根尖X线片和锥形束CT评价根尖周骨病变的比较研究

发布时间：2018-01-21 20:32

本文关键词： 根尖周疾病锥束计算机体层摄影术放射摄影术牙科数字　出处：《北京大学学报(医学版)》2016年03期 　论文类型：期刊论文

【摘要】：目的:比较根尖X线片和锥形束CT(cone-beam computed tomograghy,CBCT)两种影像学手段在判断根管治疗后根尖病变的有无及揭示病变变化方面的差异。方法:收集术前诊断为慢性根尖周炎,于北京大学口腔医院牙体牙髓科接受根管治疗及复查患者的病案资料(包括根尖X线片和CBCT影像学资料)233例,由经过一致性检验的两名评价者,对复查时治疗后根尖病变有无做出诊断,并判断根尖病变的变化(病变消失、缩小、不变、增大)。经Mc Nemar检验及Fisher确切概率检验分别比较根尖X线片及CBCT在判断病变有无、揭示病变变化方面是否存在差异。结果:在233份复查资料中,CBCT发现治疗后根尖病变178例,相较于根尖X线片发现的146例,差异有统计学意义(P0.01)。在25%(57/233)的病例中,根尖X线片和CBCT揭示根尖病变变化趋势不同,统计学分析表明根尖X线片和CBCT这两种影像学手段在判断病变变化方面存在差异(P0.01)。结论:根尖X线片和锥形束CT在判断治疗后根尖病变的有无、揭示根尖病变变化方面存在差异。
[Abstract]:Objective: to compare the root-tip X-ray film with the conical beam CT(cone-beam computed tomograghy. The difference between the two imaging methods in judging whether the apical lesion exists after root canal therapy and revealing the changes of the lesion. Methods: the diagnosis of chronic periapical periapical periodontitis before operation was collected. In the dental pulp department of Peking University Stomatology Hospital, the medical records of the patients received root canal therapy and re-examination (including apical radiography and CBCT imaging data) were evaluated by two patients who were evaluated by consistency test. The diagnosis of apical lesion after treatment was made, and the change of apical lesion was judged (the lesion disappeared, decreased and remained unchanged). By MC Nemar test and Fisher exact probability test, the apical X-ray film and CBCT were compared to determine the lesion. Results: there were 178 cases of post-treatment root tip lesions found by CBCT, compared with 146 cases of root apex X-ray findings. The difference was statistically significant (P 0.01). In 25 / 57 / 233 cases, apical radiography and CBCT revealed different trends in apical lesions. Statistical analysis showed that there was a difference between root-tip radiography and CBCT in judging pathological changes (P0.01). Conclusion: the apical X-ray film and conical beam CT were used to determine the apical lesion after treatment. There are differences in the changes of apical lesions.
【作者单位】：北京大学口腔医学院·口腔医院牙体牙髓科口腔数字化医疗技术和材料国家工程实验室;
【基金】：首都临床特色应用研究(Z131107002231045)资助~~
【分类号】：R781.34
【正文快照】： 对于存在根尖病变的患牙,根管治疗的目的为通过对根管系统的机械清创、化学消毒以及严密充填,消除感染源,从而治愈已经发生的根尖病变[1-2]。影像学检查是判断根管治疗疗效非常重要的客观指标[3-5],可以指导临床医生选择修复的时机以及判断是否需要再治疗。目前,各种影像学检

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