Teeuw W J, Coelho L, Silva A, van der Palen C J N M, Lessmann F G J M, van der Velden U, Loos B G
Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University, Amsterdam, The Netherlands.
J Periodontal Res. 2009 Feb;44(1):94-102. doi: 10.1111/j.1600-0765.2008.01111.x. Epub 2008 Oct 7.
Radiographs are an essential adjunct to the clinical examination for periodontal diagnoses. Over the past few years, digital radiographs have become available for use in clinical practice. Therefore, the present study investigated whether measuring alveolar bone loss, using digital radiographs with a newly constructed dental image analyzer tool was comparable to the conventional method, using intra-oral radiographs on film, a light box and a Schei ruler.
Alveolar bone loss of the mesial and distal sites of 60 randomly selected teeth from 12 patients with periodontitis was measured using the conventional method, and then using the dental image analyzer tool, by five dentists. The conventional method scored bone loss in categories of 10% increments relative to the total root length, whereas the software dental image analyzer tool calculated bone loss in 0.1% increments relative to the total root length after crucial landmarks were identified.
Both methods showed a high interobserver reliability for bone loss measurements in nonmolar and molar sites (intraclass correlation coefficient > or = 0.88). Also, a high reliability between both methods was demonstrated (intraclass correlation coefficient nonmolar sites, 0.98; intraclass correlation coefficient molar sites, 0.95). In addition, the new dental image analyzer tool showed a high sensitivity (1.00) and a high specificity (0.91) in selecting teeth with > or = 50% or < 50% alveolar bone loss in comparison with the conventional method.
This study provides evidence that, if digital radiographs are available, the dental image analyzer tool can reliably replace the conventional method for measuring alveolar bone loss in periodontitis patients.
X线片是牙周病诊断临床检查的重要辅助手段。在过去几年中，数字X线片已可用于临床实践。因此，本研究调查了使用新构建的牙科图像分析工具的数字X线片测量牙槽骨吸收与使用口腔内胶片X线片、观片灯和谢伊标尺的传统方法是否具有可比性。
由五名牙医使用传统方法，然后使用牙科图像分析工具，对12名牙周炎患者随机选取的60颗牙齿的近中及远中部位的牙槽骨吸收情况进行测量。传统方法根据相对于牙根总长度的10%增量对骨吸收进行评分，而软件牙科图像分析工具在识别关键标志点后根据相对于牙根总长度的0.1%增量计算骨吸收。
两种方法在非磨牙和磨牙部位的骨吸收测量中均显示出较高的观察者间可靠性（组内相关系数≥0.88）。此外，两种方法之间也显示出较高的可靠性（组内相关系数非磨牙部位为0.98；组内相关系数磨牙部位为0.95）。此外，与传统方法相比，新型牙科图像分析工具在选择牙槽骨吸收≥50%或<50%的牙齿时显示出高敏感性（1.00）和高特异性（0.91）。
本研究提供的证据表明，如果有数字X线片，牙科图像分析工具可可靠地替代传统方法来测量牙周炎患者的牙槽骨吸收。
