CBCT对不同牙周袋深度、裂纹宽度隐匿性牙根纵裂的诊断效能  

Diagnostic efficacy of CBCT on hidden longitudinal root fracture with different periodontal pocket depths and crack widths

作　　者：刘辉 戴思远 谢宝强 LIU Hui;DAI Siyuan;XIE Baoqiang(Department of Stomatology,Bengbu Third People's Hospital Affiliated to Bengbu Medical University,Bengbu,Anhui 233000,China)

机构地区：[1]蚌埠医科大学附属蚌埠第三人民医院口腔科,安徽蚌埠233000

出　　处：《淮海医药》2024年第6期571-574,共4页Journal of Huaihai Medicine

摘　　要：目的:探究锥形束电子计算机断层扫描(CBCT)对不同牙周袋深度、裂纹宽度隐匿性牙根纵裂的诊断效能。方法:选取2020年8月—2023年12月某院口腔科收治的90例(99颗患牙)疑似隐匿性牙根纵裂患者,所有患牙均行X线根尖片和CBCT检查,以患牙治疗术中观察到的裂纹结果为金标准。比较X线根尖片、CBCT与手术诊断隐匿性牙根纵裂结果,以及隐匿性牙根纵裂与非隐匿性牙根纵裂患牙的牙周袋深度、裂纹宽度;分析CBCT对不同牙周袋深度、裂纹宽度隐匿性牙根纵裂的诊断效能。结果:经术中观察,发现隐匿性牙根纵裂84颗,非隐匿性牙根纵裂15颗;X线根尖片显示,隐匿性牙根纵裂45颗;CBCT显示,隐匿性牙根纵裂76颗。经一致性Kappa检验,X线根尖片与手术诊断隐匿性牙根纵裂结果一致性一般(Kappa=0.221),CBCT与手术诊断结果一致性较高(Kappa=0.742)(P均<0.05)。隐匿性牙根纵裂组牙周袋深度、裂纹宽度均大于非隐匿性牙根纵裂组,差异有统计学意义(P<0.05)。CBCT对牙周袋深度≥5 mm患牙隐匿性牙根纵裂的检出率(82.86%)、灵敏度(95.08%)、准确度(95.71%)高于牙周袋深度<5 mm患牙(62.07%、78.26%、82.76%),差异有统计学意义(P<0.05);对裂纹宽度≥123μm患牙隐匿性牙根纵裂的检出率(82.61%)、灵敏度(98.28%)、准确度(98.55%)高于裂纹宽度<123μm患牙(63.33%、73.08%、76.67%),差异有统计学意义(P<0.05);对不同牙周袋深度、裂纹宽度隐匿性牙根纵裂诊断的特异度均为100%。结论:CBCT诊断隐匿性牙根纵裂与手术诊断结果一致性较高,对牙周袋深度≥5 mm、牙裂纹宽度≥123μm患牙的诊断效能较高。Objective:To explore the diagnostic efficacy of cone beam computed tomography(CBCT)for hidden longitudinal root fractures with different periodontal pocket depths and crack widths.Methods:90 patients(99 affected teeth)suspected of having hidden longitudinal root fractures admitted to the dental department of a certain hospital from August 2020 to December 2023 were selected.All affected teeth underwent X-ray root apex film and CBCT examination,with the crack results observed during the tooth treatment surgery as the gold standard.Comparison was conducted between the results of X-ray root apex film,CBCT,and surgical diagnosis of occult root longitudinal fractures,as well as the periodontal pocket depth and crack width of teeth with occult root longitudinal fractures and non-occult root longitudinal fractures.The diagnostic efficacy of CBCT for hidden longitudinal root fractures with different periodontal pocket depths and crack width was analyzed.Results:Through intraoperative observation,84 hidden root fractures and 15 non-hidden root fractures were found;X-ray root apex film showed 45 hidden longitudinal root fractures and CBCT showed 76 hidden longitudinal root fractures.According to the consistency Kappa test,the consistency between X-ray root apex film and surgical diagnosis of occult longitudinal root fracture was generally low(Kappa=0.221),while the consistency between CBCT and surgical diagnosis was relatively high(Kappa=0.742)(both P<0.05).The depth and crack width of the periodontal pocket in the hidden root longitudinal fracture group were greater than those in the non hidden root longitudinal fracture group(P<0.05).The detection rate(82.86%),sensitivity(95.08%),and accuracy(95.71%)of CBCT for occult longitudinal root fractures in teeth with periodontal pocket depth≥5 mm were higher than those in teeth with periodontal pocket depth<5 mm(62.07%,78.26%,82.76%)(P<0.05).The detection rate(82.61%),sensitivity(98.28%),and accuracy(98.55%)of occult root longitudinal cracks in teeth with crack width≥123μm

关 键 词：牙根纵裂 锥形束CT X线根类片 牙裂纹宽度 牙周袋深度 

分 类 号：R781.2[医药卫生—口腔医学]