Ordinola-Zapata R, Bramante C M, Versiani M A, Moldauer B I, Topham G, Gutmann J L, Nuñez A, Duarte M A Hungaro, Abella F
Department of Endodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil.
Advanced Education in General Dentistry Program, Larkin Community Hospital, Miami, FL, USA.
Int Endod J. 2017 Jan;50(1):90-96. doi: 10.1111/iej.12593. Epub 2016 Jan 19.
To compare the accuracy of the clearing technique and cone beam computed tomography (CBCT) in the assessment of root canal configurations using micro-computed tomography (micro-CT) imaging system as the reference standard.
Thirty-two mesial roots of mandibular first molars, selected on the basis of micro-CT scans (voxel size: 19.6 μm) and presenting several canal configurations, were evaluated using 2 CBCT scanners (voxels sizes: 120 μm and 150 μm) followed by the clearing technique. Two examiners analysed the data from each method and classified the anatomical configuration of the mesial canal according to Vertucci's system. Data were compared using Fisher's exact and chi-square tests. Reliability for each assessment was verified by the kappa test, and significance level was set at 5%.
Kappa value indicated a high level of agreement between the examiners. Detection of type I configurations was significantly lower in cleared teeth (P < 0.05), whilst type II root canals were detected in all specimens by both tests (P > 0.05). In mesial roots with variable anatomical configurations, CBCT and the clearing method were significantly less accurate than the reference standard (P < 0.05).
Within the tooth population studied, accuracy of identifying mesial root canal configuration was influenced greatly by the evaluation method and the type of anatomy. Detection of type I configurations in cleared teeth was significantly lower, whilst type II configurations were detected in all specimens by both methods. In mesial roots with variable anatomical configurations, neither CBCT nor clearing methods were accurate for detecting the actual root canal anatomy.
以微型计算机断层扫描(micro-CT)成像系统作为参考标准,比较清理技术和锥形束计算机断层扫描(CBCT)在评估根管形态方面的准确性。
基于微型计算机断层扫描(体素大小:19.6μm)选择32颗下颌第一磨牙的近中根,这些根呈现出多种根管形态,先用2台CBCT扫描仪(体素大小分别为120μm和150μm)进行评估,然后采用清理技术。两名检查者分析每种方法的数据,并根据韦尔图奇系统对近中根管的解剖形态进行分类。使用Fisher精确检验和卡方检验比较数据。通过kappa检验验证每次评估的可靠性,显著性水平设定为5%。
kappa值表明检查者之间具有高度一致性。清理后的牙齿中I型形态的检出率显著较低(P<0.05),而两种检测方法在所有标本中均检测到II型根管(P>0.05)。在解剖形态各异的近中根中,CBCT和清理方法的准确性均显著低于参考标准(P<0.05)。
在所研究的牙齿群体中,近中根管形态的识别准确性受评估方法和解剖类型的影响很大。清理后的牙齿中I型形态的检出率显著较低,而两种方法在所有标本中均检测到II型形态。在解剖形态各异的近中根中,CBCT和清理方法在检测实际根管解剖结构方面均不准确。