Ricucci Domenico, Mannocci Francesco, Ford Thomas R Pitt
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Mar;101(3):389-94. doi: 10.1016/j.tripleo.2005.08.026.
To compare the presence or absence of a radiopaque lamina of 60 human periapical lesions with the histological findings from a case study in dental practice.
Paralleling radiographs were taken of 60 teeth with periapical radiolucencies. The periapical radiographs were scanned, and standardized images were evaluated on a computer screen for the presence or absence of a radiopaque lamina by 2 calibrated observers according to agreed criteria. The serially sectioned histological specimens were obtained from the extraction of 13 endodontically treated teeth and 27 nontreated teeth, as well as 20 post-treatment teeth with apical periodontitis removed during periapical surgical procedure; the specimens were classified according to agreed criteria. The findings of the 2 evaluations were compared.
Out of 57 electronic images that could be interpreted, 10 lesions had a radiopaque lamina, but of these only 3 were histologically diagnosed as cysts, while 7 were granulomas or abscesses. Out of 47 lesions without a radiopaque lamina, 40 were histologically diagnosed as granulomas or abscesses, while 7 were cysts.
The diagnosis of periapical lesions cannot be made on the basis of the presence or absence of a radiopaque lamina, but requires histological examination of serial sections.
比较60例人类根尖周病变中不透射线板层的有无与牙科实践中一项病例研究的组织学结果。
对60颗有根尖周透射区的牙齿拍摄平行投照X线片。扫描根尖周X线片,由2名经过校准的观察者根据商定标准在电脑屏幕上评估标准化图像中不透射线板层的有无。连续切片的组织学标本取自13颗经根管治疗的牙齿、27颗未经治疗的牙齿的拔除,以及20颗在根尖周手术过程中拔除的根尖周炎治疗后牙齿;标本根据商定标准进行分类。比较两种评估的结果。
在57张可解读的电子图像中,10个病变有不透射线板层,但其中只有3个在组织学上被诊断为囊肿,7个为肉芽肿或脓肿。在47个没有不透射线板层的病变中,40个在组织学上被诊断为肉芽肿或脓肿,7个为囊肿。
根尖周病变的诊断不能基于不透射线板层的有无,而需要对连续切片进行组织学检查。