Salemi Fatemeh, Shokri Abbas, Mortazavi Hamed, Baharvand Maryam
Assistant Professor, Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran.
Associate Professor, Department of Oral Medicine, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Clin Exp Dent. 2015 Feb 1;7(1):e34-9. doi: 10.4317/jced.51736. eCollection 2015 Feb.
Radiographic examination is one of the most important parts of the clinical assessment routine for temporomandibular disorders. The aim of this study was to compare the diagnostic accuracy of cone-beam computed tomography(CBCT) with panoramic radiography and spiral computed tomography for the detection of the simulated mandibular condyle bone lesions.
The sample consisted of 10 TMJs from 5 dried human skulls. Simulated erosive and osteophytic lesions were created in 3 different sizes using round diamond bur and bone chips, respectively. Panoramic radiography, spiral tomography and cone-beam computed tomography were used in defect detection. Data were statistically analyzed with the Mann-Whitney test. The reliability and degrees of agreement between two observers were also determined by the mean of Cohen's Kappa analysis.
CBCT had a statistically significant superiority than other studied techniques in detection of both erosive and osteophytic lesions with different sizes. There were significant differences between tomography and panoramic in correct detection of both erosive and osteophytic lesions with 1mm and 1.5 mm in size. However, there were no significant differences between Tomography and Panoramic in correct detection of both erosive and osteophytic lesions with 0.5 mm in size.
CBCT images provide a greater diagnostic accuracy than spiral tomography and panoramic radiography in the detection of condylar bone erosions and osteophytes. Key words:Bone defect, Condyle, CBCT, Panoramic, radiography.
影像学检查是颞下颌关节紊乱病临床评估常规中最重要的部分之一。本研究的目的是比较锥形束计算机断层扫描(CBCT)与全景放射摄影和螺旋计算机断层扫描在检测模拟下颌髁突骨病变方面的诊断准确性。
样本包括来自5个干燥人类头骨的10个颞下颌关节。分别使用圆形金刚石钻和骨屑制作了3种不同大小的模拟侵蚀性和骨赘性病变。在缺陷检测中使用了全景放射摄影、螺旋断层扫描和锥形束计算机断层扫描。数据采用曼-惠特尼检验进行统计分析。两位观察者之间的可靠性和一致性程度也通过科恩卡方分析的平均值来确定。
在检测不同大小的侵蚀性和骨赘性病变方面,CBCT在统计学上比其他研究技术具有显著优势。在正确检测大小为1mm和1.5mm的侵蚀性和骨赘性病变方面,断层扫描和全景放射摄影之间存在显著差异。然而,在正确检测大小为0.5mm的侵蚀性和骨赘性病变方面,断层扫描和全景放射摄影之间没有显著差异。
在检测髁突骨侵蚀和骨赘方面,CBCT图像比螺旋断层扫描和全景放射摄影具有更高的诊断准确性。关键词:骨缺损;髁突;CBCT;全景;放射摄影。