Padmanabhan Shyam, Dommy Ahila, Guru Sanjeela R, Joseph Ajesh
Department of Periodontics, Vydehi Institute of Dental Sciences and Research Centre, Bengaluru, Karnataka, India.
Department of Periodontics, Educare Institute of Dental Sciences, Malappuram, Kerala, India.
Contemp Clin Dent. 2017 Jul-Sep;8(3):439-445. doi: 10.4103/ccd.ccd_515_17.
Periodontists frequently experience inconvenience in accurate assessment and treatment of furcation areas affected by periodontal disease. Furcation involvement (FI) most commonly affects the mandibular molars. Diagnosis of furcation-involved teeth is mainly by the assessment of probing pocket depth, clinical attachment level, furcation entrance probing, and intraoral periapical radiographs. Three-dimensional imaging has provided advantage to the clinician in assessment of bone morphology. Thus, the present study aimed to compare the diagnostic efficacy of cone-beam computed tomography (CBCT) as against direct intrasurgical measurements of furcation defects in mandibular molars.
Study population included 14 patients with 25 mandibular molar furcation sites. CBCT was performed to measure height, width, and depth of furcation defects of mandibular molars with Grade II and Grade III FI. Intrasurgical measurements of the FI were assessed during periodontal flap surgery in indicated teeth which were compared with CBCT measurements. Statistical analysis was done using paired -test and Bland-Altman plot.
The CBCT versus intrasurgical furcation measurements were 2.18 ± 0.86 mm and 2.30 ± 0.89 mm for furcation height, 1.87 ± 0.52 mm and 1.84 ± 0.49 mm for furcation width, and 3.81 ± 1.37 mm and 4.05 ± 1.49 mm for furcation depth, respectively. Results showed that there was no statistical significance between the measured parameters, indicating that the two methods were statistically similar.
Accuracy of assessment of mandibular molar FI by CBCT was comparable to that of direct surgical measurements. These findings indicate that CBCT is an excellent adjunctive diagnostic tool in periodontal treatment planning.
牙周病医生在准确评估和治疗受牙周病影响的根分叉区域时经常遇到不便。根分叉病变(FI)最常影响下颌磨牙。根分叉受累牙齿的诊断主要通过评估探诊袋深度、临床附着水平、根分叉入口探诊和口内根尖片。三维成像为临床医生评估骨形态提供了优势。因此,本研究旨在比较锥形束计算机断层扫描(CBCT)与下颌磨牙根分叉缺损直接手术测量的诊断效能。
研究人群包括14例患者的25个下颌磨牙根分叉部位。对患有II级和III级FI的下颌磨牙根分叉缺损进行CBCT检查,测量其高度、宽度和深度。在对指定牙齿进行牙周翻瓣手术期间评估FI的手术内测量值,并与CBCT测量值进行比较。采用配对t检验和Bland-Altman图进行统计分析。
CBCT与手术内根分叉测量的根分叉高度分别为2.18±0.86mm和2.30±0.89mm,根分叉宽度分别为1.87±0.52mm和1.84±0.49mm,根分叉深度分别为3.81±1.37mm和4.05±1.49mm。结果显示,测量参数之间无统计学意义,表明两种方法在统计学上相似。
CBCT评估下颌磨牙FI的准确性与直接手术测量相当。这些发现表明,CBCT是牙周治疗计划中一种优秀的辅助诊断工具。