锥形束CT与数字化牙片诊断牙根纵裂的比较  

Comparison of cone-beam computed tomography and digital radiography for the detection of vertical root fractures

作　　者：魏婷[1] 吴友农[2,3] 王晶艳[4] 孙超[4] 

机构地区：[1]南京市第二医院口腔科,江苏南京210009 [2]南京医科大学口腔疾病研究江苏省重点实验室 [3]南京医科大学附属口腔医院牙体牙髓病科,江苏南京210029 [4]南京医科大学附属口腔医院放射科,江苏南京210029

出　　处：《口腔医学》2015年第6期449-451,472,共4页Stomatology

基　　金：江苏高校优势学科建设工程(2014-37)

摘　　要：目的比较锥形束CT与数字化牙片诊断人离体牙牙根纵裂的准确度。方法人类头颅标本1个,完整拔出其27颗牙,去冠后用摸球法随机分为两组,实验组14颗牙,以锥子插入根管内劈开制牙根纵裂模型,对照组13颗牙不劈开。所有牙重新复位至牙槽窝内行CBCT扫描和拍摄数字化牙片。两组医生分别对图像进行独立评片,做出是否折裂的诊断。以是否劈裂为金标准,对两种方法及评片员所得结果的一致性进行评价。结果 CBCT诊断牙根纵裂的灵敏度和特异度分别为75%和100%,数字化牙片分别为60.72%和84.62%,CBCT的可靠性(κ=0.743)较高,而数字化牙片(κ=0.449)一般。两组评片员使用CBCT诊断牙根纵裂的总体一致性高(κ=0.922),使用数字化牙片诊断牙根纵裂的总体一致性一般(κ=0.611)。结论与数字化牙片比,CBCT诊断牙根纵裂的灵敏度、特异度和可靠性均较高。评片员使用CBCT比使用数字化牙片得出牙根纵裂诊断结论的一致性好。Objective To compare the accuracy of CBCT scans and digital radiography （DR） for detecting simulated VRF. Methods Twenty-seven teeth of one human skull specimen were extracted out decoronated and randomly divided into 2 groups. 14 roots were in experimental group and 13 in control group. An awl in root canal was inserted to split up the root to make the vertical fracture model in experimental group. Those in control group were kept intact. Then all teeth were placed back to the skull specimen. CBCT scans and DR were obtained. Two blinded groups of observers evaluated the CBCT and DR images independently to make the diagnosis of fracture. Whether there was fracture or not was taken as the gold standard, and the two methods and the consistency of results by the observers were evaluated. Results The sensitivity and specificity of VRF of human specimen diagnosed by the CBCT were 75% and 100% ,and those by digital radiography were 60.72% and 84.62% , respectively. The reliability of CBCT （ κ = 0. 743 ） was higher than that of dig- ital radiography （K =0. 449）. The coherence of the two groups of investigators was high with CBCT （κ = 0. 922） and medium with dig- ital radiography （ κ = 0.611 ）. Conclusions The results showed higher sensitivity, specificity and reliability for CBCT scans than dig- ital radiography for detecting VRF. The coherence of the observers was higher using CBCT.

关 键 词：锥形束CT 数字放射技术 牙根纵裂 诊断 

分 类 号：R781.2[医药卫生—口腔医学]