Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
J Endod. 2011 Aug;37(8):1046-51. doi: 10.1016/j.joen.2011.05.005.
The objective of this pilot investigation was to evaluate the utility and precision of already existing limited cone-beam computed tomography (CBCT) scans in measuring the endodontic working length, and to compare it with standard clinical procedures.
Three patients referred to the department received limited CBCT scans for diagnostics and preoperative treatment planning of cystic jawbone pathologies. Part of the therapy consisted of root canal treatments before surgical enucleation of the lesion. For the determination of the working length, the root canal length was measured with an electronic apex locator (EAL) by the endodontist. This measurement was compared with the root canal length as measured on the respective CBCT scans by an examiner not involved in the endodontic treatment. The interrater agreement between the two examiners was analyzed to determine the feasibility of this technique.
In the three included patients, 9 teeth with a total of 10 root canals were treated. For these canals, a strong correlation was found between the endodontic working length as measured in the CBCT images and the EAL measurements (Pearson correlation coefficient ranging from 0.904 to 0.968).
Based on the present findings, an already existing CBCT scan of teeth to be endodontically treated can be useful to determine the endodontic working length in combination with clinical measurements such as the EAL. Future prospective studies should evaluate if and when intraoral radiography for measuring the length of root canals can be avoided when CBCT images are available.
本初步研究旨在评估现有有限锥形束 CT(CBCT)扫描在测量牙髓工作长度方面的实用性和准确性,并将其与标准临床程序进行比较。
三位因颌骨囊性病变就诊的患者接受了有限 CBCT 扫描,用于诊断和术前治疗计划。部分治疗包括在手术切除病变前进行根管治疗。为了确定工作长度,由牙髓病医生使用电子根尖定位仪(EAL)测量根管长度。该测量值与未参与根管治疗的检查者在相应 CBCT 扫描上测量的根管长度进行比较。分析两位检查者之间的评分者间一致性,以确定该技术的可行性。
在 3 名纳入的患者中,共对 9 颗牙齿的 10 个根管进行了治疗。对于这些根管,在 CBCT 图像中测量的牙髓工作长度与 EAL 测量值之间存在很强的相关性(Pearson 相关系数范围从 0.904 到 0.968)。
根据目前的发现,对于要进行牙髓治疗的牙齿,现有的 CBCT 扫描结合 EAL 等临床测量值,可用于确定牙髓工作长度。未来的前瞻性研究应评估在有 CBCT 图像时,是否以及何时可以避免使用口腔内射线照相术来测量根管长度。