Komšić Sanja, Plančak Darije, Kašaj Adrian, Puhar Ivan
Dental Office Michael Wolf and Colleagues, Patrickstrasse 2, 65191 Wiesbaden.
Department of Periodontology, School of Dental Medicine, University of Zagreb, and Clinical Department of Periodontology, Clinical Hospital Center.
Acta Stomatol Croat. 2019 Dec;53(4):326-336. doi: 10.15644/asc53/4/3.
The aim of this study was to compare clinical, intra-surgical, 2D (panoramic) and 3D (CBCT)-based parameters in assessing molar furcation involvement (FI).
Six patients with generalized periodontitis Stage II to IV, Grade B and C who were scheduled for the periodontal flap surgical treatment were recruited in the study. In total, 38 molar teeth with 93 furcation sites were analysed. All subjects had comprehensive periodontal examination, which included an assessment of molar FI using Naber's probe according to modified Glickman's classification. Periodontal surgery was performed in patients with at least one maxillary molar with probing depth of ≥6 mm. This probing demonstrated lower grade of FI compared with intra-surgical findings.
Periodontal probing, intra-surgical measurement and measurements based on CBCT significantly correlated with each other regarding the assessment of FI, with r values ranging between 0.81 to 1.00 (p<0.01). The correlation of panoramic radiograph with periodontal probing is 0.49, with CBCT 0.39 and with intra-surgical measurements 0.36. The results showed an excellent agreement and higher accuracy between intra-surgical measurements and CBCT (0.96), in contrast to clinical examination and panoramic radiography- 0.87 and 0.63 respectively. Different clinical and radiological modalities showed a correlation among each other. They are accurate and have their own benefits, which makes (renders) them useful in establishing periodontal diagnosis and treatment planning.
However, CBCT offers significant advantages including excellent agreement and higher accuracy and can be used as justified as excellent diagnostic tool in detecting and locating FI to provide a more reliable diagnosis and basis for treatment decisions.
本研究旨在比较临床、手术中、基于二维(全景片)和三维(锥形束计算机断层扫描,CBCT)的参数在评估磨牙根分叉病变(FI)中的情况。
招募了6例计划接受牙周瓣手术治疗的广泛性牙周炎II至IV期、B级和C级患者。共分析了38颗磨牙的93个根分叉部位。所有受试者均接受了全面的牙周检查,包括根据改良的Glickman分类法使用Naber探针评估磨牙FI。对至少有一颗上颌磨牙探诊深度≥6 mm的患者进行了牙周手术。该探诊显示的FI分级低于手术中的发现。
在FI评估方面,牙周探诊、手术中测量和基于CBCT的测量之间显著相关,r值在0.81至1.00之间(p<0.01)。全景片与牙周探诊的相关性为0.49,与CBCT的相关性为0.39,与手术中测量的相关性为0.36。结果显示手术中测量与CBCT之间具有极好的一致性和更高的准确性(0.96),相比之下临床检查与全景片分别为0.87和0.63。不同的临床和放射学方法相互之间存在相关性。它们准确且各有优势,这使得它们在建立牙周诊断和治疗计划中很有用。
然而,CBCT具有显著优势,包括极好的一致性和更高的准确性,并且可以合理地用作检测和定位FI的优秀诊断工具,以提供更可靠的诊断和治疗决策依据。