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在治疗中期,基于临床决策的预期根位设置的准确性和可靠性。

Accuracy and reliability of the expected root position setup on clinical decision making of root position at midtreatment.

机构信息

Division of Orthodontics, University of California, San Francisco, San Francisco, Calif.

Division of Orthodontics, University of California, San Francisco, San Francisco, Calif.

出版信息

Am J Orthod Dentofacial Orthop. 2019 Oct;156(4):566-573. doi: 10.1016/j.ajodo.2019.03.018.

Abstract

INTRODUCTION

Accurate root position is imperative for successful orthodontic treatment that is stable and functional. Current methods to monitor root position are either inaccurate or use relatively high levels of radiation. A method to generate an expected root position (ERP) setup has been reported to have the potential to accurately evaluate root position with minimal radiation. The purpose of this study was to determine the accuracy and reliability of the clinical decisions made on root position using the ERP setup.

METHODS

This retrospective study included 10 subjects who had pretreatment and midtreatment cone-beam computed tomography (CBCT) scans and study models. An ERP setup was generated for all patients at midtreatment. Four examiners assessed both the CBCT scan and ERP setup and made clinical decisions regarding the root position with each method. Cohen's kappa was determined to assess intraoperator and intermethod reliability. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated to determine the accuracy of the ERP setup.

RESULTS

The kappa values for intraoperator reliability for both the CBCT scan and ERP setup fell within the 0.61-0.80 range. The kappa values for intermethod reliability between the CBCT scan and ERP setup fell within the 0.61-0.80 range for all tooth groups. The sensitivity of the ERP setup ranged from 0.72 to 0.90, specificity ranged from 0.89 to 0.97, positive predictive value ranged from 0.57 to 0.85, and negative predictive value ranged from 0.93 to 0.99.

CONCLUSIONS

This study demonstrated that the ERP setup, when compared with the gold standard CBCT scan, was accurate and reliable in making clinical decisions regarding root position at midtreatment.

摘要

简介

准确的牙根位置对于稳定且功能良好的正畸治疗至关重要。目前监测牙根位置的方法要么不准确,要么使用相对较高水平的辐射。已经报道了一种生成预期牙根位置(ERP)设置的方法,该方法具有用最小辐射准确评估牙根位置的潜力。本研究的目的是确定使用 ERP 设置进行牙根位置临床决策的准确性和可靠性。

方法

这项回顾性研究包括 10 名接受治疗前和中期锥形束计算机断层扫描(CBCT)扫描和研究模型的患者。为所有患者在中期生成 ERP 设置。四名检查者评估 CBCT 扫描和 ERP 设置,并使用每种方法对牙根位置做出临床决策。通过 Cohen's kappa 评估操作者内和方法间的可靠性。计算敏感性、特异性、阳性预测值和阴性预测值以确定 ERP 设置的准确性。

结果

CBCT 扫描和 ERP 设置的操作者内可靠性的 kappa 值均在 0.61-0.80 范围内。CBCT 扫描和 ERP 设置之间的方法间可靠性的 kappa 值在所有牙齿组中均在 0.61-0.80 范围内。ERP 设置的敏感性范围为 0.72 至 0.90,特异性范围为 0.89 至 0.97,阳性预测值范围为 0.57 至 0.85,阴性预测值范围为 0.93 至 0.99。

结论

与金标准 CBCT 扫描相比,本研究表明 ERP 设置在治疗中期进行牙根位置的临床决策时准确且可靠。

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