Rawlinson A, Elcock C, Cheung A, Al-Buhairi A, Khanna S, Walsh T F, Ellwood R P
Department of Adult Dental Care, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield S10 2TA, UK.
J Dent. 2005 Oct;33(9):781-8. doi: 10.1016/j.jdent.2005.01.013.
(a) To validate a method for acquiring reproducible radiographic images and repeatable measurements of digital images. (b) To investigate the clinical and radiographic changes following periodontal surgery and in a periodontally healthy control group.
In-vitro study. Sixteen dried human skulls had replicate intra-oral radiographs taken using an extra-oral alignment apparatus under simulated clinical conditions, and measurements were made on the images using Image Pro-Plus analysis software. In-vivo study. Seven subjects, aged 38-63 years with chronic periodontitis, were treated using replaced flap surgery. Nine patients with healthy periodontal tissues were recruited as a control group. Clinical measurements and radiographs were taken pre-surgery and 6 months afterwards, and at the same interval for untreated healthy controls using the alignment apparatus. Radiographs were analysed using Image Pro-Plus and subtraction radiography.
Radiographs had a high degree of reliability (ICC 0.98-0.99) for the in-vitro study and intra-operator repeatability of measurements was high (ICC 0.65-0.99) for the in-vivo study. Over this interval there were both significant clinical improvements and in bone gain within infra-bony defects on radiographs. Subtracted images showed that out of 17 surgically treated sites, 13 showed evidence of bone gain, one showed no change, two showed bone loss and one could not be interpreted due to poor alignment. Overall there were no significant clinical or radiographic changes in the control group.
Radiographic images were highly reproducible. Measurements had a high degree of repeatability. The methods used allowed accurate quantitative and qualitative measurement of change in alveolar bone. This technique would allow accurate measurement of any changes in alveolar bone levels in patients with periodontal disease.
(a) 验证一种获取可重复的放射影像及对数字影像进行可重复测量的方法。(b) 研究牙周手术后及牙周健康对照组的临床和放射学变化。
体外研究。16个干燥的人类颅骨在模拟临床条件下使用口外定位装置拍摄重复的口腔内放射片，并使用Image Pro-Plus分析软件对影像进行测量。体内研究。7名年龄在38 - 63岁的慢性牙周炎患者接受了改良翻瓣手术治疗。招募9名牙周组织健康的患者作为对照组。术前及术后6个月进行临床测量和放射片拍摄，未治疗的健康对照组在相同间隔时间使用定位装置进行测量。使用Image Pro-Plus和减影放射摄影对放射片进行分析。
体外研究中放射片具有高度可靠性（组内相关系数ICC为0.98 - 0.99），体内研究中测量的操作者内重复性较高（ICC为0.65 - 0.99）。在此期间，临床上有显著改善，放射片显示骨下袋内骨量增加。减影图像显示，在17个手术治疗部位中，13个有骨量增加的证据，1个无变化，2个有骨量丢失，1个因对位不佳无法解读。总体而言，对照组在临床和放射学上均无显著变化。
放射影像具有高度可重复性。测量具有高度重复性。所使用的方法能够准确地对牙槽骨变化进行定量和定性测量。该技术可准确测量牙周病患者牙槽骨水平的任何变化。
