Evaluation of furcation involvement with diagnostic imaging methods: a systematic review.
Evaluation of furcation involvement with diagnostic imaging methods: a systematic review.
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DOI：
10.1259/dmfr.20210529
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发表时间：
2022-12-01
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影响因子：
--
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中科院分区：
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多根牙对非手术牙周治疗的反应较差，长期牙齿预后受根分叉受累程度（FI）的影响。多根牙的治疗策略基本上是基于FI的准确诊断。本系统综述的目的是评价不同根分叉评估方法的准确性，并确定是否需要放射学帮助来确定早期FI。检索了截至2021年3月的电子数据库。对描述不同临床和/或放射学分叉评估方法可靠性的比较研究进行了识别。共纳入22项比较至少2种根分叉评估方法的研究，其中回顾性研究15项，前瞻性研究5项，随机对照试验1项，病例系列1项。评价了锥形束CT（CBCT）、口内X线片（IO）、正射断层扫描（OPG）和MRI识别FI的可靠性。使用OFS作为FI检测和诊断的参考，OPG的一致性范围为43.3 - 63%，IO为38.7 - 83.1%，CBCT为82.4 - 84%。测量的有效性主要受分叉入口位置的影响。对于放射学诊断，CBCT显示与OFS最接近的一致性，而IO和OPG的准确性显示适度的一致性，并受检查者经验的影响。总之，似乎使用IO、OPG或CBCT可以检测FI，但不能被视为金标准技术。
Multirooted teeth respond less favorably to non-surgical periodontal treatment and long-term tooth prognosis is influenced by the degree of furcation involvement (FI). Therapeutic strategy for multirooted teeth is essentially based on accurate diagnosis of the FI. The aim of this systematic review is to evaluate the accuracy of the different furcation assessment methods and to determine if radiographic help is needed to determine early stage of FI. Electronic databases were searched up to March 2021. Comparative studies describing the reliability of different clinical and/or radiological furcation assessment methods were identified. A total of 22 studies comparing at least 2 furcation assessment methods, among which 15 retrospective studies, 5 prospective studies, 1 randomized controlled trial and 1 case series, were included in this review. The reliability of cone beam CT (CBCT), intraoral radiographs (IOs), orthopantomograms (OPGs) and MRI to identify FI was evaluated. Using OFS as a reference for FI detection and diagnosis, agreement ranged from 43.3 to 63% for OPG, 38.7 to 83.1% for IO and 82.4 to 84% for CBCT. The validity of the measurements was mainly influenced by the location of the furcation entrance. For radiological diagnosis, CBCT displayed the closest agreement with OFS while the accuracy of IO and OPG showed modest agreement and were influenced by the examiner’s experience. Altogether, it appears that the use of IO, OPG or CBCT allows detection of FI but could not be considered as gold-standard techniques.
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