Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
J Endod. 2020 Jun;46(6):827-831. doi: 10.1016/j.joen.2020.03.004. Epub 2020 Apr 16.
Periapical radiography (PR) is a diagnostic tool to be used by professionals in clinical practice. The method presents limitations, and doubts still exist about its value to evaluate furcation perforation and the reparative process of hard or soft tissues after treatment. Thus, the aim of this study was to evaluate the accuracy of PR as a diagnostic method to detect both resorption of the furcation area after induced experimental perforation and repair after perforation treatment using histopathological findings as a gold standard.
Thirty teeth of beagle dogs with furcation perforation were filled with Biodentine (Septodont, Saint-Maur-des-Fossés, France), ProRoot White mineral trioxide aggregate (Dentsply Tulsa Dental Specialties, Tulsa, OK), or gutta-percha and examined using PR and histology. Sensitivity, specificity, predictive values, and accuracy were calculated.
PR detected repair and reabsorption of furcation perforation in 55% and 48% of the teeth, respectively. Histologic analysis showed furcation perforation in 66% and 21% of the teeth, respectively. Sensitivity and specificity of PR for the detection of repair were 0.84 and 1, respectively, whereas for resorption detection, the values were 0.43 and 0.65, respectively. Diagnostic accuracy for PR was 0.89 and 0.72 for repair and resorption of furcation perforation, respectively. PR showed more accurate diagnostic (true positives + true negatives/total) in repair detection compared with resorption of furcation perforation.
We conclude that PR is not adequate in detecting resorption progress after the treatment of furcation perforation, and we encourage the use of digital imaging when suspicious of a possible unsuccessful result after furcation perforation treatment.
根尖射线照相（PR）是临床实践中专业人员使用的诊断工具。该方法存在局限性，对于评估分叉穿孔和治疗后硬组织或软组织的修复过程的价值仍存在疑问。因此，本研究旨在评估 PR 作为一种诊断方法的准确性，以检测诱导实验性穿孔后分叉区域的吸收以及穿孔治疗后的修复情况，以组织病理学发现为金标准。
对 30 颗具有分叉穿孔的比格犬牙齿用 Biodentine（圣莫里斯德福斯，法国赛普敦）、ProRoot White 矿三氧化物聚合体（登士柏图尔萨牙科专业公司，塔尔萨，OK）或牙胶进行填充，并用 PR 和组织学进行检查。计算了敏感性、特异性、预测值和准确性。
PR 分别在 55%和 48%的牙齿中检测到修复和吸收分叉穿孔。组织学分析显示，在 66%和 21%的牙齿中分别出现分叉穿孔。PR 检测修复的敏感性和特异性分别为 0.84 和 1，而对于吸收检测，敏感性和特异性分别为 0.43 和 0.65。PR 对分叉穿孔修复和吸收的诊断准确性分别为 0.89 和 0.72。PR 在检测修复方面的诊断准确性（真阳性+真阴性/总）高于检测分叉穿孔吸收。
我们得出结论，PR 不能准确检测治疗后分叉穿孔的吸收进展，并且我们鼓励在怀疑分叉穿孔治疗后可能出现不成功结果时使用数字成像。
