Vaz de Souza Daniel, Schirru Elia, Mannocci Francesco, Foschi Federico, Patel Shanon
Postgraduate Endodontic Unit, Kings College Dental Institute at Guy's King's and St Thomas' Hospital, London, UK.
Postgraduate Endodontic Unit, Kings College Dental Institute at Guy's King's and St Thomas' Hospital, London, UK.
J Endod. 2017 Jan;43(1):121-125. doi: 10.1016/j.joen.2016.09.008. Epub 2016 Dec 6.
The aim of this study was to compare the diagnostic efficacy of 2 cone-beam computed tomographic (CBCT) units with parallax periapical (PA) radiographs for the detection and classification of simulated external cervical resorption (ECR) lesions.
Simulated ECR lesions were created on 13 mandibular teeth from 3 human dry mandibles. PA and CBCT scans were taken using 2 different units, Kodak CS9300 (Carestream Health Inc, Rochester, NY) and Morita 3D Accuitomo 80 (J Morita, Kyoto, Japan), before and after the creation of the ECR lesions. The lesions were then classified according to Heithersay's classification and their position on the root surface. Sensitivity, specificity, positive predictive values, negative predictive values, and receiver operator characteristic curves as well as the reproducibility of each technique were determined for diagnostic accuracy.
The area under the receiver operating characteristic value for diagnostic accuracy for PA radiography and Kodak and Morita CBCT scanners was 0.872, 0.99, and 0.994, respectively. The sensitivity and specificity for both CBCT scanners were significantly better than PA radiography (P < .001). There was no statistical difference between the sensitivity and specificity of the 2 scanners. The percentage of correct diagnoses according to the tooth type was 87.4% for the Kodak scanner, 88.3% for the Morita scanner, and 48.5% for PA radiography.The ECR lesions were correctly identified according to the tooth surface in 87.8% Kodak, 89.1% Morita and 49.4% PA cases. The ECR lesions were correctly classified according to Heithersay classification in 70.5% of Kodak, 69.2% of Morita, and 39.7% of PA cases.
This study revealed that both CBCT scanners tested were equally accurate in diagnosing ECR and significantly better than PA radiography. CBCT scans were more likely to correctly categorize ECR according to the Heithersay classification compared with parallax PA radiographs.
本研究的目的是比较两种锥形束计算机断层扫描（CBCT）设备与根尖周平行投照（PA）片对模拟的外源性颈缘吸收（ECR）病变的检测和分类诊断效能。
在取自3具人类干燥下颌骨的13颗下颌牙齿上制造模拟的ECR病变。在制造ECR病变前后，使用两种不同的设备，即柯达CS9300（Carestream Health Inc，纽约罗切斯特）和森田3D Accuitomo 80（日本京都J Morita）进行PA和CBCT扫描。然后根据海瑟西的分类方法及其在牙根表面的位置对病变进行分类。为评估诊断准确性，确定了敏感性、特异性、阳性预测值、阴性预测值、受试者工作特征曲线以及每种技术的可重复性。
PA片、柯达CBCT扫描仪和森田CBCT扫描仪诊断准确性的受试者工作特征值下的面积分别为0.872、0.99和0.994。两种CBCT扫描仪的敏感性和特异性均显著优于PA片（P <.001）。两种扫描仪的敏感性和特异性之间无统计学差异。根据牙齿类型，柯达扫描仪的正确诊断率为87.4%，森田扫描仪为88.3%，PA片为48.5%。根据牙齿表面，柯达扫描仪对ECR病变的正确识别率为87.8%，森田扫描仪为89.1%，PA片为49.4%。根据海瑟西分类，柯达扫描仪对ECR病变的正确分类率为70.5%，森田扫描仪为69.2%，PA片为39.7%。
本研究表明，所测试的两种CBCT扫描仪在诊断ECR方面同样准确，且显著优于PA片。与根尖周平行投照PA片相比，CBCT扫描更有可能根据海瑟西分类正确地对ECR进行分类。
