Ihlis Randi Lynds, Giovanos Christina, Liao Haihong, Ring Ingrid, Malmgren Olle, Tsilingaridis Georgios, Benchimol Daniel, Shi Xie Qi
Department of Clinical Dentistry, University of Bergen, Bergen, Norway; Region Dalarna and the Center for Clinical Research, Association with Uppsala University, Falun, Uppsala, Sweden.
Private practice, Stockholm, Sweden.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2023 Jan;135(1):e1-e9. doi: 10.1016/j.oooo.2022.06.013. Epub 2022 Jul 3.
To investigate how cone beam computed tomography (CBCT) affects the therapeutic planning of impacted maxillary canines.
A total of 132 impacted canines from 89 pediatric patients were collected from 3 specialist clinics in Stockholm, Sweden. An interdisciplinary therapy planning team consisting of 5 dental specialists evaluated each case and chose their preferred treatment alternative, initially without and later with CBCT images, to decide whether CBCT was justified for therapy planning. Predefined variables measurable using only 2-dimensional (2D) assessments were analyzed using stepwise logistic regression analyses.
The CBCT was considered indicated in 47% of the cases. Additional information from CBCT led to a treatment decision change in 9.8%. Significant 2D predictors for CBCT justification were horizontal canine angulation compared with vertical angulation (odds ratio [OR] = 10.9), extraction strategy involvement (OR = 6.7), and buccally positioned canines compared with palatal (OR = 5.3), central (OR = 25.0), and distal or uncertain positions (OR = 7.7).
The benefit-risk assessment of CBCT for impacted canines may be reinforced by performing and applying justification decisions for CBCT acquisition at the therapeutic thinking level. If preliminary treatment planning motivates further in-depth investigation of either root status or tooth location, a CBCT is indicated.
探讨锥形束计算机断层扫描（CBCT）如何影响上颌阻生尖牙的治疗计划。
从瑞典斯德哥尔摩的3家专科诊所收集了89例儿科患者的132颗阻生尖牙。一个由5名牙科专家组成的多学科治疗计划团队对每个病例进行评估，并选择他们首选的治疗方案，最初不使用CBCT图像，后来使用CBCT图像，以确定CBCT是否适用于治疗计划。使用逐步逻辑回归分析对仅使用二维（2D）评估可测量的预定义变量进行分析。
47%的病例被认为需要使用CBCT。CBCT提供的额外信息导致9.8%的治疗决策发生改变。CBCT必要性的重要二维预测因素包括水平尖牙角度与垂直角度相比（优势比[OR]=10.9）、拔牙策略的参与情况（OR=6.7）以及颊侧位尖牙与腭侧（OR=5.3）、中央（OR=25.0）和远中或不确定位置（OR=7.7）的尖牙相比。
通过在治疗思维层面进行并应用CBCT采集的必要性决策，可加强对CBCT用于阻生尖牙的效益风险评估。如果初步治疗计划促使对牙根状况或牙齿位置进行进一步深入研究，则表明需要进行CBCT检查。
