Sousa Thiago Oliveira, Hassan Bassam, Mirmohammadi Hesam, Shemesh Hagay, Haiter-Neto Francisco
Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Campinas, São Paulo, Brazil.
Department of Oral Implantology and Prosthetic Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands.
J Endod. 2017 Jun;43(6):1014-1017. doi: 10.1016/j.joen.2017.01.025. Epub 2017 Apr 14.
The study objective was to evaluate the effectiveness of cone-beam computed tomographic (CBCT) imaging for the detection of lateral canals (LCs) in endodontically treated premolars.
Two evaluators classified 80 extracted premolars into 2 groups based on the absence (n = 40) or presence (n = 40) of LCs according to micro-computed tomographic analysis. The extracted teeth were fixated in a human mandible and scanned with CBCT imaging. Subsequently, each tooth was endodontically treated, and CBCT scans were repeated. Three experienced examiners evaluated all images randomly. Receiver operating characteristic curves were compared using the McNemar test, and sensitivity, specificity, positive predictive value, and negative predictive value (NPV) were obtained.
The area under the receiver operating characteristic curve values were 0.58 and 0.49 before and after root canal treatment, respectively. These values were statistically significantly different (P < .001). Before root canal treatment sensitivity, specificity, positive predictive value, and negative predictive value were 55%, 52%, 55%, and 56%, whereas after root canal treatment the values were 33%, 61%, 46%, and 48%, respectively.
LC detection in nontreated teeth presented low accuracy, whereas among treated teeth CBCT imaging showed no efficacy. The results suggest that CBCT imaging is not an effective diagnostic tool for LC detection.
本研究的目的是评估锥形束计算机断层扫描(CBCT)成像在检测根管治疗后的前磨牙侧支根管(LCs)方面的有效性。
两名评估人员根据微型计算机断层扫描分析,将80颗拔除的前磨牙根据是否存在侧支根管分为两组(无侧支根管组,n = 40;有侧支根管组,n = 40)。将拔除的牙齿固定在人体下颌骨中,并用CBCT成像进行扫描。随后,对每颗牙齿进行根管治疗,并重复进行CBCT扫描。三名经验丰富的检查人员随机评估所有图像。使用McNemar检验比较受试者工作特征曲线,并获得敏感性、特异性、阳性预测值和阴性预测值(NPV)。
根管治疗前后受试者工作特征曲线下面积值分别为0.58和0.49。这些值在统计学上有显著差异(P <.001)。根管治疗前的敏感性、特异性、阳性预测值和阴性预测值分别为55%、52%、55%和56%,而根管治疗后的相应值分别为33%、61%、46%和48%。
在未经治疗的牙齿中检测侧支根管的准确性较低,而在已治疗的牙齿中,CBCT成像显示无效。结果表明,CBCT成像不是检测侧支根管的有效诊断工具。