Pinheiro Lucas Rodrigues, Scarfe William C, de Oliveira Sales Marcelo Augusto, Gaia Bruno Felipe, Cortes Arthur Rodriguez, Gusmão Paraiso Cavalcanti Marcelo
Int J Oral Maxillofac Implants. 2017 Jul/Aug;32(4):741-750. doi: 10.11607/jomi.5311.
To determine the effectiveness of cone beam computed tomography (CBCT) images obtained with different kilovoltage settings compared with intraoral periapical photostimulable storage phosphor (PSP) plate images in the detection of chemically created peri-implant defects utilizing a bovine rib bone model in vitro.
After placing 80 implants in bovine ribs, peri-implant circumferential bone defects of different sizes were created with 70% perchloric acid. CBCT images (3D Accuitomo 170) were acquired at 90 and 75 kVp, and intraoral periapical images were acquired using a PSP system (Carestream KODAK, CS 7600). Using a 5-point Likert scale, two oral and maxillofacial radiologists (OMR) and two oral and maxillofacial surgeons (OMS) evaluated the likelihood of a bone defect being absent or present. The kappa statistic was used to compare observer agreement, and area under the curve values were compared using analysis of variance and the post hoc Tukey test. Significance was set at P ≤ .05.
PSP reliability ranged from discordance to slight for small defects and fair to moderate for larger defects. For CBCT, OMRs had good agreement for defects using 90 kVp, and slight to fair using 75 kVp. Agreement for OMS observations was fair for 75 kVp, and varied from slight to good for 90 kVp. Small lesions were detected more effectively by CBCT than by PSP, and larger lesions were detected more effectively by CBCT at 90 kVp than by CBCT at 75 kVp or by PSP.
CBCT imaging at 90 kVp was associated with a significantly higher rate of detection of both small and large chemically simulated bone defects than PSP or CBCT at 75 kVp. CBCT imaging at 75 kVp proved better than PSP for the detection of small defects.
在体外利用牛肋骨模型，确定不同千伏设置下获得的锥束计算机断层扫描（CBCT）图像与口内根尖光激励存储磷光体（PSP）板图像相比，在检测化学造成的种植体周围骨缺损方面的有效性。
在牛肋骨中植入80颗种植体后，用70%的高氯酸制造不同大小的种植体周围环形骨缺损。分别在90 kVp和75 kVp下采集CBCT图像（3D Accuitomo 170），并使用PSP系统（Carestream KODAK，CS 7600）采集口内根尖图像。两名口腔颌面放射科医生（OMR）和两名口腔颌面外科医生（OMS）使用5级李克特量表评估骨缺损存在或不存在的可能性。kappa统计量用于比较观察者间的一致性，曲线下面积值采用方差分析和事后Tukey检验进行比较。显著性设定为P≤0.05。
对于小缺损，PSP的可靠性从不一致到轻微；对于大缺损，可靠性从中等到良好。对于CBCT，OMR对90 kVp下的缺损一致性良好，对75 kVp下的缺损一致性轻微到中等。OMS观察的一致性在75 kVp时为中等，在90 kVp时从轻微到良好不等。CBCT比PSP更能有效地检测小病变，在90 kVp下CBCT比75 kVp下的CBCT或PSP更能有效地检测大病变。
与75 kVp下的PSP或CBCT相比，90 kVp下的CBCT成像对大小化学模拟骨缺损的检测率显著更高。75 kVp下的CBCT成像在检测小缺损方面优于PSP。
