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This review aimed to evaluate the efficacy of diagnostic imaging of the periapical tissues using histopathology as a reference standard for diagnosing apical periodontitis. Seven articles involving tissue samples from cadavers were included in the analysis. The review found that periapical radiography had low sensitivity and negative predictive value, while cone-beam computed tomography (CBCT) was more accurate and had a good agreement with histopathology, particularly for non-root-filled teeth. However, the findings are based on cadaver studies, and more standardized methodology and reporting are needed.
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