锥形束CT在早期诊断牙根纵裂中的应用  

Application of cone-beam computed tomography in the early diagnosis of vertical root fracture

作　　者：闫雪冰[1] 彭红[1] 刘利[1] 宋爱平[1] 孙凤[1] 

机构地区：[1]北京大学口腔医学院门诊部特诊科,100034

出　　处：《实用口腔医学杂志》2011年第1期46-49,共4页Journal of Practical Stomatology

摘　　要：目的:探讨锥形束CT对牙根纵裂(简称根裂)早期诊断的价值。方法:对23颗临床检查可疑为根裂且通过X线根尖片不能确诊的患牙,拍摄锥形束CT(cone-beam computed tomography,CBCT)观察是否存在根裂影像,分别记录为明确根裂、可疑或非根裂。根裂的CT诊断标准为:至少连续2个牙根断面上可见明显的低密度裂隙影或折断片明显移位。结果:CBCT显示23颗患牙中明确根裂17颗,可疑4颗,非根裂2颗。17颗明确根裂患牙均经拔除证实;4颗可疑患牙经4～6月观察后亦拔除并确诊为根裂;CT图像未见根裂表现的2颗患牙经临床证实无根裂。经拔除后确诊根裂的21颗患牙中,活髓牙10颗,已牙髓治疗的无髓牙11颗。CBCT的诊断敏感度为81%。结论:锥形束CT有助于牙根纵裂的早期诊断。Objective：To evaluate the value of cone-beam computed tomography（CBCT） in the early diagnosis of vertical root fracture（VRF）.Methods：The study was conducted on 23 cases with clinically suspected VRF which were not confirmed by conventional periapical radiograph.All the cases were examined by CBCT.The CBCT images were evaluated and recorded in 1 of the following 3 categories：definite fracture,probable fracture,and no-fracture.The CBCT criteria of VRFs were set as detection of a hypoattenuated line on at least 2 continuous axial sections,or separation of the fracture segments.Results：In CBCT images,17 teeth were diagnosed as definite fracture,4 probable fracture and 2 no-fracture.The 17 teeth with definite fracture on CBCT images were proved after extraction and the 4 teeth with probable fracture on CBCT images were also evidenced to have VRFs during 4-6 months follow-up.The other 2 cases without CBCT detectable fracture were finally confirmed to be non-fractured.Among the 21 teeth with surgery-evidenced root fracture,10 were nonendodontically treated and 11 were endodontically treated.The Sensitivity for VRF detection of CBCT were 81%.Conclusion：CBCT was valuable for the early detection of VRFs.

关 键 词：牙根纵裂 X线根尖片 锥形束CT 

分 类 号：R816.98[医药卫生—放射医学]