Thermography as a Non-ionizing Quantitative Tool for Diagnosing Endo-perio Lesions

Abstract Background: Thermography is a contemporary imaging modality based on acquiring and analyzing thermal data using non-contact devices. The aim of the present study was to assess the validity of thermography, compared with that of the gold standard, for the diagnosis of endo-perio lesions and to evaluate the temperature ranges for acute pulpitis with apical periodontitis (AAP), acute periapical abscess (AA) and chronic periapical abscess (CA).Methods: AAP, AA and CA were diagnosed based on clinical and radiographic criteria. Thermographic data were acquired using the FLIR E-5 Infrared Camera. Extraoral thermal images were taken from the front and right and left sides of patients whose mouths were closed, and one intraoral thermal image was taken from the palatal perspective. Agreement in the diagnoses based on the combination of clinical and radiographic assessments and the thermographic evaluation was calculated. The temperature ranges of the three subdiagnostic groups were also measured.Results: A total of 80 patients were enrolled in this study. The mean thermal image temperature for AA was 37.26±0.36, that for CA was 35.03±0.63 and that for AAP was 36.07±0.45. The differences between the mean thermal temperatures of the three diagnostic groups were highly statistically significant (P<0.001). The result of the Kappa coefficient of agreement between the combination of clinical and radiographic assessments and the thermographic evaluation was highly significant (P<0.001). The rates of change in temperature with time for each diagnostic group were highly statistically significantly different (P<0.001).Conclusions: Thermography is an effective, quantitative and nonionizing approach that can be used for the diagnosis of endo-perio lesions. This technology is able to distinguish different forms of infection by identifying the range of temperature increases related to each form.