国内外口腔锥形束CT临床实践标准化文件的内容及制定方法

doi:10.13591/j.cnki.kqyx.2023.11.001

口腔医学 ›› 2023, Vol. 43 ›› Issue (11): 961-967.doi: 10.13591/j.cnki.kqyx.2023.11.001

• 述评 • 下一篇

国内外口腔锥形束CT临床实践标准化文件的内容及制定方法

王凯利,叶泽林,游梦(),王虎()

口腔疾病防治全国重点实验室，国家口腔医学中心家口腔疾病临床医学研究中心四川大学华西口腔医院医学影科，四川成都(610041)

修回日期:2023-09-07 出版日期:2023-11-28 发布日期:2023-11-21
通讯作者: 王虎 E-mail: wanghu62@qq.com，游梦 E-mail: youmeng@scu.edu.cn
作者简介:游梦,四川大学华西口腔医院医学影像科主任,副教授,研究生导师;中华口腔医学会口腔放射专业委员会常委;四川省口腔医学会口腔放射专业委员会副主任委员。参编《口腔临床CBCT影像诊断学》《口腔种植影像学》《唇腭裂影像学》等多部专著。|王虎,四川大学华西口腔医院教授,主任医师,研究生导师;中华口腔医学会口腔放射专业委员会前任主任委员;中华口腔医学会理事;中华口腔医学会标准委员会委员;四川省口腔医学会口腔放射专业委员会名誉主任委员;四川省口腔急诊专业委员会副主任委员;四川省卫生健康委学术技术带头人。
基金资助:
科技部国家重点研发计划(2022YFC2402103)

Content and development method of standardizing documents for clinical use of oro-maxillofacial cone-beam computed tomography

WANG Kaili,YE Zelin,YOU Meng(),WANG Hu()

State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral Medical Imaging,West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Revised:2023-09-07 Online:2023-11-28 Published:2023-11-21

摘要/Abstract

摘要：

口腔锥形束CT(cone-beam computed tomography, CBCT)临床实践标准化文件的建立是保障CBCT合理使用、获得精准诊疗信息,以及维护患者合理权益的前提。在过去CBCT发展的近20年间,国际上陆续发布与CBCT临床实践相关的各类声明、共识或指南等标准化文件近30部,为当地从业人员使用CBCT的方方面面提供指导。这些标准化文件在涵盖的内容以及制定的方法学上有所不同,随着近年临床实践指南相关方法学的完善,以及各级学会、机构对高质量标准化文件的要求,未来CBCT相关标准化文件的制定和更新需要在完整性和科学性两方面达到更高的水平。鉴于此,本文对国内外已有标准化文件的涵盖内容以及制定方法进行了总结和回顾,以期为国内高质量CBCT标准化文件的制定提供参考。

关键词: 锥形束CT, 口腔颌面医学影像学, 指南, 专家共识, 制定方法

Abstract:

The establishment of a standardizing document for the clinical practice of oro-maxillofacial cone-beam CT(CBCT)is a prerequisite for ensuring the rational use of CBCT, obtaining accurate diagnostic and therapy information, as well as safeguarding the reasonable rights and interests of patients. During the past 20 years of CBCT development, nearly 30 standardizing documents including statements, consensus and guidelines related to CBCT clinical practice have been published internationally, providing guidance for local practitioners in all aspects of CBCT use. These standardizing documents differ in terms of content and methodology. With the recent refinement of the methodology related to clinical practice guidelines, as well as the demand for high-quality standardizing documents from academic associations and institutions at all levels, the future development and updating of standardizing documents related to CBCT will need to be at a higher level in terms of both completeness and scientific validity. In view of this, the current article reviewed and summarized the contents and methods of published standardizing documents, with a view to providing references for the development of high-quality CBCT clinical practice guidelines in China.

Key words: cone-beam computed tomography(CBCT), oral and maxillofacial radiology, guideline, expert consensus, methodology

中图分类号:

R814.42

王凯利, 叶泽林, 游梦, 王虎. 国内外口腔锥形束CT临床实践标准化文件的内容及制定方法[J]. 口腔医学, 2023, 43(11): 961-967.

WANG Kaili, YE Zelin, YOU Meng, WANG Hu. Content and development method of standardizing documents for clinical use of oro-maxillofacial cone-beam computed tomography[J]. Stomatology, 2023, 43(11): 961-967.

