Dr. Helder is an interim program director, Nemours Children's Health, in Wilmington.
Dr. Alimorad is an attending pediatric dentist, Nemours Children's Health, in Wilmington.
Pediatr Dent. 2022 May 15;44(3):186-191.
The purpose of this study was to evaluate whether preoperative radiographic measurements could predict the final steel crown selection size for restoration of primary molars. A retrospective chart review of children two to 10 years old receiving oral rehabbilitation between July 2019 and May 2020 was completed. Bitewing radiographs were used to obtain two linear radiographic measurements (coronal and cervical) using DEXIS™ Imaging Software (KaVo Dental). Separate models using each, along with covariates of primary first versus primary second molars, maxillary versus mandibular molars, and their interaction, were developed using linear regression analysis (N equals 225), treating the final crown size as a continuous response. Final models utilizing stainless steel crown sizes of previously crowned teeth showed that predictors and all covariates were significant (P<0.001). Three cross-validation models (80 percent training sets) for each radiographic measurement showed strong agreement with the final models. Based on the final coronal model, a practitioner would achieve a correct fit using one, two, or three attempts with accuracy rates of 46 percent, 47 percent, and seven percent, respectively, with a cumulative rate through two attempts of 93 percent; for the cervical model, respective accuracy rates were 38 percent, 51 percent, 11 percent, and 89 percent. These models were used to create size fitting guides. This crown fitting guide has favorable clinical potential to assist providers, especially novice dentists, in selecting crown sizes, showing promise for expanded radiographic application in dentistry, specifically to education, technical efficiency, and minimization of waste.
本研究旨在评估术前放射影像学测量值是否可预测恒牙早期磨牙修复用最终不锈钢冠选择尺寸。对 2019 年 7 月至 2020 年 5 月间接受口腔修复的 2 至 10 岁儿童进行了回顾性图表审查。使用 DEXIS™ Imaging Software（卡瓦牙科）获取口内 X 线片的两个线性放射影像学测量值（冠向和颈向）。使用线性回归分析（N=225）建立了分别使用这两个值的单独模型，以及初级第一磨牙与初级第二磨牙、上颌磨牙与下颌磨牙及其相互作用的协变量，将最终冠尺寸作为连续响应处理。使用先前已冠修复的牙齿的不锈钢冠尺寸的最终模型显示，预测因子和所有协变量均有统计学意义（P<0.001）。每个放射影像学测量值的三个交叉验证模型（80%的训练集）与最终模型具有很强的一致性。根据最终的冠向模型，临床医生在使用一次、两次或三次尝试时，准确度分别为 46%、47%和 7%，累积两次尝试的准确率为 93%；对于颈向模型，相应的准确率分别为 38%、51%、11%和 89%。这些模型被用于创建尺寸适配指南。这种冠适配指南具有良好的临床应用潜力，可帮助临床医生，尤其是初出茅庐的牙医，选择冠尺寸，有望在口腔医学领域进一步扩大放射影像学的应用，特别是在教育、技术效率和减少浪费方面。
