Grimard Brently A, Hoidal Matt J, Mills Michael P, Mellonig James T, Nummikoski Pirkka V, Mealey Brian L
Department of Periodontics, University of Texas Health Science Center, San Antonio, TX. USA.
J Periodontol. 2009 Jan;80(1):48-55. doi: 10.1902/jop.2009.080289.
Intraoral radiographs (IRs) provide a two-dimensional view of osseous structures, whereas cone-beam volumetric tomography (CBVT) images are viewable in three dimensions. The aim of this investigation was to compare the measurements from digital IR and CBVT images to direct surgical measurements for the evaluation of regenerative treatment outcomes.
Digital IR and CBVT images were taken prior to initial bone grafting and at the 6-month reentry surgery for 35 intrabony defects. After defect debridement, direct bony defect measurements were made with a periodontal probe. These same measurements were made on the IR and CBVT images and then compared to the direct surgical values.
CBVT correlated strongly with surgical measurements (r = 0.89 to 0.95), whereas IRs correlated less favorably (r = 0.53 to 0.67). IR measurements were significantly less accurate compared to CBVT for all parameters investigated and underestimated surgical measurements from 0.6 +/- 2.3 mm to 1.5 +/- 2.3 mm. No significant difference for the distance from the cemento-enamel junction (CEJ) to the alveolar crest (P = 0.66 for initial measurement and P = 0.92 for reentry), defect fill (P = 0.14), or defect resolution (P = 0.09) was seen between CBVT and surgical measurements; however, there was a significant difference for the distance from the CEJ to the base of the defect, with CBVT measurements underestimating the surgical measurements by 0.5 +/- 1.1 mm for reentry (P <0.01) and 0.9 +/- 0.8 mm for the initial measurement (P <0.01).
Overall, compared to direct surgical measurements, CBVT was significantly more precise and accurate than IRs. If supported by further research, CBVT may obviate surgical reentry as a technique for assessing regenerative therapy outcomes.
口内X光片（IRs）提供骨结构的二维视图，而锥束容积断层扫描（CBVT）图像是三维可视的。本研究的目的是比较数字IR和CBVT图像测量结果与直接手术测量结果，以评估再生治疗效果。
对35例骨内缺损患者在初次植骨前和6个月再次手术时拍摄数字IR和CBVT图像。在缺损清创后，用牙周探针进行直接骨缺损测量。在IR和CBVT图像上进行相同的测量，然后与直接手术值进行比较。
CBVT与手术测量结果高度相关（r = 0.89至0.95），而IRs的相关性较差（r = 0.53至0.67）。对于所有研究参数，IR测量的准确性明显低于CBVT，并且手术测量值被低估了0.6±2.3毫米至1.5±2.3毫米。在CBVT和手术测量之间，从牙骨质-釉质界（CEJ）到牙槽嵴的距离（初次测量时P = 0.66，再次手术时P = 0.92）、缺损填充（P = 0.14）或缺损分辨率（P = 0.09）没有显著差异；然而，从CEJ到缺损底部的距离存在显著差异，再次手术时CBVT测量值比手术测量值低估了0.5±1.1毫米（P <0.01），初次测量时低估了0.9±0.8毫米（P <0.01）。
总体而言，与直接手术测量相比，CBVT比IRs明显更精确和准确。如果得到进一步研究的支持，CBVT可能无需再次手术作为评估再生治疗效果的技术。
