CBCT在下颌磨牙根分叉病变诊断中的应用价值研究  

The Application Value of CBCT in the Diagnosis of Mandibular Molar Root Bifurcation

作　　者：桂莉[1] 刘振飞[1] 刘洁 郝玉璋 胡士亮 GUI Li;LIU Zhenfei;LIU Jie;HAO Yuzhang;HU Shiliang(Department of Stomatology,Bozhou People's Hospital,Bozhou 236800,Anhui,China)

机构地区：[1]亳州市人民医院口腔科,安徽亳州236800

出　　处：《中国美容医学》2022年第5期134-137,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:研究锥形束CT(Cone beam computed tomography,CBCT)在下颌磨牙根分叉病变诊断中的应用价值,为下颌磨牙根分叉病变的诊断提供参考。方法:选取40例需行翻瓣术治疗的慢性牙周炎患者(共40颗下颌磨牙),术前进行根尖片及CBCT检查,对根分叉病变进行诊断及分度,测定垂直骨丧失、水平骨丧失、根分叉区骨缺损近远中向距离、根柱长度等相关参数,对病变牙进行翻瓣术清创,同时术中对根分叉进行探诊。结果:40例患者,术中共发现存在73个根分叉病变,其中0度5个、Ⅰ度15个、Ⅱ度41个、Ⅲ度12个,分别占6.85%、20.55%、56.16%、16.44%;CBCT检查共显示70个根分叉病变,根尖片检查共显示63个根分叉病变,CBCT对根分叉病变的检查阳性率为95.89%(70/73)、根尖片检查阳性率为86.30%(63/73),CBCT检查阳性率高于根尖片检查(P<0.05);CBCT检查与术中实际分度比较,差异无统计学意义(P>0.05);CBCT对根分叉病变的准确分度诊断的敏感度为95.59%(65/68)、阳性预测值为92.86%(65/70)、诊断符合率为89.04%(65/73);CBCT测量的垂直骨丧失、根分叉区骨缺损近远中向距离、根柱长度与术中实际测得值比较差异无统计学意义(P>0.05),水平骨丧失小于术中实际测得值,差异有统计学意义(P<0.05),根尖片未能测量到水平骨丧失与根柱长度,测得的垂直骨丧失、根分叉区骨缺损近远中向距离明显小于术中实际测得值,差异有统计学意义(P<0.05)。结论:根尖片对下颌磨牙根分叉病变诊断准确性不及CBCT,CBCT能准确对下颌磨牙根分叉病变进行显影及分度,同时能良好地反映出病变牙骨缺损情况。Objective To discuss the comparative study of cone beam computed tomography(CBCT)and periapical radiography in furcation involvements of mandibular molars,Provide reference for diagnosis in furcation involvements of mandibular molars.Methods 40 patients in assessing furcation involvements of mandibular molars(40 of mandibular molars),periapical radiography and CBCT were performed,Diagnosis and indexing,diagnosis and grading of bifurcated root lesions,the parameters of vertical bone loss,horizontal bone loss,proximal and distal distance of bone defect in root bifurcation region,and length of root column were measured,the diseased teeth were debrided by fl ap fl ap and the root bifurcation was probed intraoperatively.Results 73 assessing furcation involvements of mandibular molars in 40 patients with intraoperative examination,5 of 0 degrees(6.85%),15 ofⅠdegrees(20.55%),41 ofⅡdegrees(56.16%),12 ofⅢdegrees(16.44%),70 furcation involvements of mandibular molars in CBCT,63 furcation involvements of mandibular molars in periapical radiography,The positive rate were 95.89%and 86.30%,Compare the diff erence was statistically signifi cant(P<0.05).CBCT and intraoperative examination index comparison,Compare the difference was statistically significant(P<0.05).The indexing of furcation involvements in CBCT,Sensitivity was 95.59%(65/68),the positive predictive value was 92.86%(65/70),diagnostic coincidence rate was 89.04%(65/73).About vertical bone loss,about mesial-distal bone loss,about length of the root trunk,There was no statistically signifi cant diff erence of CBCT and surgery(P>0.05),The horizontal bone loss revealed by CBCT was signifi cantly smaller than that by surgery(P<0.05).Periapical radiography could only obtain vertical bone loss and mesial-distal bone loss,the diff erence was statistically signifi cant(P<0.05),about length of the root trunk and horizontal bone loss revealed not obtained the numerical.Conclusion Accuracy of periapical radiography lower CBCT in furcation involvements of mandibular molar

关 键 词：根分叉病变 下颌 磨牙 锥形束CT 根尖片 

分 类 号：R781.42[医药卫生—口腔医学]