Abella F, Patel S, Durán-Sindreu F, Mercadé M, Bueno R, Roig M
Department of Endodontics, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.
Int Endod J. 2014 Apr;47(4):387-96. doi: 10.1111/iej.12159. Epub 2013 Jul 26.
To evaluate the presence or absence of periapical (PA) radiolucencies on individual roots of teeth with necrotic pulps, as assessed with digital PA radiographs and cone-beam computed tomography (CBCT).
Digital PA radiographs and CBCT scans were taken from 161 endodontically untreated teeth (from 155 patients) diagnosed with non-vital pulps (pulp necrosis with normal PA tissue, symptomatic apical periodontitis, asymptomatic apical periodontitis, acute apical abscess and chronic apical abscess). Images were assessed by two calibrated endodontists to analyse the radiographic PA status of the teeth. A consensus was reached in the event of any disagreement. The data were analysed using a McNemar's test, and significance was set at P ≤ 0.05.
Three hundred and forty paired images of roots were assessed with both digital PA radiographs and CBCT images. Fifteen additional roots were identified with CBCT. PA radiolucencies were present in 132 (38.8%) roots when assessed with PA radiographs, and in 196 (57.6%) roots when assessed with CBCT. This difference was statistically significant (P < 0.05). In teeth diagnosed with pulp necrosis, symptomatic apical periodontitis or acute apical abscess, CBCT images revealed a statistically larger number of PA radiolucencies than did PA radiographs (P < 0.05). No statistical differences were observed between PA radiographs and CBCT in teeth classified with asymptomatic apical periodontitis (P = 0.31) or chronic apical abscess (P = 1).
Unlike PA radiographs, CBCT revealed a higher prevalence of PA radiolucencies when endodontically untreated teeth with non-vital pulps were examined.
通过数字化根尖片和锥形束计算机断层扫描（CBCT）评估牙髓坏死牙齿各牙根根尖周（PA）透射区的有无。
对161颗（来自155例患者）诊断为牙髓无活力（牙髓坏死伴正常PA组织、有症状的根尖周炎、无症状的根尖周炎、急性根尖脓肿和慢性根尖脓肿）且未经牙髓治疗的牙齿拍摄数字化根尖片和CBCT扫描。由两位经过校准的牙髓病医生评估图像，以分析牙齿的根尖片PA状况。如有分歧则达成共识。使用McNemar检验分析数据，显著性设定为P≤0.05。
用数字化根尖片和CBCT图像评估了340对牙根图像。CBCT还发现了另外15个牙根。根尖片评估时132个（38.8%）牙根存在PA透射区，CBCT评估时196个（57.6%）牙根存在PA透射区。这种差异具有统计学意义（P<0.05）。在诊断为牙髓坏死、有症状的根尖周炎或急性根尖脓肿的牙齿中，CBCT图像显示的PA透射区数量在统计学上多于根尖片（P<0.05）。在无症状根尖周炎（P = 0.31）或慢性根尖脓肿（P = 1）分类的牙齿中，根尖片和CBCT之间未观察到统计学差异。
与根尖片不同，在检查未经牙髓治疗的牙髓无活力牙齿时，CBCT显示PA透射区的患病率更高。
