Estrela Carlos, Bueno Mike Reis, Azevedo Bruno Correa, Azevedo José Ribamar, Pécora Jesus Djalma
Federal University of Goiás, Goiânia, GO, Brazil.
University of Cuiabá, Cuiabá, MT, Brazil.
J Endod. 2008 Nov;34(11):1325-1331. doi: 10.1016/j.joen.2008.08.013. Epub 2008 Sep 17.
The purpose of this study was to evaluate a new periapical index based on cone beam computed tomography (CBCT) for identification of apical periodontitis (AP). The periapical index proposed in this study (CBCTPAI) was developed on the basis of criteria established from measurements corresponding to periapical radiolucency interpreted on CBCT scans. Radiolucent images suggestive of periapical lesions were measured by using the working tools of Planimp software on CBCT scans in 3 dimensions: buccopalatal, mesiodistal, and diagonal. The CBCTPAI was determined by the largest lesion extension. A 6-point (0-5) scoring system was used with 2 additional variables, expansion of cortical bone and destruction of cortical bone. A total of 1014 images (periapical radiographs and CBCT scans) originally taken from 596 patients were evaluated by 3 observers by using the CBCTPAI criteria. AP was identified in 39.5% and 60.9% of cases by radiography and CBCT, respectively (P < .01). The CBCTPAI offers an accurate diagnostic method for use with high-resolution images, which can reduce the incidence of false-negative diagnosis, minimize observer interference, and increase the reliability of epidemiologic studies, especially those referring to AP prevalence and severity.
本研究的目的是评估一种基于锥形束计算机断层扫描（CBCT）的新根尖周指数，用于识别根尖周炎（AP）。本研究中提出的根尖周指数（CBCTPAI）是根据CBCT扫描上根尖周透射影像测量所确立的标准制定的。通过使用Planimp软件的工作工具，在CBCT扫描的三维（颊腭向、近远中向和对角线方向）上测量提示根尖周病变的透射影像。CBCTPAI由最大病变范围确定。采用6分（0 - 5）评分系统，并附加两个变量，即皮质骨扩展和皮质骨破坏。3名观察者使用CBCTPAI标准对最初来自596例患者的1014张影像（根尖片和CBCT扫描）进行了评估。通过X线摄影和CBCT分别在39.5%和60.9%的病例中识别出AP（P <.01）。CBCTPAI为高分辨率影像提供了一种准确的诊断方法，可降低假阴性诊断的发生率，减少观察者干扰，并提高流行病学研究的可靠性，尤其是那些涉及AP患病率和严重程度的研究。
