A retrospective study on molar furcation assessment via clinical detection, intraoral radiography and cone beam computed tomography.
A retrospective study on molar furcation assessment via clinical detection, intraoral radiography and cone beam computed tomography.
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DOI：
10.1186/s12903-018-0544-0
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发表时间：
2018-05-03
期刊：
影响因子：
2.9
通讯作者：
Wang BY
中科院分区：
文献类型：
--
作者：
Zhang W;Foss K;Wang BY
在许多情况下，通过临床检测和口内X线片准确确定磨牙分叉区域的骨丢失具有挑战性。锥形束计算机断层扫描（CBCT）有望打开牙周评估的新视野。本研究的目的是通过临床检测、口内X线摄影和CBCT图像比较和关联磨牙根分叉评估的准确性。纳入了83例接受CBCT扫描的慢性牙周炎患者。根分叉受累评估上颌骨和下颌第一磨牙。牙周病图表（改良Glickman分类），口内（根尖周和/或咬翼）X线片（记录为存在或不存在）和轴向CBCT重建用于评估颊和腭/舌部位的根分叉受累。Pearson分析评价3种方法对根分叉的评价结果的相关性。在所有测量部位，临床检测与口内X线摄影、临床检测与CBCT以及口内X线摄影与CBCT之间均存在显著相关性（p < 0.05）（r值范围在0.230至0.644之间）。CBCT与临床的相关性普遍高于口内X线片，尤其是上颌第一磨牙远中腭侧（p < 0.05）。此外，CBCT提供了更准确的评估，骨丢失测量值高达2个小数点（毫米），而临床检测有3个级别，口内X线片通常仅检测到Glickman 2级和3级分叉病变的存在。本研究证实，除了临床检测和口内X线摄影外，CBCT在磨牙根分叉评估中是一种有价值的工具。
Accurate determination of bone loss at the molar furcation region by clinical detection and intraoral radiograph is challenging in many instances. Cone beam computed tomography (CBCT) is expected to open a new horizon in periodontal assessment. The purpose of this study was to compare and correlate accuracy of molar furcation assessment via clinical detection, intraoral radiography and CBCT images. Eighty-three patients with chronic periodontitis who had existing CBCT scans were included. Furcation involvement was assessed on maxillary and mandibular first molars. Periodontal charts (modified Glickman’s classification), intraoral (periapical and/or bitewing) radiographs (recorded as presence or absence) and axial CBCT reconstructions were used to evaluate furcation involvement on buccal and palatal/lingual sites. The correlation of furcation assessment by the three methods was evaluated by Pearson analysis. There were significant correlations (p < 0.05) between clinical detection and intraoral radiography, clinical detection and CBCT, as well as intraoral radiography and CBCT at all the measured sites (r values range between 0.230 to 0.644). CBCT generally exhibited higher correlation with clinical detection relative to intraoral radiography, especially at distal palatal side of maxillary first molar (p < 0.05). In addition, CBCT provided more accurate assessment, with bone loss measurement up to 2 decimals in millimeters, whereas clinical detection had 3 classes and the intraoral radiographs usually only detected the presence of furcation involvement in Glickman Class 2 and 3. This study validates that CBCT is a valuable tool in molar furcation assessment in addition to clinical detection and intraoral radiography.
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