Cassetta Michele, Pranno Nicola, Stasolla Alessandro, Orsogna Nicola, Fierro Davide, Cavallini Costanza, Cantisani Vito
1 Department of Oral and Maxillo-Facial Sciences, "Sapienza", University of Rome, Rome, Italy.
2 Neuroradiology Unit, S. Camillo Hospital, Rome, Italy.
Dentomaxillofac Radiol. 2017 Aug;46(6):20170051. doi: 10.1259/dmfr.20170051. Epub 2017 Jun 21.
To evaluate the effect of orthodontic stainless steel brackets and two different types of archwires on the diagnostic quality of 3-T MR images.
This prospective, case-control study was conducted following Strengthening the Reporting of Observational Studies in Epidemiology guidelines. The recruitment was conducted among orthodontic patients. 80 subjects, requiring MRI for the presence of temporomandibular disorders, were enrolled and divided into four groups: 20 patients using aligners (control group); 20 patients with stainless steel brackets without archwires; 20 patients with stainless steel brackets and nickel-titanium archwires; and 20 patients with stainless steel brackets and stainless steel archwires. Two experts in neuroradiology evaluated the images to determine the amount of distortion in 6 regions and 48 districts. A score was subjectively assigned according to a modified receiver operating characteristic method of distortion classification. Any disagreement was resolved through consensus seeking; when this was not possible, a third neuroradiologist was consulted. The following statistical methods were used: descriptive statistics, Cohen's kappa coefficient (k), Kruskal-Wallis test, pairwise comparisons using the Dunn-Bonferroni approach. The significance was set at p ≤ 0.05.
The presence of stainless steel brackets with or without archwires negatively influenced MRI of the cervical region, paranasal sinuses, head and neck region, and cervical vertebrae but did not influence MRI of brain and temporomandibular joint regions.
Patients with a stainless steel multibracket orthodontic appliance should remove it before cervical vertebrae, cervical region, paranasal sinuses, and head and neck MRI scans. The brain and temporomandibular joint region MRI should not require the removal of such appliances.
评估正畸不锈钢托槽和两种不同类型的弓丝对3-T磁共振成像（MRI）诊断质量的影响。
本前瞻性病例对照研究按照加强流行病学观察性研究报告指南进行。在正畸患者中进行招募。纳入80名因存在颞下颌关节紊乱而需要进行MRI检查的受试者，并将其分为四组：20名使用矫治器的患者（对照组）；20名佩戴不锈钢托槽但未使用弓丝的患者；20名佩戴不锈钢托槽和镍钛弓丝的患者；以及20名佩戴不锈钢托槽和不锈钢弓丝的患者。两名神经放射学专家对图像进行评估，以确定6个区域和48个分区的畸变程度。根据改良的接收者操作特征畸变分类方法主观分配分数。任何分歧都通过寻求共识解决；若无法达成共识，则咨询第三位神经放射科医生。使用以下统计方法：描述性统计、科恩kappa系数（k）、Kruskal-Wallis检验、使用Dunn-Bonferroni方法进行两两比较。显著性设定为p≤0.05。
无论有无弓丝，不锈钢托槽的存在均对颈椎、鼻窦、头颈部区域和颈椎的MRI产生负面影响，但对脑和颞下颌关节区域的MRI无影响。
佩戴不锈钢多托槽正畸矫治器的患者在进行颈椎、颈部区域、鼻窦以及头颈部MRI扫描前应取下矫治器。脑和颞下颌关节区域的MRI扫描则无需取下此类矫治器。
