López Fernanda Ullmann, Kopper Patrícia Maria Poli, Cucco Carolina, Della Bona Alvaro, de Figueiredo José Antônio Poli, Vier-Pelisser Fabiana Vieira
Post-Graduate Program of Dentistry, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
J Endod. 2014 Dec;40(12):2057-60. doi: 10.1016/j.joen.2014.09.003. Epub 2014 Oct 11.
This study aimed to investigate the correlation and the agreement between periapical radiography (PR) and cone-beam computed tomography (CBCT) correlating to histologic findings in the diagnosis of apical periodontitis (AP).
One hundred thirty-four premolar root canals from 10 dogs were treated after AP induction. Four months later, the animals were killed, and standard digital PRs were obtained. The area of AP was measured by using ImageJ software. CBCT (i-CAT) images from each arch were obtained, and AP area and volume were measured by using Osiri-X software. The apical inflammatory infiltrate was evaluated under light microscopy. The correlation between imaging methods was evaluated by using the Pearson coefficient. The Bland-Altman method was used to assess the agreement between PR and CBCT data. The Spearman coefficient was used to correlate the imaging data and histologic findings.
Despite a strong correlation between PR and CBCT areas, the agreement limits were very broad (95% limits of agreement, 0.19-1.08). PR only measured, on average, 63% of CBCT values. Although there was a strong correlation between PR area and CBCT volume, the Bland-Altman method suggests that the larger the CBCT volume, the more underestimated the PR value. When APs had a volume smaller than 6 mm(3), the PR estimation of CBCT data was unpredictable. A positive correlation was found for PR area, CBCT area, CBCT volume, and histology data.
The diagnosis of AP based on PR data is clinically limited, and it should not be used for scientific investigations.
本研究旨在调查根尖片（PR）与锥形束计算机断层扫描（CBCT）在根尖周炎（AP）诊断中与组织学结果的相关性及一致性。
对10只犬的134颗前磨牙根管进行AP诱导后治疗。四个月后，处死动物，获取标准数字化根尖片。使用ImageJ软件测量AP面积。获取每个牙弓的CBCT（i-CAT）图像，使用Osiri-X软件测量AP面积和体积。在光学显微镜下评估根尖炎性浸润。使用Pearson系数评估成像方法之间的相关性。采用Bland-Altman方法评估PR和CBCT数据之间的一致性。使用Spearman系数将成像数据与组织学结果进行关联。
尽管PR与CBCT面积之间存在强相关性，但一致性界限非常宽（95%一致性界限，0.19 - 1.08）。PR平均仅测量到CBCT值的63%。尽管PR面积与CBCT体积之间存在强相关性，但Bland-Altman方法表明，CBCT体积越大，PR值被低估得越多。当AP体积小于6立方毫米时，PR对CBCT数据的估计不可预测。PR面积、CBCT面积、CBCT体积与组织学数据之间存在正相关。
基于PR数据的AP诊断在临床上具有局限性，不应将其用于科学研究。
