Department of Orthodontics, Public Dental Health Service, Eskilstuna, Sweden; Department of Orthodontics, Postgraduate Dental Education Center, Örebro, Sweden.
Clinical Epidemiology and Biostatistics Unit, Orebro University Hospital, Orebro, Sweden.
Am J Orthod Dentofacial Orthop. 2019 Mar;155(3):380-387. doi: 10.1016/j.ajodo.2018.05.015.
The early interceptive treatment of palatally displaced canines (PDCs) has for decades been based on their position in panoramic radiographs. In the 1990s, cone-beam computed tomography (CBCT) started to become popular in cases with PDCs. The aims of this prospective study were to evaluate the agreement of PDC sector position and angle to midline between panoramic radiographs and CBCT scans.
PDC sector and angle to midline were measured in panoramic radiographs and CBCT scans in 58 consecutive patients with 64 PDCs. Kappa with linear weighting was used to assess the agreement between the measurements of PDC sector position and Bland-Altman limits of agreement to assess the agreement between the PDC angular measurements in the 2 methods.
PDC sector position and angle to midline had systematically higher values in panoramic radiographs compared with those in the CBCT scans. The agreement of sector position between the methods was fair: weighted kappa 0.36 (95% CI 0.24-0.49). The mean difference in angle was almost 7° (95% CI 5.9°-7.9°) higher in panoramic radiographs compared with CBCT.
Panoramic radiographs overestimate PDC sector and angle to midline position, compared with the use of CBCT scans, but clinically the differences are quite modest. Panoramic radiographs could be considered good enough for rendering PDC position when the need for 3D information is not crucial for treatment planning.
几十年来，临床上对于腭侧错位牙（PDC）的早期阻断性治疗一直基于其全景片上的位置。20 世纪 90 年代，锥形束 CT（CBCT）开始在 PDC 病例中普及。本前瞻性研究旨在评估全景片和 CBCT 扫描中 PDC 扇区位置和与中线夹角的一致性。
在 58 例 64 颗 PDC 连续患者中，分别在全景片和 CBCT 扫描中测量 PDC 扇区位置和与中线的夹角。采用线性加权 Kappa 评估 PDC 扇区位置测量的一致性，并采用 Bland-Altman 界限评估两种方法中 PDC 角度测量的一致性。
与 CBCT 扫描相比，全景片上 PDC 扇区位置和与中线的夹角的测量值系统偏高。两种方法的扇区位置一致性为中等：加权 Kappa 值为 0.36（95%CI：0.24-0.49）。与 CBCT 相比，全景片上的角度均值差值几乎高了 7°（95%CI：5.9°-7.9°）。
与 CBCT 扫描相比，全景片高估了 PDC 扇区和与中线的夹角位置，但临床上差异相当小。当 3D 信息对治疗计划不是至关重要时，全景片可以被认为足以确定 PDC 位置。
