摘要
目的评价锥形束CT(CBCT)和数字化X线片诊断牙周牙髓联合病变的准确性,以期为CBCT在牙周牙髓联合病变诊断中的应用提供依据。方法采用简单随机化抽样法选取2015年6月至2016年12月就诊于大连市口腔医院牙周科被诊断为牙周牙髓联合病变的患者55例(患牙55颗),分别进行CBCT和数字化X线片扫描,同时行临床探诊检查,确定附着丧失水平及釉牙骨质界至牙槽嵴顶的距离。比较3种方法对患牙牙槽骨缺损高度测量及根分叉病变诊断的差异。结果 CBCT和临床探诊均可对患牙进行近中、远中、唇(颊)侧和舌(腭)侧的牙槽骨缺损进行测量,而数字化X线牙片仅可以进行近中、远中牙槽骨缺损测量。单因素方差分析结果显示,数字化X线片、CBCT及临床探诊3种方法测量的牙周牙髓联合病变患牙近、远中牙槽骨缺损程度差异均有统计学意义(近中:F=3.56,远中:F=5.37;均P <0.001);进一步两两比较结果显示,数字化X线片与CBCT、数字化X线片与临床探诊的测量结果差异均有统计学意义(均P <0.05)。患牙各位点[近中、远中、唇(颊)侧、舌(腭)侧)]的牙槽骨缺损高度,采用CBCT与临床探诊的测量结果差异均无统计学意义(均P> 0.05)。在诊断牙周牙髓联合病变患牙的根分叉病变发生率方面,数字化X线片与CBCT、数字化X线片与临床探诊比较,差异均有统计学意义(均P <0.001);而CBCT与临床探诊比较,差异无统计学意义(P> 0.05)。结论 CBCT与临床探诊在评价牙周牙髓联合病变的牙槽骨缺损程度和根分叉病变发生率方面具有一致性,均优于数字化X线片,CBCT准确性更高。
Objective To analyse the accuracy of cone-beam computed tomography（CBCT）in the diagnosis of combined periodontal-endodontic lesions,in order to provide the foundation for the application of CBCT in the diagnosis of combined periodontal-endodontic lesions. Methods Randomly select fifty-five tooth of fifty-five patients with combined periodontal-endodontic lesion in Department of Periodontics of Dalian Stomatological Hospital. Each patient received radiovisiography（RVG）,CBCT and clinical examination. Clinical examination determined the level of attachment loss and the distance from the bone of the cemento enamel junction to the top of the alveolar crest. Compare the values of alveolar bone defect and the diagnosis of furcation involvement by clinical examination,RVG and CBCT. Results RVG could measure the mesial and the distal aspects of alveolar bone defect. Clinical examination and CBCT could measure the mesial,the distal,the buccal and the palatal aspects of alveolar bone defect. The single-factor variance analysis showed that the 3 methods had statistical difference in the measurement of mesial and distal alveolar bone defect in combined periodontal-endodontic lesions（mesial：F = 3.56,distal：F = 5.37,P 0.001）. The results of measurement of bone defects in mesial and distal aspects were shown that there were significant statistical differences in the results of RVG vs. CBCT and RVG vs.clinical examination（P 0.05）. The comparison of the measurement of alveolar bone defect in each sites by CBCT and clinical examination showed no statistical differences（P 0.05）. In the incidence of diagnosis of furcation involvement of combined periodontal-endodontic lesions,there were significant statistical differences between RVG and CBCT and between RVG and clinical examination（P 0.001）.There were no statistical differences between CBCT and clinical examination（P 0.05）. Conclusion CBCT and clinical examination have consistency in evaluation of the degree of alveolar bone defect and the incidence of furcation involvement in the combined periodontal-endodontic lesions,both being superior to RVG,and CBCT is the highest in the accuracy of the three methods.
作者
任颂
韩文利
范崇巍
孙江
REN Song;HAN Wen-li;FAN Chong-wei;SUN Jiang(Department of Periodontics,Dalian Stornatological Hospital,Dalian 116021,China)
出处
《中国实用口腔科杂志》
CAS
2018年第10期608-612,共5页
Chinese Journal of Practical Stomatology
基金
大连市医学科学研究计划项目(1711085)
关键词
数字化X线片
锥形束CT
牙周牙髓联合病变
牙槽骨缺损
根分叉病变
radiovisiography
cone-beam computed tomography
CBCT
combined periodontal-endodontic lesions
alveolar bone defect
furcation involvement
作者简介
通信作者：孙江，电子信箱：sunjiang129@163．com
