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乳牙深龋病变下方剩余牙本质厚度的测量可靠性

Measurement Reliability of the Remaining Dentin Thickness below Deep Carious Lesions in Primary Molars.

作者信息

Berbari Roula, Khairallah Alexandre, Kazan Hussein F, Ezzedine Mohamad, Bandon Daniel, Sfeir Elia

机构信息

Clinical Chief, Department of Pediatric Dentistry, School of Dentistry Lebanese University, Beirut, Lebanon.

Clinical Chief, Department of Radiology, School of Dentistry, Lebanese University, Beirut, Lebanon.

出版信息

Int J Clin Pediatr Dent. 2018 Jan-Feb;11(1):23-28. doi: 10.5005/jp-journals-10005-1478. Epub 2017 Feb 1.

Abstract

AIM

This study was carried out to assess the reliability of measurements of the remaining dentin thickness under deep carious lesions as estimated from digital radiographs. The goal is to allow clinicians to correlate the radiographic measurement to the exact value of the remaining dentin thickness. The results obtained will be tested further in a study that will evaluate the histopathologic pulpal state according to the caries' lesion depth.

MATERIALS AND METHODS

The study was conducted in the Pediatric Dentistry Department at the Lebanese University, in collaboration with the research platform of the same university. Fifty deciduous molars with deep caries on proximal surfaces liable to extraction were collected. Before extraction, a digital periapical radiograph was taken, followed by manual excavation of the caries. After excavation, another radiograph was taken before the tooth was sectioned through the deepest site of the lesion. Another radiograph was then obtained for each tooth fragment. To evaluate the exact thickness of the remaining dentin, each fragment was measured on a histologic macropho-tograph. The measurements were then compared statistically using a paired-samples t-test, and a correlation was sought.

RESULTS

No significant difference was observed in the radiographs between the measurement of the remaining dentin thickness before and after the excavation of caries. In contrast, the radiographic measurements of remaining dentin thickness were underestimated by an average of 20% compared with those made with macrophotographs.

LIMITATIONS

Interpretation of radiographs varies from one practitioner to another and is a function of the operator's visual acuity.

CONCLUSION

Measuring the residual dentin thickness on a radiograph underestimates the actual thickness by about 20%. Further studies are needed to confirm these results.

CLINICAL SIGNIFICANCE

Our results indicate that remaining dentin thickness is greater in reality than is shown on a radiograph. This information can help clinicians to refine their diagnoses and treatment plans. Berbari R, Khairallah A, Kazan HF, Ezzedine M, Bandon D, Sfeir E. Measurement Reliability of the Remaining Dentin Thickness below Deep Carious Lesions in Primary Molars. Int J Clin Pediatr Dent 2018;11(1):23-28.

摘要

目的

本研究旨在评估通过数字X线片估计深龋病变下剩余牙本质厚度测量的可靠性。目标是让临床医生将X线片测量结果与剩余牙本质厚度的准确值相关联。所获得的结果将在一项根据龋损深度评估组织病理学牙髓状态的研究中进一步测试。

材料与方法

本研究在黎巴嫩大学儿科牙科与同一大学的研究平台合作开展。收集了50颗近中面有深龋且易于拔除的乳牙。拔牙前,拍摄数字化根尖片,随后手动去除龋坏组织。去除龋坏组织后,在牙齿通过病变最深部位进行切片前再拍摄一张X线片。然后为每个牙齿碎片再拍摄一张X线片。为评估剩余牙本质的准确厚度,在组织学放大照片上测量每个碎片。然后使用配对样本t检验进行统计学比较,并寻找相关性。

结果

龋坏组织去除前后剩余牙本质厚度的X线片测量结果无显著差异。相比之下,与放大照片测量结果相比,剩余牙本质厚度的X线片测量结果平均低估了20%。

局限性

不同从业者对X线片的解读存在差异,这取决于操作者的视力。

结论

在X线片上测量剩余牙本质厚度会低估实际厚度约20%。需要进一步研究来证实这些结果。

临床意义

我们的结果表明,实际剩余牙本质厚度大于X线片显示的厚度。这些信息可帮助临床医生完善其诊断和治疗计划。贝尔巴里R、海拉勒A、卡赞HF、埃泽丁M、班登D、斯费尔E。乳牙深龋病变下剩余牙本质厚度的测量可靠性。《国际临床儿科牙科学杂志》2018年;11(1):23 - 28。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7614/5968158/c51270492edb/ijcpd-11-023-g001.jpg

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