根管治疗术后根尖周修复:二维和三维影像评估方法
Periapical repair following endodontic surgery: two- and three-dimensional imaging evaluation methods.
作者信息
Jorge Érica Gouveia, Tanomaru-Filho Mario, Guerreiro-Tanomaru Juliane Maria, Reis José Maurício dos Santos Nunes, Spin-Neto Rubens, Gonçalves Marcelo
机构信息
Department of Restorative Dentistry, Araraquara Dental School, UNESP - Univ Estadual Paulista, Araraquara, SP, Brazil.
Department of Prosthodontics, Araraquara Dental School, UNESP - Univ Estadual Paulista, Araraquara, SP, Brazil.
出版信息
Braz Dent J. 2015 Jan-Feb;26(1):69-74. doi: 10.1590/0103-6440201300252.
This study quantitatively assessed the periapical bone repair following endodontic surgery, using planimetric evaluation based on two- (conventional and digital intraoral radiographic images - IRs) and three-dimensional (cone beam computed tomography - CBCT) evaluation. Eleven maxillary anterior teeth (of 11 patients) with periapical bone lesions and indication for surgical endodontic treatment were selected. IRs and CBCT images were acquired before the endodontic surgery, and 48 h, 4, and 8-months after the surgery. In each period of evaluation, the area (mm2) of the bone lesion was measured in the images, and the values for the three methods were compared. The area in the CBCT images was measured in the mesio-distal sections comprising the largest diameter of the lesion. Data were submitted to repeated measures 2-way ANOVA and t-tests with Bonferroni correction. There was significant difference between the periods of evaluation (p=0.002) regarding the assessed periapical bone lesion area. There was no statistically significant difference between the methods of evaluation (p=0.023). In the CBCT images the lesion areas were 10% larger than those observed in the conventional IRs (22.84 mm2) and 15% larger than those observed in the digital IRs (21.48 mm2). From the baseline (40.12 mm2) to 4 (20.06 mm2) and 8-months (9.40 mm2), reductions of 50 and 77% in the lesion area, respectively, were observed (p<0.0001). From 4 to 8-months, this value was 53%. Progressive bone repair could be seen from 48 h to 8-months following endodontic surgery based on two- (conventional and digital IRs) and three-dimensional (CBCT) evaluation. CBCT images provided results similar to those assessed by means of IRs.
本研究采用基于二维(传统和数字化口腔内放射影像 - IRs)和三维(锥形束计算机断层扫描 - CBCT)评估的面积测量法,对根管治疗术后根尖周骨修复情况进行了定量评估。选取了11例患有根尖周骨病变且有手术根管治疗指征的患者的11颗上颌前牙。在根管治疗术前、术后48小时、4个月和8个月采集IRs和CBCT图像。在每个评估阶段,测量图像中骨病变的面积(mm²),并比较三种方法的测量值。在包含病变最大直径的近远中截面测量CBCT图像中的面积。数据采用重复测量双向方差分析和经Bonferroni校正的t检验。在评估阶段之间,关于评估的根尖周骨病变面积存在显著差异(p = 0.002)。评估方法之间没有统计学上的显著差异(p = 0.023)。在CBCT图像中,病变面积比传统IRs(22.84 mm²)中观察到的大10%,比数字化IRs(21.48 mm²)中观察到的大15%。从基线(40.12 mm²)到4个月(20.06 mm²)和8个月(9.40 mm²),病变面积分别减少了50%和77%(p < 0.0001)。从4个月到8个月,该值为53%。基于二维(传统和数字化IRs)和三维(CBCT)评估,在根管治疗术后48小时至8个月可观察到渐进性骨修复。CBCT图像提供的结果与通过IRs评估的结果相似。