Diagnostic Accuracy of Cone-Beam Computed Tomography and Periapical Radiography in Detecting External Cervical Resorption: A Systematic Review and Meta-Analysis

Abstract

This study assessed the diagnostic accuracy of periapical radiography and cone-beam computed tomography for detecting external cervical resorption. An electronic search was conducted in seven databases. The protocol was registered in PROSPERO, and the risk of bias was assessed with QUADAS-2. Retrospective studies using human dental images were included. A bivariate random-effects model estimated pooled diagnostic values using MetaDisc v1. Four studies met the inclusion criteria. Three demonstrated a high risk of bias in patient selection. The meta-analysis revealed specificity values of 0.93 for periapical radiography and 1.00 for cone-beam computed tomography, with corresponding sensitivity values of 0.85 and 1.00, respectively. Cone-beam computed tomography showed statistically superior diagnostic accuracy (p = 0.0016). The GRADE assessment rated the overall certainty of the evidence as ‘very low.’ Cone-beam computed tomography showed superior accuracy to periapical radiography in detecting external cervical resorption, but the very low certainty of evidence highlights the need for further studies.