Tamse Aviad, Kaffe Israel, Lustig Joseph, Ganor Yehuda, Fuss Zvi
Department of Endodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Jun;101(6):797-802. doi: 10.1016/j.tripleo.2005.09.014. Epub 2006 Mar 24.
The purpose of this study was to evaluate the most frequent radiographic appearance of bony lesions around endodontically treated vertically fractured mesial roots of mandibular molars.
For the study, 49 extracted mesial roots with vertical fractures (study group) were evaluated and compared to 52 extracted roots without fractures (control).
The "halo" (36.7%) and "periodontal" (28.6%) type radiolucencies were the most typical appearances of periradicular areas around the mesial roots of mandibular molars with vertical root fractures. By itself, bifurcation radiolucency was statistically insignificant (6.1%), however in conjunction with other areas of radiolucency, it was significant (63.3%, P < .0378). No radiolucency (38.5%) and periapical radiolucency (32.7%) were predominant features in the control (nonfractured roots). Amalgam dowel in the coronal part (1-2 mm) of the root was found in 67.3% of the vertically fractured roots (P < .0006). Defined but not corticated (57.2%) or diffuse (32.6%) borders were typical for vertically fractured mesial roots.
The use of significant variables, such as "periodontal" and "halo" bony radiolucencies, bifurcation involvement, and the presence of amalgam dowel, has prediction sensitivity of 77.6% (VRF group) and specificity of 82.7% (nonfractured roots).
本研究旨在评估下颌磨牙经根管治疗的近中根垂直骨折周围骨病变最常见的影像学表现。
本研究对49颗拔除的垂直骨折近中根(研究组)进行评估,并与52颗未骨折的拔除根(对照组)进行比较。
“晕圈”(36.7%)和“牙周”(28.6%)型透射影是下颌磨牙近中根垂直骨折周围根尖周区域最典型的表现。单独来看,根分叉透射影在统计学上无显著意义(6.1%),然而与其他透射影区域同时出现时则具有显著意义(63.3%,P <.0378)。无透射影(38.5%)和根尖透射影(32.7%)是对照组(未骨折根)的主要特征。在67.3%的垂直骨折根中发现根冠部(1 - 2毫米)有银汞桩(P <.0006)。明确但无皮质骨包绕(57.2%)或弥漫性(32.6%)的边界是垂直骨折近中根的典型表现。
使用“牙周”和“晕圈”型骨透射影、根分叉受累情况以及银汞桩的存在等显著变量,预测敏感性为77.6%(垂直骨折组),特异性为82.7%(未骨折根)。