Moshfeghi Mahkameh, Sajadi Soodabeh Sadat, Sajadi Sepideh, Shahbazian Majid
Assistant Professor, Department of Oral and maxillofacial Radiology, Dental School, Shahid Beheshti University of Medical Science, Tehran, Iran.
J Dent (Tehran). 2013 Jan;10(1):74-81. Epub 2013 Jan 31.
Successful endodontic therapy depends on adequate mechanical and chemical debridement of the canal which requires knowledge of the canal morphology. Conventional radiography has been used to evaluate the canal type; however, direct digital radiography has recently been practiced for this purpose due to the shortcomings of conventional radiography. The aim of the present study was to compare the accuracy of digital and conventional radiography taken at 0° and 30° angles in the diagnosis of the canal type of extracted maxillary premolars.
This diagnostic study was performed on 90 extracted maxillary premolars. Conventional and digital radiographies were taken of all teeth at 0° and 30° horizontal angles. The images were assessed by an oral and maxillofacial radiologist. The clearing technique was used as the gold standard. The canal type was determined using Weine classification. The agreement between each one of the 4 radiographic modalities and gold standard was determined by kappa statistics.
The kappa values for the agreement of parallel conventional, 30° conventional, parallel digital and 30° digital modalities with the clearing technique were 0.059, 0.215, 0.043 and 0.391, respectively. Parallel modalities were unable to determine the tooth canal type. Radiographic images taken at 30° significantly determined the canal type, although only a poor level of agreement was noted between the two modalities and the clearing technique.
All modalities had limited value to determine the root canal type in maxillary premolars. However, direct digital imaging taken at 30° angle showed the highest accuracy for canal type assessment.
成功的牙髓治疗取决于对根管进行充分的机械和化学清创，这需要了解根管形态。传统放射摄影已被用于评估根管类型；然而，由于传统放射摄影的缺点，近年来直接数字放射摄影已用于此目的。本研究的目的是比较在0°和30°角度拍摄的数字和传统放射摄影在诊断上颌前磨牙根管类型方面的准确性。
本诊断研究对90颗拔除的上颌前磨牙进行。所有牙齿均在0°和30°水平角度拍摄传统和数字放射照片。图像由口腔颌面放射科医生评估。清理技术用作金标准。根管类型采用韦内分类法确定。通过kappa统计确定4种放射成像方式中的每一种与金标准之间的一致性。
平行传统放射摄影、30°传统放射摄影、平行数字放射摄影和30°数字放射摄影方式与清理技术一致性的kappa值分别为0.059、0.215、0.043和0.391。平行方式无法确定牙齿根管类型。30°拍摄的放射图像显著确定了根管类型，尽管两种方式与清理技术之间的一致性水平较差。
所有方式在确定上颌前磨牙根管类型方面价值有限。然而，30°角拍摄的直接数字成像在根管类型评估中显示出最高的准确性。
