An In Vivo and Cone Beam Computed Tomography Investigation of the Accuracy in Measuring Alveolar Bone Height and Detecing Dehiscence and Fenestra ion Defects
An In Vivo and Cone Beam Computed Tomography Investigation of the Accuracy in Measuring Alveolar Bone Height and Detecing Dehiscence and Fenestra ion Defects
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DOI：
10.11607/jomi.6633
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发表时间：
2018-11-01
影响因子：
2
通讯作者：
Sehgal, Harjit Singh
中科院分区：
文献类型：
--
作者：
Peterson, Andrew G.;Wang, Mansen;Sehgal, Harjit Singh
目的：研究锥形束计算机断层扫描 (CBCT) 在测量面部骨高度和检测牙齿周围开裂和开窗缺陷方面的准确性。材料和方法：纳入计划进行牙周瓣或牙种植手术治疗的患者（n = 25）。在 0.09 毫米体素（n = 10 名患者，23 颗牙齿）和 0.18 毫米体素（n = 15 名患者，33 颗牙齿）处获得 CBCT 成像 (Carestream CS 9300)。由两名检查者独立地从 CBCT 图像中记录从牙尖尖到沿牙齿长轴的骨顶高度的面部骨高度测量，以及是否存在开裂或开窗缺陷。在手术时进行相应的临床测量。使用配对 t 检验对牙齿进行 CBCT 和临床测量的比较：前牙和后牙、上颌骨和下颌骨、有或没有修复体或根管治疗。研究者之间的一致性程度通过一致性相关系数 (CCC)、皮尔逊相关系数 (PCC) 和科恩卡帕 (Cohen's Kappa) 进行评估。结果：比较平均 CBCT 和临床测量结果，发现 0.09 毫米和 0.18 毫米体素尺寸、前牙和后牙、上颌牙和下颌牙、有或没有修复体的牙齿以及没有根管治疗的牙齿存在统计学显着差异 (P < .05)。对于带牙冠和接受根管治疗的牙齿，临床和 CBCT 测量结果相似 (P > .05)。 CBCT 测量低估了平均面骨高度，从 0.33 +/- 0.78 到 0.88 +/- 1.14 毫米（平均值 +/- SD），绝对面骨高度值从 0.56 +/- 0.35 到 1.08 +/- 0.92 毫米。检查者内部和检查者间测量面骨高度的可靠性从差到高不等（分别为 PCC = 0.78 至 0.97 和 CCC = 0.63 至 0.96）。检测裂开和开窗缺陷的检查者间可靠性范围从差到中等（Cohen's Kappa = -0.09 至 0.66）。结论：CBCT 成像低估了面骨高度，高估了裂开和开窗缺陷的存在。
Purpose: To investigate cone beam computed tomography (CBCT) accuracy in measuring facial bone height and detecting dehiscence and fenestration defects around teeth. Materials and Methods: Patients who were treatment planned for periodontal flap or dental implant surgeries were enrolled (n = 25). CBCT imaging (Carestream CS 9300) was obtained at 0.09-mm voxels (n = 10 patients, 23 teeth) and at 0.18-mm voxels (n = 15 patients, 33 teeth). Facial bone height measurements, from cusp tip to crest of bone height along the long axis of the tooth, and presence or absence of dehiscence or fenestration defects were recorded from CBCT images in triplicates independently by two examiners. The corresponding clinical measurements were made at the time of surgery. Comparisons of CBCT and clinical measurements were made using paired t tests for teeth: anterior and posterior, maxillary and mandibular, with or without restorations, or root canal therapy. Level of agreement between investigators was assessed by concordance correlation coefficients (CCC), Pearson's correlation coefficient (PCC), and Cohen's Kappa. Results: Comparing mean CBCT and clinical measurements, statistically significant differences were noted for 0.09-mm and 0.18-mm voxel sizes, for anterior and posterior teeth, for maxillary and mandibular teeth, for teeth with or without restorations, and for teeth without root canal therapy (P < .05). Clinical and CBCT measurements were similar for teeth with crowns and with root canal therapy (P > .05). CBCT measurements underestimated mean facial bone height from 0.33 +/- 0.78 to 0.88 +/- 1.14 mm (mean +/- SD) and absolute facial bone height values from 0.56 +/- 0.35 to 1.08 +/- 0.92 mm. lntraexaminer and interexaminer reliability for measuring facial bone height ranged from poor to substantial (PCC = 0.78 to 0.97 and CCC = 0.63 to 0.96, respectively). interexaminer reliability for detection of dehiscence and fenestration defects ranged from poor to moderate (Cohen's Kappa = -0.09 to 0.66). Conclusion: CBCT imaging underestimated facial bone height and overestimated the presence of dehiscence and fenestration defects.