement for DR, but could not distinguish the nature of lesions. Ultrasound images were given a diagnosis agreed by an ultrasonographer and an endodontist. In 7 cases, the ultrasound diagnosis was of a cyst, and in 8 cases, a granuloma. This agreed exactly with the histopathological diagnosis.