Heidrich G, Hassepass F, Dullin C, Attin T, Grabbe E, Hannig C
Abteilung Diagnostische Radiologie, Universitätsklinikum Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen.
Rofo. 2005 Dec;177(12):1683-90. doi: 10.1055/s-2005-858557.
Successful endodontic diagnostics and therapy call for adequate depiction of the root canal anatomy with multimodal diagnostic imaging. The aim of the present study is to evaluate visualization of the endodont with flat-panel detector volume CT (FD-VCT).
13 human teeth were examined with the prototype of a FD-VCT. After data acquisition and generation of volume data sets in volume rendering technology (VRT), the findings obtained were compared to conventional X-rays and cross-section preparations of the teeth.
The anatomical structures of the endodont such as root canals, side canals and communications between different root canals as well as denticles could be detected precisely with FD-VCT. The length of curved root canals was also determined accurately. The spatial resolution of the system is around 140 microm. Only around 73 % of the main root canals detected with FD-VCT and 87 % of the roots could be visualized with conventional dental X-rays. None of the side canals, shown with FD-VCT, was detectable on conventional X-rays. In all cases the enamel and dentin of the teeth could be well delineated. No differences in image quality could be discerned between stored and freshly extracted teeth, or between primary and adult teeth.
FD-VCT is an innovative diagnostic modality in preclinical and experimental use for non-destructive three-dimensional analysis of teeth. Thanks to the high isotropic spatial resolution compared with conventional X-rays, even the minutest structures, such as side canals, can be detected and evaluated. Potential applications in endodontics include diagnostics and evaluation of all steps of root canal treatment, ranging from trepanation through determination of the length of the root canal to obturation.
成功的牙髓病诊断和治疗需要通过多模态诊断成像充分描绘根管解剖结构。本研究的目的是评估平板探测器容积CT（FD-VCT）对根管的可视化效果。
使用FD-VCT原型对13颗人牙进行检查。在容积数据采集并通过容积再现技术（VRT）生成容积数据集后，将所得结果与传统X线片及牙齿的横断面标本进行比较。
FD-VCT能够精确检测根管的解剖结构，如根管、侧支根管、不同根管之间的交通支以及牙本质小体。弯曲根管的长度也能准确测定。该系统的空间分辨率约为140微米。FD-VCT检测到的主根管中，只有约73%以及牙根的87%能够在传统牙科X线片上显影。FD-VCT显示的侧支根管在传统X线片上均无法检测到。在所有病例中，牙齿的釉质和牙本质都能清晰显示。储存牙与新鲜拔除牙之间，以及乳牙与恒牙之间在图像质量上没有差异。
FD-VCT是一种用于牙齿非破坏性三维分析的临床前和实验性创新诊断方法。与传统X线片相比，由于具有高各向同性空间分辨率，即使是最微小的结构，如侧支根管，也能被检测和评估。在牙髓病学中的潜在应用包括根管治疗所有步骤的诊断和评估，从开髓到根管长度测定再到充填。
