ACCURACY OF MAGNETIC RESONANCE IMAGING IN CLINICAL ENDODONTIC APPLICATIONS: A SYSTEMATIC REVIEW

 

Published:January 28, 2024DOI:https://doi.org/10.1016/j.joen.2024.01.014

ABSTRACT

Introduction

The development of dedicated coils and new Magnetic Resonance Imaging (MRI) sequences has led to an increase in image resolution and a reduction in artifacts. Consequently, numerous studies have demonstrated the utility of MRI as a non-ionizing alternative to cone-beam computed tomography (CBCT). The aim of this systematic review was to evaluate the accuracy of MRI in clinical applications in Endodontics.

Material and Methods

A literature search was conducted on PubMed, Embase, Scopus, and Web of Science. Inclusion criteria encompassed studies evaluating MRI applications in Endodontics, covering tooth and root canal anatomy, root canal working length, pulp vitality and regeneration, the effect of caries on dental pulp, guided endodontics, periapical lesions, and root cracks/fractures. The selected studies examined both ex-vivo and in-vivo human teeth using clinical MRI units. Two researchers independently screened the studies, applied the eligibility criteria, and assessed the potential risk of bias using the revised QUADAS-2 tool (Quality Assessment of Diagnostic Accuracy Studies).

Results

A total of 18 studies were included in this systematic review, demonstrating that the use of MRI has a high diagnostic value in Endodontics. In the evaluation of tooth and root canal anatomy, pulp vitality and regeneration, the effect of caries on dental pulp, periapical lesions, and root cracks/fractures, MRI’s accuracy is comparable to or even higher than reference standards such as CBCT, micro-CT and histology.

Conclusion

MRI has high potential accuracy for diagnosing various clinical endodontic tasks except for root canal length, size of caries, and periapical lesion dimensions, which are overestimated in MRI.