利用一种新的放射影像分割方法评估再生性手术治疗后牙周组织的愈合情况。

Utilizing a novel radiographic image segmentation method for the assessment of periodontal healing following regenerative surgical treatment.

出版信息

Quintessence Int. 2022 May 11;53(6):492-501. doi: 10.3290/j.qi.b2793209.

DOI:10.3290/j.qi.b2793209

Abstract

OBJECTIVE

The aim of the current article was to present a radiographic method to determine the surface area of newly formed periodontal attachment, as well as to analyze volumetric and morphologic changes after regenerative periodontal treatment.

METHOD AND MATERIALS

In this retrospective study, 11 singular intrabony periodontal defects were selected for minimally invasive surgical treatment and 3D evaluation. 3D virtual models were acquired by the segmentation of pre- and postoperative CBCT scans. This study determined the surface area of baseline periodontal attachment (RSA-A) and defect-involved root surface (RSA-D) on the preoperative 3D models, and the surface area of new periodontal attachment (RSA-NA) on the postoperative models. Finally, cumulative change of periodontal attachment (∆RSA-A) was calculated and Boolean subtraction was applied on pre- and postoperative 3D models to demonstrate postoperative 3D hard tissue alterations.

RESULTS

The average RSA-A was 84.39 ± 33.27 mm2, while the average RSA-D was 24.26 ± 11.94 mm2. The average surface area of RSA-NA after regenerative periodontal surgery was 17.68 ± 10.56 mm2. Additionally, ∆RSA-A was determined to assess the overall effects of ridge alterations on periodontal attachment, averaging 15.53 ± 12.47 mm2, which was found to be statistically significant (P = .00149). Lastly, the volumetric hard tissue gain was found to be 33.56 ± 19.35 mm3, whereas hard tissue resorption of 26.31 ± 38.39 mm3 occurred.

CONCLUSION

The proposed 3D radiographic method provides a detailed understanding of new periodontal attachment formation and hard tissue alterations following regenerative surgical treatment of intrabony periodontal defects.

摘要

目的

本研究旨在提出一种放射学方法，以确定新形成的牙周附着表面面积，并分析再生性牙周治疗后的体积和形态变化。

方法和材料

在这项回顾性研究中，选择了 11 个单一的骨内牙周缺损进行微创外科治疗和 3D 评估。通过对术前和术后 CBCT 扫描的分割，获得 3D 虚拟模型。本研究在术前 3D 模型上确定了基线牙周附着表面面积（RSA-A）和缺损涉及的牙根表面面积（RSA-D），以及术后模型上的新牙周附着表面面积（RSA-NA）。最后，计算牙周附着的累积变化（∆RSA-A），并在前、后 3D 模型上应用布尔减法以显示术后 3D 硬组织改变。

结果

平均 RSA-A 为 84.39 ± 33.27mm2，而平均 RSA-D 为 24.26 ± 11.94mm2。再生性牙周手术后 RSA-NA 的平均表面面积为 17.68 ± 10.56mm2。此外，通过评估牙槽嵴改变对牙周附着的总体影响来确定∆RSA-A，平均为 15.53 ± 12.47mm2，结果具有统计学意义（P=0.00149）。最后，发现体积硬组织获得为 33.56 ± 19.35mm3，而硬组织吸收为 26.31 ± 38.39mm3。