图/表 2

表1

表2

参考文献 48

[1]	Arai Y, Tammisalo E, Iwai K, et al. Development of a compact computed tomographic apparatus for dental use[J]. Dentomaxillofac Radiol, 1999, 28(4):245-248. doi: 10.1038/sj.dmfr.4600448
[2]	Mozzo P, Procacci C, Tacconi A, et al. A new volumetric CT machine for dental imaging based on the cone-beam technique: Preliminary results[J]. Eur Radiol, 1998, 8(9):1558-1564. doi: 10.1007/s003300050586 pmid: 9866761
[3]	Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice[J]. J Can Dent Assoc, 2006, 72(1):75-80.
[4]	Scarfe WC, Farman AG. What is cone-beam CT and how does it work?[J]. Dent Clin North Am, 2008, 52(4):707-730, v. doi: 10.1016/j.cden.2008.05.005 pmid: 18805225
[5]	Schulze RKW, Drage NA. Cone-beam computed tomography and its applications in dental and maxillofacial radiology[J]. Clin Radiol, 2020, 75(9):647-657. doi: S0009-9260(20)30158-6 pmid: 32451060
[6]	马绪臣. 口腔颌面锥形束CT在我国临床研究和应用的回顾及展望[J]. 中华口腔医学杂志, 2014, 49(1):2-4.
[7]	Grilli R, Magrini N, Penna A, et al. Practice guidelines developed by specialty societies: The need for a critical appraisal[J]. Lancet, 2000, 355(9198):103-106. doi: 10.1016/S0140-6736(99)02171-6 pmid: 10675167
[8]	杨雪, 张祖燕. 口腔颌面锥形束CT(CBCT)应用指南的研究现状[J]. 现代口腔医学杂志, 2013, 27(5):291-294.
[9]	Carter L, Farman AG, Geist J, et al. American Academy of Oral and Maxillofacial Radiology executive opinion statement on performing and interpreting diagnostic cone beam computed tomography[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2008, 106(4):561-562. doi: 10.1016/j.tripleo.2008.07.007 pmid: 18928899
[10]	American Dental Association Council on Scientific Affairs. The use of cone-beam computed tomography in dentistry: An advisory statement from the American Dental Association Council on Scientific Affairs[J]. J Am Dent Assoc, 2012, 143(8):899-902. doi: 10.14219/jada.archive.2012.0295 pmid: 22855905
[11]	National Council on Radiation Protection and Measurements 2019. 177-Radiation Protection in Dentistry and Oral & Maxillofacial Imaging(2019)[M/OL]. Bethesda, MD: National Council on Radiation Protection and Measurements, 2019. https://ncrponline.org/shop/reports/report-no-177/.
[12]	Health Public Agency. Guidance on the Safe Use of Dental Cone Beam CT(Computed Tomography)Equipment[R/OL]. (2010-11)[2021-12-26].https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/340159/HPA-CRCE-010_for_website.pdf.
[13]	The Superior Health CouncilBelgium. Advisory Reportof the Superior Health Council No 8705: Dental Cone Beam Computed Tomography[R/OL]. (2011-02-11)[2023-02-09]. https://www.health.belgium.be/en/dentale-cone-beam-computed-tomography-february-2011-shc-8705.
[14]	Noffke CEE, Farman AG, Nel S, et al. Guidelines for the safe use of dental and maxillofacial CBCT: A review with recommendations for South Africa[J]. SADJ, 2011, 66(6):262,264-262, 266.
[15]	European Commission. Radiation protection No. 172: Cone beam CT for dental and maxillofacial radiology(Evidence-based guidelines)[R/OL]. (2012-05)[2023-01-30].http://www.sedentexct.eu/files/radiation_protection_172.pdf.
[16]	Almén A. ICRP publication 129 radiological protection in cone beam computed tomography (CBCT)[J]. Radiat Prot Dosimetry, 2016, 171(3):418-420.
[17]	Hayashi T, Arai Y, Chikui T, et al. Clinical guidelines for dental cone-beam computed tomography[J]. Oral Radiol, 2018, 34(2):89-104. doi: 10.1007/s11282-018-0314-3 pmid: 30484133
[18]	Dula K, Bornstein MM, Buser D, et al. SADMFR guidelines for the use of cone-beam computed tomography/digital volume tomography[J]. Swiss Dent J, 2014, 124(11):1169-1183.
[19]	Dula K, Benic GI, Bornstein M, et al. SADMFR guidelines for the use of cone-beam computed tomography/digital volume tomography[J]. Swiss Dent J, 2015, 125(9):945-953. pmid: 26399521
[20]	中华口腔医学会牙体牙髓病学专业委员会. 牙体牙髓病诊疗中口腔放射学的应用指南[J]. 中华口腔医学杂志, 2021, 56(4):311-317.
[21]	Benavides E, Rios HF, Ganz SD, et al. Use of cone beam computed tomography in implant dentistry: The International Congress of Oral Implantologists consensus report[J]. Implant Dent, 2012, 21(2):78-86. doi: 10.1097/ID.0b013e31824885b5 pmid: 22382748
[22]	Kühnisch J, Anttonen V, Duggal MS, et al. Best clinical practice guidance for prescribing dental radiographs in children and adolescents: An EAPD policy document[J]. Eur Arch Paediatr Dent, 2020, 21(4):375-386. doi: 10.1007/s40368-019-00493-x pmid: 31768893
[23]	Patel S, Brown J, Semper M, et al. European Society of Endodontology position statement: Use of cone beam computed tomography in Endodontics[J]. Int Endod J, 2019, 52(12):1675-1678. doi: 10.1111/iej.13187 pmid: 31301231
