Ruetters Maurice, Gehrig Holger, Kim Ti-Sun, Bartha Valentin, Bruckner Thomas, Schwindling Franz Sebastian, Felten Anna, Lux Christopher, Sen Sinan
Section of Periodontology, Department of Operative Dentistry, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Institute of Medical Biometry, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
Sci Rep. 2022 Apr 26;12(1):6824. doi: 10.1038/s41598-022-10781-0.
Different cone beam computed tomography (CBCT) protocols have shown promising results for imaging furcation defects. This study evaluates the suitability of low-dose (LD)-CBCT for this purpose. Fifty-nine furcation defects of nine upper and 16 lower molars in six human cadavers were measured by a high-dose (HD)-CBCT protocol, a LD-CBCT protocol, and a surgical protocol. HD-CBCT and LD-CBCT measurements were made twice by two investigators and were compared with the intrasurgical measurements, which served as the reference. Furcation defect volumes generated from HD-CBCT and LD-CBCT imaging were segmented by one rater. Cohen's kappa and intraclass correlation coefficient (ICC) values were calculated to determine intra- and interrater reliability. The level of significance was set at α = 0.05. In total, 59 furcation defects of nine upper and 16 lower human molars were assessed. Comparing CBCT furcation defect measurements with surgical measurements revealed a Cohen's kappa of 0.5975 (HD-and LD-CBCT), indicating moderate agreement. All furcation defects identified by HD-CBCT were also detected by LD-CBCT by both raters, resulting in a Cohen's kappa of 1. For interrater agreement, linear furcation defect measurements showed an ICC of 0.992 for HD-CBCT and 0.987 for LD-CBCT. The intrarater agreement was 0.994(r1)/0.992(r2) for HD-CBCT and 0.987(r1)/0.991(r2) for LD-CBCT. The intermodality agreement was 0.988(r1)/0.991(r2). Paired t-test showed no significant differences between HD-CBCT and LD-CBCT measurements. LD-CBCT is a precise and reliable method for detecting and measuring furcation defects in mandibular and maxillary molars in this experimental setting. It has the potential to improve treatment planning and treatment monitoring with a far lower radiation dose than conventional HD-CBCT.
不同的锥束计算机断层扫描（CBCT）方案在根分叉病变成像方面已显示出有前景的结果。本研究评估低剂量（LD）-CBCT用于此目的的适用性。通过高剂量（HD）-CBCT方案、LD-CBCT方案和手术方案对6具人类尸体中9颗上颌磨牙和16颗下颌磨牙的59个根分叉病变进行了测量。HD-CBCT和LD-CBCT测量由两名研究人员进行了两次，并与作为参考的手术内测量进行比较。由一名评估者对HD-CBCT和LD-CBCT成像生成的根分叉病变体积进行分割。计算科恩kappa值和组内相关系数（ICC）以确定评估者内和评估者间的可靠性。显著性水平设定为α = 0.05。总共评估了9颗上颌磨牙和16颗下颌磨牙的59个根分叉病变。将CBCT根分叉病变测量值与手术测量值进行比较，得出科恩kappa值为0.5975（HD-和LD-CBCT），表明一致性中等。两名评估者通过LD-CBCT均检测到了HD-CBCT识别出的所有根分叉病变，科恩kappa值为1。对于评估者间一致性，线性根分叉病变测量显示HD-CBCT的ICC为0.992，LD-CBCT的ICC为0.987。评估者内一致性HD-CBCT为0.994（r1）/0.992（r2），LD-CBCT为0.987（r1）/0.991（r2）。不同模态间的一致性为0.988（r1）/0.991（r2）。配对t检验显示HD-CBCT和LD-CBCT测量之间无显著差异。在本实验环境中，LD-CBCT是检测和测量下颌和上颌磨牙根分叉病变的一种精确且可靠的方法。它有可能以远低于传统HD-CBCT的辐射剂量改善治疗计划和治疗监测。
