Sousa Melo Saulo L, Vasconcelos Karla de Faria, Holton Nathan, Allareddy Veeratrishul, Allareddy Veerasathpurush, Tabchoury Cinthia Pereira Machado, Haiter-Neto Francisco, Ruprecht Axel
Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, Iowa.
Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Campinas, São Paulo, Brazil.
Am J Orthod Dentofacial Orthop. 2017 Jun;151(6):1073-1082. doi: 10.1016/j.ajodo.2016.10.041.
The aim of this in-vitro study was to evaluate the influence of cone-beam computed tomography scans on the diagnosis of chemically simulated external root resorption.
One hundred extracted anterior teeth were selected. Subsurface demineralization was induced on a limited area of the apical third of the root of 49 teeth. Each tooth was placed in an empty socket of a partially edentulous dry mandible. Cone-beam computed tomography images were obtained according to 3 protocols: (1) half scan, 0.40-mm voxel size; (2) full scan, 0.40-mm voxel size; and (3) full scan, 0.125-mm voxel size. Three observers evaluated the images. Sensitivity, specificity, accuracy, and area under the curve were compared with the Cochran Q and Mann-Whitney U tests.
Protocol 3 had the highest sensitivity (81.63%), accuracy (80.67%), and area under the curve (0.807). There were statistically significant differences between protocol 3 and the other 2 protocols (P <0.001). The specificity of protocol 1 (84.97%) was greater than that of protocols 2 (69.93%) and 3 (79.74%); however, a statistically significant difference was found only between protocols 1 and 2 (P = 0.005).
A more dedicated, high-resolution scan should be acquired when one intends to investigate the early stage of external root resorption during orthodontic treatment. However, this does not imply that all orthodontic patients should be subjected to high-dose cone-beam computed tomography scans.
本体外研究的目的是评估锥形束计算机断层扫描对化学模拟性外吸收诊断的影响。
选取100颗拔除的前牙。对49颗牙齿牙根根尖三分之一的有限区域进行牙本质深层脱矿。将每颗牙齿置于部分缺牙的干燥下颌骨的空牙槽中。根据3种方案获取锥形束计算机断层扫描图像:(1)半扫描,体素大小0.40毫米;(2)全扫描,体素大小0.40毫米;(3)全扫描,体素大小0.125毫米。三名观察者对图像进行评估。采用Cochran Q检验和Mann-Whitney U检验比较敏感性、特异性、准确性和曲线下面积。
方案3具有最高的敏感性(81.63%)、准确性(80.67%)和曲线下面积(0.807)。方案3与其他两种方案之间存在统计学显著差异(P<0.001)。方案1的特异性(84.97%)高于方案2(69.93%)和方案3(79.74%);然而,仅在方案1和方案2之间发现统计学显著差异(P = 0.005)。
当打算在正畸治疗期间研究外吸收的早期阶段时,应进行更专门的高分辨率扫描。然而,这并不意味着所有正畸患者都应接受高剂量锥形束计算机断层扫描。