[24]	Oenning AC, Jacobs R, Pauwels R, et al. Cone-beam CT in paediatric dentistry: DIMITRA project position statement[J]. Pediatr Radiol, 2018, 48(3):308-316. doi: 10.1007/s00247-017-4012-9 pmid: 29143199
[25]	Harris D, Horner K, Gröndahl K, et al. E.A.O. guidelines for the use of diagnostic imaging in implant dentistry 2011. A consensus workshop organized by the European Association for Osseointegration at the Medical University of Warsaw[J]. Clin Oral Implants Res, 2012, 23(11):1243-1253. doi: 10.1111/clr.2012.23.issue-11
[26]	Mandelaris GA, Scheyer ET, Evans M, et al. American academy of periodontology best evidence consensus statement on selected oral applications for cone-beam computed tomography[J]. J Periodontol, 2017, 88(10):939-945. doi: 10.1902/jop.2017.170234 pmid: 28967333
[27]	American Academy of Oral and Maxillofacial Radiology. Clinical recommendations regarding use of cone beam computed tomography in orthodontics. Position statement by the American Academy of Oral and Maxillofacial Radiology[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2013, 116(2):238-257. doi: 10.1016/j.oooo.2013.06.002
[28]	Fayad MI, Nair MK, Barghan S, et al. AAE and AAOMR Joint Position Statement: Cone-beam computed tomography in endodontics—2015/2016 Update[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2015, 120(4), 508-512. doi: 10.1016/j.oooo.2015.07.033
[29]	Isaacson KG, Thom AR, Atack NE, et al. Guidelines for the use of radiographs in clinical orthodontics, 4th Edition[R/OL]. (2015-09-01)[2022-04-01].https://www.bos.org.uk/Portals/0/Public/docs/Orthodontic%20Radiographs%202016%20-%202.pdf.
[30]	Brown J, Jacobs R, Jäghagen EL, et al. Basic training requirements for the use of dental CBCT by dentists: A position paper prepared by the European Academy of Dentomaxillofacial Radiology[J]. Dentomaxillofac Radiol, 2014, 43(1):20130291. doi: 10.1259/dmfr.20130291
[31]	Patel S, Harvey S. Guidelines for reporting on CBCT scans[J]. Int Endod J, 2021, 54(4):628-633. doi: 10.1111/iej.13443 pmid: 33170952
[32]	Tyndall DA, Price JB, Tetradis S, et al. Position statement of the American Academy of Oral and Maxillofacial Radiology on selection criteria for the use of radiology in dental implantology with emphasis on cone beam computed tomography[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2012, 113(6):817-826. doi: 10.1016/j.oooo.2012.03.005
[33]	靳英辉, 王丹琦, 李艳, 等. 临床实践指南制定方法: 国内外临床实践指南制定手册概要[J]. 中国循证心血管医学杂志, 2018, 10(1):1-10.
[34]	王小钦, 王吉耀. 循证临床实践指南的制定与实施[M]. 北京: 人民卫生出版社, 2016.
[35]	Schünemann HJ, Oxman AD, Brozek J, et al. Grading quality of evidence and strength of recommendations for diagnostic tests and strategies[J]. BMJ, 2008, 336(7653):1106-1110. doi: 10.1136/bmj.39500.677199.AE
[36]	吕晗, 王振常, 刘晓清, 等. 影像学检查的临床适用性评价:基于循证医学证据,合理选择检查方法[J]. 中华外科杂志, 2020, 58(11):831-834.
[37]	Horner K, Eaton K A. Selection criteria for dental radiography, 3rd edition(UPDATED 2018)[M/OL]. London: Faculty of General DentalPractice(UK), 2018.[2023-08-24].https://cgdent.uk/wp-content/uploads/2021/08/FGDP-SCDR-ALL-Web.pdf.
[38]	Scottish Intercollegiate Guidelines Network. SIGN 50: a guideline developer’s handbook[EB/OL].[2023-03-01]. https://www.sign.ac.uk/what-we-do/methodology/sign-50-a-guideline-developers-handbook/..
[39]	傅开元, 胡敏, 余强, 等. 颞下颌关节紊乱病锥形束CT检查规范及诊断标准的专家共识[J]. 中华口腔医学杂志, 2020, 55(9):613-616.
[40]	Murphy MK, Black NA, Lamping DL, et al. Consensus development methods, and their use in clinical guideline development[J]. Health Technol Assess, 1998, 2(3):i-iv, 1-88.
[41]	周奇, 王琪, 俞阳, 等. 临床实践指南制定中的共识方法[J]. 药品评价, 2016, 13(16):13-17.
[42]	陈耀龙, 罗旭飞, 王吉耀, 等. 如何区分临床实践指南与专家共识[J]. 协和医学杂志, 2019, 10(4):403-408.
[43]	Harbour R, Miller J. A new system for grading recommendations in evidence based guidelines[J]. BMJ, 2001, 323(7308):334-336. doi: 10.1136/bmj.323.7308.334 pmid: 11498496
[44]	Horner K, Islam M, Flygare L, et al. Basic principles for use of dental cone beam computed tomography: Consensus guidelines of the European Academy of Dental and Maxillofacial Radiology[J]. Dentomaxillofac Radiol, 2009, 38(4):187-195. doi: 10.1259/dmfr/74941012
[45]	American College of RadiologyACR. About the ACR Appropriateness Criteria[EB/OL]. (2023)[2023-08-24]. https://www.acr.org/Clinical-Resources/ACR-Appropriateness-Criteria/About-the-ACR-AC.
[46]	World Health Organization. WHO handbook for guideline development, 2nd ed[M/OL]. World Health Organization, 2014.[2023-08-24].https://apps.who.int/iris/handle/10665/145714.
[47]	陈耀龙, 杨克虎, 王小钦, 等. 中国制订/修订临床诊疗指南的指导原则(2022版)[J]. 中华医学杂志, 2022, 102(10):697-703.
[48]	吕晗, 王振常. 重视影像学检查临床适用性评价(EB-MICA)[J]. 中华医学杂志, 2022, 102(27):2063-2066.

