Department of Conservative Dentistry, Dental Institute, King's College London, London, UK.
Int Endod J. 2011 Feb;44(2):136-47. doi: 10.1111/j.1365-2591.2010.01819.x. Epub 2010 Nov 17.
AIM: To compare in an ex vivo model the ability of digital intraoral radiography and cone beam computed tomography (CBCT) to detect simulated external inflammatory root resorption lesions, and to investigate the effect of altering the degree of rotation of the CBCT scanners X-ray source and imaging detector on the ability to detect the same lesions. METHODOLOGY: Small and large simulated external inflammatory resorption (EIR) lesions were created on the roots of 10 mandibular incisor teeth from three human mandibles. Small volume CBCT scans with 180° and 360° of X-ray source rotation and periapical radiographs, using a digital photostimulable phosphor plate system, were taken prior to and after the creation of the EIR lesions. The teeth were relocated in their original sockets during imaging. Receiver operator characteristic (ROC) analysis and kappa tests of the reproducibility of the imaging techniques were carried out and sensitivity, specificity, positive and negative predictive values (PPV and NPV) were also determined for each technique. RESULTS: The overall area under the ROC curve (Az value) for intraoral radiography was 0.665, compared to Az values of 0.984 and 0.990 for 180° and 360° CBCT, respectively (P<0.001). The sensitivity and specificity of 180° and 360° CBCT were significantly better than intraoral radiography (P<0.001). CBCT, regardless of the degree of rotation, had superior NPVs (P<0.01) and PPVs (P<0.001) to periapical radiography. The intra- and inter-examiner agreement was significantly better for CBCT than it was for intraoral radiography (P<0.001). The ability of small volume CBCT to detect simulated EIR was the same regardless of whether 180° or 360° scans were taken. Examiners were significantly better able to identify the exact location of the artificial resorption lesions with CBCT than they were with periapical radiographs (P<0.001). CONCLUSION: CBCT is a reliable and valid method of detecting simulated EIR and performs significantly better than intraoral periapical radiography. Small volume CBCT operating with 360° of rotation of the X-ray source and detector is no better at detecting small, artificially created EIR cavities than the same device operating with 180° of rotation.
目的：在离体模型中比较数字口腔内放射摄影术和锥形束计算机断层扫描（CBCT）检测模拟的外部炎症性根吸收病变的能力，并研究改变 CBCT 扫描仪 X 射线源和成像探测器的旋转程度对检测相同病变的能力的影响。 方法：从小颌骨的三个下颌切牙的根上创建小的和大的模拟外部炎症性吸收（EIR）病变。使用数字光激励磷光板系统，在创建 EIR 病变之前和之后，对小体积的 CBCT 扫描进行了 180°和 360°X 射线源旋转和根尖射线照相。在成像过程中，牙齿被重新定位到其原始牙槽中。进行了接收者操作特性（ROC）分析和成像技术可重复性的 Kappa 检验，并为每种技术确定了敏感性、特异性、阳性和阴性预测值（PPV 和 NPV）。 结果：口腔内放射摄影的总体 ROC 曲线下面积（Az 值）为 0.665，而 180°和 360°CBCT 的 Az 值分别为 0.984 和 0.990（P<0.001）。180°和 360°CBCT 的敏感性和特异性明显优于口腔内放射摄影（P<0.001）。无论旋转程度如何，CBCT 的阴性预测值（P<0.01）和阳性预测值（P<0.001）均优于根尖射线照相。CBCT 的观察者内和观察者间一致性明显优于口腔内放射摄影（P<0.001）。与根尖射线照相相比，CBCT 能够更准确地识别人工吸收病变的确切位置（P<0.001）。 结论：CBCT 是一种可靠且有效的检测模拟 EIR 的方法，其性能明显优于口腔内根尖射线照相。与使用 180°旋转的相同设备相比，使用 360°旋转的 X 射线源和探测器的小体积 CBCT 对检测小的人工创建的 EIR 腔没有更好的效果。
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