北京大学学报(医学版) ›› 2014, Vol. 46 ›› Issue (6): 975-979.

• 技术方法 • 上一篇    下一篇

锥形束CT在下颌磨牙根分叉病变诊断中的准确性分析

乔静1,段晋瑜1,孙昌洲1△,柳登高2   

  1. (北京大学口腔医学院·口腔医院 1. 第一门诊部,2. 放射科,北京100034)
  • 出版日期:2014-12-18 发布日期:2014-12-18

Accuracy analysis of cone beam computed tomography in assessing furcation involvements of mandibular molars

QIAO Jing1, DUAN Jin-yu1, SUN Chang-zhou1△, LIU Deng-gao2   

  1. (1. First Clinical Division, 2. Department of Oral Radiology, Peking University School and Hospital of Stomatology, Beijing 100034, China)
  • Online:2014-12-18 Published:2014-12-18

摘要: 目的:评价锥形束CT(cone beam CT, CBCT)在下颌磨牙根分叉病变诊断中的准确性。方法:纳入牙周基础治疗后需进行根分叉区翻瓣术的22颗下颌磨牙共38个根分叉病变,术前对根分叉进行临床探诊,并拍摄平行投照根尖片和CBCT,比较术前临床探诊、根尖片和CBCT与术中实际测量结果之间的一致性。结果:CBCT检查与术中检查所得根分叉病变分度一致性较高(κ=0.976),完全一致率为86.8%。CBCT上测得的根分叉区垂直骨缺损[(4.03±2.27) mm]与术中直接测量值[(4.32±2.31) mm] 差异无统计学意义(P>0.05);两者根分叉区骨缺损的近远中向距离差异无统计学意义(P>0.05),CBCT为(2.05±0.89) mm,术中为(2.07±0.97) mm;两者测得的根柱长差异亦无统计学意义(P>0.05),CBCT为(2.35±0.88) mm,术中为(2.24±0.75) mm;而CBCT测得的水平骨丧失[(3.40±1.27) mm]则小于术中直接测量值[(3.72±1.19) mm,P<0.05],但差异的平均值较小(0.32 mm)。根尖片只能获得垂直骨丧失[(2.17±1.32) mm]和根分叉区骨缺损的近远中向距离[(1.46±0.88) mm]这两个参数,且与术中实际测量结果差异有统计学意义(P<0.05)。结论: CBCT可以较准确地反映下颌磨牙根分叉病变的实际情况,弥补临床检查和传统X线根尖片的不足。

关键词: 锥束计算机体层摄影术, 根分叉部缺损, 磨牙

Abstract: Objective: To evaluate the accuracy of cone beam computed tomography (CBCT) in assessing furcation involvements of mandibular molars. Methods: In the study, 38 furcation involvements of 22 mandibular molars which would accept furcation surgery were included. Pre-surgical examination, CBCT and periapical radiograph were performed. Then, intra-surgical furcation assessments were compared with those data. Results: Intra-surgical findings confirmed 86.8% of the CBCT data, with a weighed kappa of 0.976. Of the four parameters tested of detailed root anatomy and furcation morphology, the vertical bone loss, the mesial-distal bone loss and the length of the root trunk revealed by CBCT were consistent with their respective intra-surgical values (P>0.05): about vertical bone loss, CBCT was (4.03±2.27) mm, but in surgery was (4.32±2.31) mm; about mesial-distal bone loss, CBCT was (2.05±0.89) mm, but in surgery was (2.07±0.97) mm; about length of the root trunk, CBCT was (2.35±0.88) mm, but in surgery was (2.24±0.75) mm. The horizontal bone loss revealed by CBCT [(3.40±1.27) mm] was significantly smaller than that by surgery [(3.72±1.19) mm]. However, the mean difference was only 0.32 mm. Periapical radiograph could only obtain vertical bone loss [(2.17±1.32) mm] and mesial-distal bone loss [(1.46±0.88) mm], which was significantly different from that obtained in surgery. Conclusion: CBCT proved high accuracy in assessing the furcation involvement of mandibular molars.

Key words: Cone-beam computed tomography, Furcation defect, Molar

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