Periodontal Probing Versus Radiographs for the Diagnosis of Furcation Involvement
Periodontal Probing Versus Radiographs for the Diagnosis of Furcation Involvement
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DOI：
10.1902/jop.2014.130612
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发表时间：
2014-10-01
影响因子：
4.3
通讯作者：
Doerfer, Christof E.
中科院分区：
文献类型：
--
作者：
Graetz, Christian;Plaumann, Anna;Doerfer, Christof E.
背景：多根牙的牙周治疗决策基本上是基于对分叉受累（FI）的准确诊断。分叉探查（FP）仍然是基本的诊断手段，尽管评估可能是困难的。本研究的目的是评价开放皮瓣手术（OFS）中FP和FI的影像学评估与视觉评估的有效性。方法：在这项回顾性临床队列研究中，215名牙周病患者和至少一颗磨牙接受了OFS治疗，共有834颗磨牙被FP指定为FI，并由经验丰富的（EE）和经验不足的检查员（LE）分析x线片。对143张全景x线片（OPGs）和77张口内x线片（i -o）进行了评估。结果：FP对FI的分级确诊率为56%，高估率为15%，低估率为29%。FI 0类和I类检出率高（分别为74%和54%）。在所有FI III类中，57%通过x线片正确检测，32%通过FP检测。FP和OFS的加权k系数(K-W) = 0.588；x线片和OFS的K-W = 0.542 （OPG K-W = 0.555, I-O K-W = 0.521）。x线片的互判者信度依赖于检查者的经验（EE K-W = 0.618; LE K-W = 0.426）。结论：分析常规x线片的经验增加了晚期FI的正确诊断的可能性。与x线评估相比，FP的可靠性取决于牙齿的解剖结构和位置。这两种诊断工具都应用于疑似FI的病例。
Background: Decisions in periodontal therapy for multi-rooted teeth are essentially based on accurate diagnosis of the furcation involvement (FI). Furcation probing (FP) is still the basic diagnostic measure, although the assessment may be difficult. The aim of this study is to evaluate the validity of FP and radiographic assessment of FI compared with visual assessment during open flap surgery (OFS).Methods: In this retrospective clinical cohort study, 215 participants with periodontal disease and at least one molar treated with OFS were enrolled, and a total of 834 molars were assigned for FI by FP and in radiographs analyzed by an experienced (EE) and less experienced examiner (LE). For the investigation, 143 panoramic radiographs (OPGs) and 77 intra-oral radiographs (I-Os) were evaluated.Results: The Class of FI by FP was confirmed in 56%, whereas 15% were overestimated and 29% underestimated. FI Class 0 and I had been detected with high probability (74% and 54%, respectively). Of all FI Class III, 57% were detected correctly by radiographs and 32% by FP. FP and OFS revealed a weighted K-coefficient (K-W) = 0.588; radiographs and OFS had K-W = 0.542 (OPG K-W = 0.555 and I-O K-W = 0.521). The interrater reliability for radiographs was dependent on the experience of the examiner (EE K-W = 0.618; LE K-W = 0.426).Conclusions: Experience in analyzing conventional radiographs increases the potential of correct diagnosis of advanced FI. The reliability of FP compared with radiographic assessment depends on the anatomy and location of the tooth. Both diagnostic tools should be used in cases of suspected FI.