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锥形束计算机断层扫描在体外识别种植体周围炎样骨缺损的诊断准确性。

Diagnostic Accuracy of Cone Beam Computed Tomography in Identifying Peri-implantitis-Like Bone Defects Ex Vivo.

出版信息

Int J Periodontics Restorative Dent. 2021 Nov-Dec;41(6):e223-e231. doi: 10.11607/prd.5201.

Abstract

This pilot study aimed to assess the diagnostic accuracy of CBCT in identifying peri-implantitis-like bone defects in cadavers. Three cadaver dental arches treated with the Thiel embalming method were used. Three different types of peri-implant bone defects (buccal dehiscence, two- to three-wall defects, and circumferential defects) were prepared on 15 implants. Defect depths and lengths were identified clinically using a periodontal probe, radiologically by means of CBCT images, and histologically with a micrometer using an optic microscope. Peri-implant bone defect morphology evaluated using CBCT images matched the clinical defect configuration (100% accuracy). CBCT assessment demonstrated lower values in defect depth and defect length when compared with the clinical evaluation. A statistically significant difference in defect depth (0.35 ± 0.45 mm; P = .037) was recorded between the clinical and CBCT data. Regarding defect length, a statistically significant mean difference of 0.81 ± 0.83 mm (P = .003) was noted between the clinical and CBCT data. Similarly, a mean difference of 1.09 ± 1.52 mm was recorded between the defect length assessed histologically and the CBCT data (P = .031). No statistically significant differences were observed between the other evaluated variables. CBCT is a reliable tool for peri-implantitis diagnosis and treatment planning, though the underestimation of defect severity may affect the prognosis and clinical decision-making. Clinicians need to be flexible in establishing prognoses and treatment based on CBCT assessment.

摘要

本初步研究旨在评估 CBCT 识别尸体中种植体周围炎样骨缺损的诊断准确性。使用了经过 Thiel 防腐处理的三个尸体牙弓。在 15 个种植体上制备了三种不同类型的种植体周围骨缺损(颊侧骨开窗、两壁至三壁缺损和环状缺损)。使用牙周探针临床确定缺损深度和长度,使用 CBCT 图像放射学确定,使用光学显微镜和千分尺进行组织学测量。使用 CBCT 图像评估的种植体周围骨缺损形态与临床缺损形态相匹配(准确性为 100%)。与临床评估相比,CBCT 评估显示缺损深度和长度值较低。临床和 CBCT 数据之间记录到缺损深度的统计学显著差异(0.35±0.45mm;P=.037)。在缺损长度方面,临床和 CBCT 数据之间记录到统计学显著的平均差异为 0.81±0.83mm(P=.003)。同样,组织学评估的缺损长度与 CBCT 数据之间记录到平均差异为 1.09±1.52mm(P=.031)。其他评估变量之间未观察到统计学显著差异。CBCT 是诊断种植体周围炎和制定治疗计划的可靠工具,尽管缺损严重程度的低估可能会影响预后和临床决策。临床医生需要根据 CBCT 评估灵活确定预后和治疗。

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