1 Department of Dentistry and Oral Health, Section of Oral Radiology, Aarhus University , Denmark , Europe.
Dentomaxillofac Radiol. 2019 May;48(4):20180313. doi: 10.1259/dmfr.20180313. Epub 2019 Feb 12.
Compare findings among observers in panoramic images (PAN) and cone beam CT (CBCT); and assess findings in PAN as indicators for marginal bone loss and resorption observed in CBCT.
120 impacted maxillary third molars with PAN and CBCT were included. Four observers assessed morphological features: (1) tooth angulation; (2) number of roots; (3) bony impaction (yes/no) and pathology; (4) marginal bone level at the second molar (normal/>3 mm = bone loss); (5) resorption in the second molar (no/superficial/< half way through the dentin/≥ half way through the dentin/involving the pulp); (6) size of follicular space (normal/> 4 mm(cyst)). Percentage accordance and κ statistics described observer variation in PAN and CBCT. Logistic regression analyses tested findings in PAN as indicators for marginal bone loss or resorption observed in CBCT.
κ values were fair and interobserver accordance was marginally higher in CBCT than PAN. Agreement between PAN and CBCT was 81-88% for marginal bone loss and 68-81% for resorption. Severe resorption was more often observed in CBCT. Mesio-angulated third molars and marginal bone loss interpreted in PAN significantly indicated marginal bone loss observed in CBCT (odds ration 17-34; < 0.012; 8.8-52.8; < 0.02). In contrast, findings in PAN were not significant indicators for resorption observed in CBCT ( > 0.05).
In general, there was a fair agreement for marginal bone loss between PAN and CBCT, and PAN could significantly predict bone loss observed in CBCT. However, presence of resorption observed in CBCT could not be determined from PAN, and more severe resorption was observed in CBCT. CBCT is indicated if resorption in the second molar needs to be assessed.
比较全景影像（PAN）和锥形束 CT（CBCT）中观察者的发现；并评估 PAN 中的发现是否可作为 CBCT 中观察到的边缘骨丢失和吸收的指标。
纳入 120 颗具有 PAN 和 CBCT 的上颌第三磨牙阻生。四位观察者评估了形态特征：（1）牙齿倾斜角度；（2）根数量；（3）骨阻生（是/否）和病理学；（4）第二磨牙的边缘骨水平（正常/ > 3 毫米=骨丢失）；（5）第二磨牙的吸收（无/浅表/穿过牙本质一半/穿过牙本质一半以上/涉及牙髓）；（6）滤泡间隙大小（正常/ > 4 毫米（囊肿））。百分比一致性和κ 统计量描述了 PAN 和 CBCT 中观察者的变异性。逻辑回归分析测试了 PAN 中的发现是否可作为 CBCT 中观察到的边缘骨丢失或吸收的指标。
κ 值为适度，CBCT 中的观察者间一致性略高于 PAN。PAN 和 CBCT 之间的边缘骨丢失的一致性为 81-88%，吸收的一致性为 68-81%。CBCT 中更常观察到严重的吸收。在 PAN 中观察到的近中倾斜第三磨牙和边缘骨丢失显著表明 CBCT 中观察到的边缘骨丢失（优势比 17-34； < 0.012；8.8-52.8； < 0.02）。相比之下，PAN 中的发现并不是 CBCT 中观察到的吸收的显著指标（> 0.05）。
总体而言，PAN 和 CBCT 之间的边缘骨丢失有适度的一致性，并且 PAN 可以显著预测 CBCT 中观察到的骨丢失。然而，CBCT 中观察到的吸收不能从 PAN 中确定，并且 CBCT 中观察到更严重的吸收。如果需要评估第二磨牙的吸收，则需要进行 CBCT。
