Tsolakis Apostolos I, Kalavritinos Michael, Bitsanis Elias, Sanoudos Mattheos, Benetou Vassiliki, Alexiou Konstantina, Tsiklakis Konstantinos
Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
Am J Orthod Dentofacial Orthop. 2018 Feb;153(2):308-314. doi: 10.1016/j.ajodo.2017.06.026.
INTRODUCTION: The purpose of this study was to evaluate the reliability of the radiographic images of the main conventional x-ray techniques compared with the information from cone-beam computed tomography (CBCT). METHODS: Twenty patients with unilateral or bilateral impaction of the maxillary canines had radiographic examinations by means of periapical x-rays, occlusal x-rays, panoramic x-rays, and CBCT scans. Three experienced orthodontists examined all x-rays from each patient and evaluated the radiographic images of the impacted canines. The examiners were asked to detect resorption in adjacent teeth and the buccal-palatal position of the impacted canines. Agreement between examiners was statistically tested. RESULTS: Different diagnoses were produced by the 3 examiners regarding localization of the impacted canines and the presence or absence of root resorption of the adjacent teeth in conventional radiographic images. It appears that whereas panoramic x-ray is more sensitive in detecting resorption and tooth position, occlusal and periapical imaging have higher specificity and positive predictive value. The examiners were in good or excellent agreement when occlusal and periapicals were used for the definite diagnosis of resorption and tooth position. There was no disagreement of the examiners in CBCT images, which were used as the gold standard. CONCLUSIONS: Conventional radiographic methods demonstrated a more subjective diagnostic procedure compared with CBCT images. CBCT is a more accurate and precise examination method compared with conventional radiography for the localization of impacted teeth and root resorption of the adjacent teeth.
引言:本研究的目的是评估主要传统X线技术的影像学图像与锥形束计算机断层扫描(CBCT)信息相比的可靠性。 方法:20例上颌尖牙单侧或双侧阻生患者接受了根尖片、咬合片、全景片及CBCT扫描等影像学检查。三位经验丰富的正畸医生检查了每位患者的所有X线片,并对阻生尖牙的影像学图像进行评估。要求检查者检测相邻牙齿的吸收情况以及阻生尖牙的颊腭位置。对检查者之间的一致性进行统计学检验。 结果:三位检查者对传统影像学图像中阻生尖牙的定位以及相邻牙齿牙根吸收的有无得出了不同诊断结果。似乎全景片在检测吸收情况和牙齿位置方面更敏感,而咬合片和根尖片具有更高的特异性和阳性预测值。当使用咬合片和根尖片进行吸收情况和牙齿位置的明确诊断时,检查者之间的一致性良好或优秀。在作为金标准的CBCT图像上,检查者之间没有分歧。 结论:与CBCT图像相比,传统影像学方法显示出更主观的诊断过程。与传统放射学相比,CBCT在阻生牙定位和相邻牙齿牙根吸收方面是一种更准确、精确的检查方法。
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