报告内容	具体项目
患者选择合理性	患者选择/转诊标准	○	○	○	○	○	○	○	○	○
放射防护	放射防护用品	○	○	○	○	○	○	○	○	○
拍摄参数	曝光参数调整	○			○		○	○		○
	辐射安全和剂量记录	○	○	○	○	○	○	○	○
	购置准备、场所设计		○	○	○			○
	图像质量控制	○		○	○		○	○	○
	数据存储格式	○	○				○			○
临床适应证						○^*	○^※	○^*		○^#
资质与培训要求	设备使用资质	○		○	○		○	○
	使用者资质/培训需要	○	○	○	○	○	○	○	○	○
	从业人员职责	○		○	○		○	○	○
检查报告	影像报告需求	○				○	○	○		○

国家地区	发布单位或作者	发表(更新)年份	领域或学科	制定方法
美国	AAOMR^[32]	2012	种植	基于文献回顾的专家共识
美国	AAOMR^[27]	2013	正畸	基于文献回顾的专家共识,部分参考ACR影像学适宜性评价方法
美国	AAE,AAOMR^[28]	2015^*	牙体牙髓	基于文献回顾的专家共识
美国	AAP^[26]	2017	牙周	基于最佳证据(系统评价)的专家共识
英国	BOS^[29]	2015^*	正畸	专家意见
英国	FGDP^[37]	2018^*	综合	基于SIGN指南制定方法^[38]
比利时	SHC^[13]	2011	综合	基于文献回顾的专家共识
南非	Noffke等^[14]	2011	综合	基于文献回顾的专家共识
欧洲	EC^[15]	2012	综合	基于SIGN指南制定方法^[38]
欧洲	EAO^[25]	2012^*	种植	基于文献回顾,专家共识会议
欧洲	DIMITRA^[24]	2018	儿童口腔	基于文献回顾
欧洲	ESE^[23]	2019^*	牙体牙髓	基于文献回顾
欧洲	EAPD^[22]	2020	儿童口腔	基于文献系统回顾,专家共识会议
国际会议	ICOI^[21]	2012	种植	基于文献系统回顾,专家共识会议
瑞士	SADMFR^[18]	2014	临床应用	基于文献回顾,专家共识会议
瑞士	SADMFR^[19]	2015	临床应用	基于文献回顾,专家共识会议
中国	中华口腔医学会^[20]	2020	牙体牙髓	使用ACR影像学适宜性评价方法
中国	中华口腔医学会^[39]	2020	颞下颌关节	专家共识会议

