锥形束CT与数字化根尖片对根充效果的评价

›› 2015, Vol. 35 ›› Issue (7): 577-580.

锥形束CT与数字化根尖片对根充效果的评价

何辰菲

上海市第六人民医院

收稿日期:2013-11-04 修回日期:2014-01-13 出版日期:2015-07-28 发布日期:2015-08-04
通讯作者: 何辰菲 E-mail:hcf1988@hotmail.com

Assessment of the canal fillings using cone beam computed tomography and digital periapical radiography

Received:2013-11-04 Revised:2014-01-13 Online:2015-07-28 Published:2015-08-04

摘要/Abstract

摘要： ［摘要］目的比较锥形束CT（CBCT）与根尖片对根管充填后效果的评价，进一步探讨CBCT在根管治疗中的优势及应用价值。方法选取经临床诊断需要进行根管治疗的100颗患牙（221例根管），根管充填后同步拍摄根尖片与CBCT，术后分别由2位经验丰富的临床医生从根管充填的有效长度与严密程度两方面进行读片，运用卡方检验比较2种方法是否在评价结果上存在差异性。结果总计充填根管214例，充填遗漏7例，在根管充填长度、严密程度及满意程度评价方面，分别约有34.58%、30.48%和37.58%的根管在数字化根尖片与CBCT的评价结果上未能达成一致意见，经过统计学检验，数字化根尖片与CBCT在上述三方面的评价均有高度显著性差异（P <0.01）。结论 CBCT较根尖片在根管治疗术的长度及严密程度评价方面更为灵敏及准确，在复杂或疑难的根管治疗术中拥有很高的临床应用价值。

关键词: 锥形束CT, CBCT, 数字化根尖片, 根管治疗, 根充效果

Abstract: Abstract: Objective To compare the root filling quality assessed by conebeam computed tomography (CBCT) and periapical radiographs (PA),and to explore the advantage and application value of CBCT in the root canal treatment.Methods In total,100 teeth (221 canals) were clinically diagnosed and received root canal therapy.After root canal filling,the length and density of root filling were assessed with PA and CBCT simultaneously by two experienced endodontists.Chisquare test was performed with the data from PA or CBCT to evaluate the quality of the root filling.Results In total，214 canals received rootcanal treatment while 7 canals were omitted.In terms of length,density and satisfaction of the root filling,there were about 34.58%,30.48% and 37.58% of canals demonstrated different results based on the evaluation from PA and CBCT respectively.According to the result of statistical test,PA and CBCT had significant differences (P <0.01) in the assessment of the three aspects mentioned above.Conclusions It is more sensible and accurate of CBCT in detecting the quality of the root filling compared with PA,thus it is of great value in the complex or difficult root canal treatment.

Key words: cone-beam copmuted tomography, CBCT, periapical radiography, root canal treament, quality of canal filling

中图分类号:

R781.05

何辰菲. 锥形束CT与数字化根尖片对根充效果的评价[J]. 口腔医学, 2015, 35(7): 577-580.

参考文献

[1] 樊明文. 牙体牙髓病[M]. 3 版. 北京: 人民卫生出版社, 2003: 245-250.
[2] Ng YL, Mann V, Rahbaran S, et al. Outcome of primary root canal treatment: systematic review of the literature—part 2: influence of clinical factors[J]. Int Endod J, 2008;41(1):6–31.
[3] Durack C, Patel S. Cone Beam Computed Tomography in Endodontics[J]. Braz Dent J, 2012;23(3):179-191.
[4] Estrela C, Bueno MR, Leles CR, et al. Accuracy of cone beam computed tomography and panoramicand periapical radiography for detection of apical periodontitis[J].J Endod, 2008, 34(3):273-279.
[5] Yoshioka T, Kikuchi I, Adorno CG, et al. Periapical bone defects of root filled teeth with persistent lesions evaluated by cone-beam computed tomography[J]. Int Endod J, 2011, 44(3):245–252.
[6] Hassan B, Metska ME, Ozok AR, et al. Detection of vertical root fractures in endodontically treated teeth by a cone beam computed tomography scan[J]. J Endod, 2009, 35(5):719-722.
[7] Burch JG, Hulen S. The relationship of the apical foramen to the anatomic apex of the tooth root[J]. Oral Surg Oral Med Oral Pathol, 1972;34(2):262-268.
[8] Dummer PM, McGinn JH, Rees DG. The position and topography of the apical foramen[J]. Int Endod J,1984;17(4):192–198.
[9] Patel S, Wilson R, Dawood A. The detection of periapical pathosis using digital periapical radiography and cone beam computed tomography – Part 2: a 1-year post-treatment follow-up[J]. Int Endod J, 2012, 45(8):711-723.
[10] de Paula-Silva FW, Wu MK, Leonardo MR, et al. Accuracy of periapical radiography and cone-beam copmuted tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard[J]. J Endod, 2009, 35(7):1009-1012.
[11] Lofthag-Hansen S, Huumonen S, Grondahl K, et al. Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2007, 103(1):114–119.
[12] Estrela C, Bueno MR, Leles CR, et al. Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis[J].J Endod, 2008, 34(3):273-279.
[13] Liang YH, Li G, Wesselink PR, et al. Endodontic outcome predictors identified with periapical radiographs and cone-beam computed tomography scans[J].J Endod， 2011，37(3):326–331.
[14] Huybrechts B, Bud M, Bergmans L, et al. Void detection in root fillings using intraoral analogue, intraoral digital and cone beam CT images[J]. Int Endod J, 2009, 42(8):675–685
[15] Joint Position Statement of the American Association of Endodontists and the American Academy of Oral and Maxillofacial Radiology. Use of cone-beam computed tomography in endodontics[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2011, 111(2):234–237.