Haghanifar Sina, Moudi Ehsan, Mesgarani Abbas, Bijani Ali, Abbaszadeh Naghi
Department of Oral and Maxillofacial Radiology, Dental Material Research Center, Dental Faculty, Babol University of Medical Sciences, Babol, Iran.
Department of Endodontics, Dental Material Research Center, Dental Faculty, Babol University of Medical Sciences, Babol, Iran.
Imaging Sci Dent. 2014 Jun;44(2):115-9. doi: 10.5624/isd.2014.44.2.115. Epub 2014 Jun 11.
The aim of this in vitro study was to determine the sensitivity and specificity of cone-beam computed tomography (CBCT) and digital periapical radiography in the detection of mesial root perforations of mandibular molars.
In this in vitro study, 48 mandibular molars were divided into 4 groups. First, the mesial canals of all the 48 teeth were endodontically prepared. In 2 groups (24 teeth each), the roots were axially perforated in the mesiolingual canal 1-3 mm below the furcation region, penetrating the root surface ("root perforation"). Then, in one of these 2 groups, the mesial canals were filled with gutta-percha and AH26 sealer. Mesial canals in one of the other 2 groups without perforation (control groups) were filled with the same materials. The CBCT and periapical radiographs with 3 different angulations were evaluated by 2 oral and maxillofacial radiologists. The specificity and sensitivity of the two methods were calculated, and P<0.05 was considered significant.
The sensitivity and specificity of CBCT scans in the detection of obturated root canal perforations were 79% and 96%, respectively, and in the case of three-angled periapical radiographs, they were 92% and 100%, respectively. In non-obturated root canals, the sensitivity and specificity of CBCT scans in perforation detection were 92% and 100%, respectively, and for three-angled periapical radiographs, they were 50% and 96%, respectively.
For perforation detection in filled-root canals, periapical radiography with three different horizontal angulations would be trustworthy, but it is recommended that CBCT be used for perforation detection before obturating root canals.
本体外研究的目的是确定锥形束计算机断层扫描（CBCT）和数字化根尖片在下颌磨牙近中根穿孔检测中的敏感性和特异性。
在本体外研究中，48颗下颌磨牙被分为4组。首先，对所有48颗牙齿的近中根管进行根管预备。在2组（每组24颗牙齿）中，在根分叉区下方1 - 3毫米处的近中舌侧根管进行轴向穿孔，穿透牙根表面（“牙根穿孔”）。然后，在这2组中的一组中，近中根管用牙胶尖和AH26封闭剂充填。另外2组中未穿孔的一组（对照组）的近中根管也用相同材料充填。由2名口腔颌面放射科医生对CBCT和3种不同角度的根尖片进行评估。计算两种方法的特异性和敏感性，P<0.05被认为具有统计学意义。
CBCT扫描检测充填根管穿孔的敏感性和特异性分别为79%和96%，而对于三种角度的根尖片，其敏感性和特异性分别为92%和100%。在未充填根管中，CBCT扫描检测穿孔的敏感性和特异性分别为92%和100%，对于三种角度的根尖片，其敏感性和特异性分别为50%和96%。
对于充填根管的穿孔检测，三种不同水平角度的根尖片是可靠的，但建议在根管充填前使用CBCT进行穿孔检测。