国内外口腔锥形束CT临床实践标准化文件的内容及制定方法

Content and development method of standardizing documents for clinical use of oro-maxillofacial cone-beam computed tomography

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

图/表 2

参考文献 48

相关文章 15

编辑推荐

Metrics

本文评价

[1]	徐青清, 王宇萌, 李梦圆, 张悦蓉, 徐海, 江飞, 张光东. 下颌第一前磨牙的形态特征与根管系统解剖的相关性分析[J]. 口腔医学, 2023, 43(7): 625-632.
[2]	肖语欢, 侯伟, 施佳丽, 刘飞, 王震东, 周薇娜. 非综合征唇腭裂患者与骨性Ⅲ类人群的上气道三维结构分析研究[J]. 口腔医学, 2023, 43(6): 529-533.
[3]	王芷凡, 戴修斌, 周炎锜, 冒添逸, 黄虹, 宋洪丞, 王东苗. 轻量型单步深度学习网络自动识别下颌智齿牙根与下颌管位置关系的研究[J]. 口腔医学, 2023, 43(6): 534-539.
[4]	朱婷婷,冷迪雅,王晶艳,顾培玉,周广超,张娟,吴大明. 基于锥形束CT的上颌窦解剖形态三维分析[J]. 口腔医学, 2023, 43(5): 446-450.
[5]	曹丹彤,觧鑫,林梓桐. 牙根纵裂锥形束CT检查的伪影及诊断探讨[J]. 口腔医学, 2023, 43(4): 376-379.
[6]	程傲然, 王珏, 范亚伟. 上牙槽前神经管及其副管形态特征的锥形束CT研究[J]. 口腔医学, 2023, 43(10): 903-909.
[7]	陈雨妍, 张志宏, 刘红红, 韩倩, 陈佳, 段琳娜. 下颌后牙区骨皮质厚度对牙种植精度的影响[J]. 口腔医学, 2022, 42(8): 713-716.
[8]	苏咏宽, 潘永初, 李媛, 罗瑶, 侯伟, 韩霖霏. 非综合征唇腭裂患者与骨性Ⅰ类人群的上气道对称性分析研究[J]. 口腔医学, 2022, 42(7): 617-621.
[9]	周威, 王林, 王亮, 赵春洋. 上颌阻生尖牙牵引治疗后邻近切牙牙根吸收情况的研究[J]. 口腔医学, 2022, 42(6): 525-528.
[10]	荣迪, 巫慧丽, 王莹, 王晶艳, 张娟, 周广超, 顾培玉, 吴大明. 根管封闭剂和锥形束CT拍摄参数对牙根纵裂诊断的影响[J]. 口腔医学, 2022, 42(6): 529-533.
[11]	雷晨, 于群, Khulood Ali ALTAEZI, 汤春波. 上颌侧切牙牙槽骨壁厚度与尖牙关系相关性的锥形束CT研究[J]. 口腔医学, 2022, 42(5): 425-430.
[12]	严沁月, 曹丹, 严斌. 上颌阻生尖牙患者寰椎形态变异情况的锥形束CT研究[J]. 口腔医学, 2022, 42(5): 437-441.
[13]	谷妍, 朱琦, 王华, 赵春洋, 王林. 236例不同骨性畸形磨牙颊舌向角度关系的研究[J]. 口腔医学, 2022, 42(4): 315-318.
[14]	卢彩莲, 杨咪, 王小琴. 下颌中切牙区牙槽骨的锥形束CT测量及其厚度的影响因素[J]. 口腔医学, 2022, 42(3): 271-275.
[15]	刘煜, 赵彬. 口腔颌面锥形束CT金属伪影的研究进展[J]. 口腔医学, 2022, 42(2): 165-169.