Huang Chih-Chia, Chang Ya-Chi, Chuang Meng-Che, Lin Hsueh-Jen, Tsai Yi-Ling, Chang Shu-Hui, Chen Jyh-Cheng, Jeng Jiiang-Huei
Department of Dentistry, Cardinal Tien Hospital, New Taipei City, Taiwan.
Department of Dentistry, Show Chwan Memorial Hospital, Changhua, Taiwan.
J Endod. 2014 May;40(5):698-702. doi: 10.1016/j.joen.2013.12.015. Epub 2014 Feb 15.
Early detection of vertical root fracture (VRF) is important for clinical endodontic practice. The purpose of this study was to measure the fracture width (distance between 2 sides of the fracture) of VRF teeth in vitro by using 2 micro-computed tomography (μ-CT) systems with different spatial resolution and voxel size.
Thirty-seven endodontically treated teeth with VRF were scanned by 80-μm pixel size μ-CT. Fifteen teeth with no obvious fracture line, blurred image, or fracture space less than 100 μm were scanned by 9-μm pixel size μ-CT.
Presence of 2 VRF lines was more common in premolars (82%) than in molars (53%). In 7 premolars (32%) and 9 molars (60%), the VRF lines extended to within the apical 3 mm of the root. All fracture lines were detected by 9-μm pixel size μ-CT, but only 22 of 37 VRF teeth had vertical fracture identified by 80-μm μ-CT. From μ-CT examination, none of the fracture lines showed consistent and uniform fracture space. If 2 fracture lines were present, they were typically in opposite (not linear) directions. There was a significant correlation between 2 fracture lines or fracture lines extending within the 3 mm of the apex and fracture width greater than 100 μm.
Application of 9-μm μ-CT can be accurately used for early detection of VRF. Fracture characteristics (eg, number of fracture lines, extension of fracture line) may affect the fracture width. Appropriate use of μ-CT technology can be helpful for early diagnosis of VRF.
垂直根折(VRF)的早期检测对临床牙髓治疗实践很重要。本研究的目的是使用具有不同空间分辨率和体素大小的两种微型计算机断层扫描(μ-CT)系统,在体外测量VRF牙齿的骨折宽度(骨折两侧之间的距离)。
对37颗经牙髓治疗的VRF牙齿进行80μm像素大小的μ-CT扫描。对15颗无明显骨折线、图像模糊或骨折间隙小于100μm的牙齿进行9μm像素大小的μ-CT扫描。
前磨牙出现两条VRF线(82%)比磨牙(53%)更常见。在7颗前磨牙(32%)和9颗磨牙(60%)中,VRF线延伸至根尖3mm范围内。所有骨折线均由9μm像素大小的μ-CT检测到,但37颗VRF牙齿中只有22颗通过80μm的μ-CT识别出垂直骨折。从μ-CT检查来看,没有一条骨折线显示出一致且均匀的骨折间隙。如果存在两条骨折线,它们通常呈相反(而非线性)方向。两条骨折线或延伸至根尖3mm范围内的骨折线与骨折宽度大于100μm之间存在显著相关性。
9μm的μ-CT可准确用于VRF的早期检测。骨折特征(如骨折线数量、骨折线延伸)可能影响骨折宽度。适当使用μ-CT技术有助于VRF的早期诊断。