We appreciate Dr Kamburoğlu’s comments and concur that CBCT-targeted assessment of dental lesions normally requires a limited field of view with small voxel dimensions. However, typical CBCT-derived images used by orthodontists are produced by a single protocol of large field-of-view scans with 0.2- to 0.3-mm voxel dimensions. This protocol produces 2-dimensional images for use in cephalometric and panoramic analyses, and 3-dimensional images that facilitate the detection of root defects. Further investigation of single or multiple tooth roots can be accomplished with less radiation by using periapical radiographs rather than CBCT with small field-of-view and voxel dimensions, with better radiation hygiene.

Since the protocol in the study reasonably replicated that used in clinical practice, the results indicated that root surface defects tended to be detected more accurately with much less radiation via periapical radiographs than with CBCT images produced by typical orthodontic protocols. With respect to the study design, the images were randomly labeled, and the examiners, who were blinded, were required to complete their assessments of all 80 images within 40 minutes. This was done to simulate image interpretation in clinical practice and to make the examiners’ image recall difficult.

Our assessment was limited to percentages of accuracy, which scored true positive and true negative results. For future work, an expanded examination of the breakdown of the inaccuracies into percentages of false positives and false negatives could be of theoretical interest; however, these results would not alter our conclusions. The cavities of various diameters and depths were produced by using round burs according to a protocol reported in the literature. These methods produced defects with regular edges that might have enhanced or detracted from the ability to detect lesions.