Low-dose cone-beam computed tomography in simulated condylar erosion detection: a diagnostic accuracy study.

Objectives: The purpose of the present study was to assess the diagnostic accuracy of low-dose cone-beam computed tomography (CBCT) in the detection of simulated mandibular condyle erosions.

Methods: 102 simulated erosions were performed on the condyles of eight dry human mandibles. Each mandible was subjected to four CBCT scan protocols: high-definition (HD), normal definition (NORM), ultra-low-dose high-definition (ULD-HD), and ultra-low-dose normal definition (ULD-NORM). All scans were analyzed by two observers. The inter-observer and intra-observer agreement as well as the agreement with the gold standard were assessed. The sensitivity, specificity, positive-predictive value, negative-predictive value and accuracy of erosion detection were calculated.

Results: A substantial to almost perfect agreement with the gold standard was found regarding the HD protocol and substantial agreement in NORM and ULD-HD protocols; however, moderate agreement was found regarding the ULD-NORM protocol. The sensitivity, specificity and accuracy values were highest for the HD protocol followed by the NORM and ULD-HD which showed comparable results; while, the ULD-NORM protocol showed the least values.

Conclusions: The studied ULD-HD CBCT protocol can be recommended for the detection of mandibular condylar erosions due to the reduced radiation dose; however, ULD-NORM is not advocated for similar clinical use.