Periodontal Probing of Dental Furcations Compared With Diagnosis by Low-Dose Computed Tomography: A Case Series
Periodontal Probing of Dental Furcations Compared With Diagnosis by Low-Dose Computed Tomography: A Case Series
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DOI：
10.1902/jop.2013.120698
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发表时间：
2013-12-01
影响因子：
4.3
通讯作者：
Ulm, Christian
中科院分区：
文献类型：
--
作者：
Laky, Markus;Majdalani, Shaila;Ulm, Christian
背景：牙周手术的治疗决定是基于对牙周分叉的准确诊断。临床探查是基本的诊断工具；然而，临床探查区分II类和III类功能缺陷的准确性尚不清楚。因此，本研究将临床探查诊断与计算机断层扫描（CT）进行比较。方法：对75例重度牙周病患者进行病例系列研究。通过临床探查，确定了582个臼齿分岔点用于诊断II类和III类分岔缺陷。以CT诊断为参考。结果：与放射学分析相比，57%的临床表现证实了分叉的受损伤程度，而20%被高估，23%被低估。CT扫描中III类功能的临床检出率仅为32%。CT扫描与临床探诊的相关性以下颌骨颊分岔部位和上颌骨颊分岔部位为最佳，k系数为0.52,kappa = 0.38。舌功能的kappa系数为0.35，中端功能为0.29，远端功能为0.27，相关性较弱。结论：CT扫描能提供比临床探查更详细的分叉受累信息。尤其是在手术治疗前，三维放射成像是评估分叉受累程度和优化治疗决策的有用工具。
Background: Therapeutic decisions in periodontal surgery are based on the accurate diagnosis of the furcation. Clinical probing is the basic diagnostic tool; however, the accuracy of clinical probing to distinguish Class II and Class III furcation defects is unknown. Therefore, this study compares clinical probing diagnoses to those of computed tomography (CT).Methods: Seventy-five patients with severe periodontal disease were enrolled in this case series study. A total of 582 furcation sites in molars were assigned for the diagnosis of Class II and Class III furcation defects by clinical probing. Diagnosis based on CT served as a reference.Results: The degree of furcation involvement on clinical findings was confirmed in 57% of the sites, whereas 20% were overestimated and 23% were underestimated compared with the radiologic analysis. Only 32% of Class III furcations in the CT scan were detected clinically. The best correlation of CT scan and clinical probing was found at buccal furcation sites in the mandible, with a k-coefficient of 0.52, and buccal furcation sites in the maxilla, kappa = 0.38. The kappa-coefficient was 0.35 for lingual furcations, 0.29 for mesial furcations, and 0.27 for distal furcations, showing weaker correlations.Conclusions: CT scans offer more detailed information on furcation involvement than clinical probing. Especially before surgical treatment, three-dimensional radiographic imaging can be a useful tool to assess the degree of furcation involvement and optimize treatment decisions.