Uraba Shintaro, Ebihara Arata, Komatsu Kei, Ohbayashi Naoto, Okiji Takashi
Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
J Endod. 2016 Aug;42(8):1186-90. doi: 10.1016/j.joen.2016.04.026. Epub 2016 Jun 29.
The detection of periapical lesions by periapical radiography (PR) can be hampered by structural noise, the impact of which differs among tooth groups. The aim of this study was to investigate the ability of cone-beam computed tomographic (CBCT) imaging to detect periapical lesions that could not be detected with PR according to tooth group.
This study retrospectively evaluated teeth that (1) had previously undergone root canal treatment (178 teeth from 86 patients), (2) had coincidentally been located within the field of view of CBCT scans performed for endodontic reasons, and (3) had also been examined with PR. The teeth of interest for the CBCT examinations were excluded to avoid sampling bias. Two dentists evaluated both the CBCT and PR images for periapical lesions. The McNemar test was used to compare the ability of CBCT imaging and PR to identify periapical lesions (α = 0.05).
The overall periapical lesion detection rates of PR and CBCT imaging were 31.5% and 52.2%, respectively (P < .0001). The ability of CBCT imaging to identify periapical lesions that were not detected by PR was statistically significant for the maxillary incisors/canines (P < .0001) and maxillary molars (P < .005).
Within the limitations of this investigation, it can be concluded that CBCT imaging is effective at detecting periapical lesions that cannot be detected on PR, particularly in the maxillary incisors/canines and molars. Our findings suggest that the influence of structural noise in the maxillary anterior region and maxillary posterior region should not be overlooked during the interpretation of PR images.
根尖片（PR）对根尖周病变的检测可能会受到结构噪声的干扰，其影响在不同牙组中有所不同。本研究的目的是根据牙组调查锥形束计算机断层扫描（CBCT）成像检测PR无法检测到的根尖周病变的能力。
本研究回顾性评估了以下牙齿：（1）先前接受过根管治疗（86例患者的178颗牙齿）；（2）因牙髓病原因进行CBCT扫描时恰好位于视野范围内；（3）也接受过PR检查。排除CBCT检查感兴趣的牙齿以避免抽样偏差。两名牙医评估CBCT和PR图像是否存在根尖周病变。采用McNemar检验比较CBCT成像和PR识别根尖周病变的能力（α = 0.05）。
PR和CBCT成像的总体根尖周病变检出率分别为31.5%和52.2%（P <.0001）。CBCT成像识别PR未检测到的根尖周病变的能力在上颌切牙/尖牙（P <.0001）和上颌磨牙（P <.005）中具有统计学意义。
在本研究的局限性内，可以得出结论，CBCT成像在检测PR上无法检测到的根尖周病变方面是有效的，特别是在上颌切牙/尖牙和磨牙中。我们的研究结果表明，在解读PR图像时，不应忽视上颌前部区域和上颌后部区域结构噪声的影响。
