Adibi Afsoon, Sobhnamayan Fereshteh, Ostovar Zijerdi Nazafarin, Tajik Mohammad, Paknahad Maryam
Dentist, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
J Dent (Shiraz). 2022 Dec;23(4):445-451. doi: 10.30476/DENTJODS.2021.91056.1548.
Perforation within external root resorption (ERR) lesions dra-matically affects the prognosis of the involved roots. Failure to diagnose perforation under-mines treatment; therefore, early detection of these lesions is of great importance. The cone-beam computed tomography (CBCT) images and electronic apex locators (EAL) are reliably used to detect root perforations.
In this in vitro study, we compared the EAL findings with the results obtained by the CBCT images for the detection of perforations within ERR lesions.
This cross sectional study included 160 extracted anterior human teeth. The teeth were categorized into four groups including teeth with intact root, teeth with ERR, teeth with ERR and 0.5 mm perforation, and teeth with ERR with 1 mm perforation. The presence of perforations was compared by CBCT images and root EAL.
The sensitivity of CBCT scans in detecting 0.5 mm and 1 mm root perforations was 100% and 97.5%, respectively, while the sensitivity of the EAL was 10% and 27.5% in de-tecting 0.5 mm and 1 mm root perforations, respectively( with the ±0.5mm range of error). For detecting intact and teeth with ERR, the specificity of CBCT scans was 100% and 95%, respectively, and for EAL, it was 100% for both. Poor agreement was found between the two techniques (kappa=-0.025).
CBCT scans were more sensitive and specific than EAL scans for detecting perforations in non-obturated root canals in this study.
外部根吸收（ERR）病变内的穿孔会显著影响受累牙根的预后。未能诊断出穿孔会影响治疗效果；因此，早期发现这些病变非常重要。锥形束计算机断层扫描（CBCT）图像和电子根尖定位仪（EAL）可可靠地用于检测牙根穿孔。
在这项体外研究中，我们将EAL的检测结果与CBCT图像检测ERR病变内穿孔的结果进行了比较。
这项横断面研究包括160颗拔除的人前牙。这些牙齿被分为四组，包括牙根完整的牙齿、患有ERR的牙齿、患有ERR且有0.5mm穿孔的牙齿以及患有ERR且有1mm穿孔的牙齿。通过CBCT图像和牙根EAL比较穿孔的存在情况。
CBCT扫描检测0.5mm和1mm牙根穿孔的敏感性分别为100%和97.5%，而EAL检测0.5mm和1mm牙根穿孔的敏感性分别为10%和27.5%（误差范围为±0.5mm）。对于检测牙根完整和患有ERR的牙齿，CBCT扫描的特异性分别为100%和95%，而EAL的特异性均为100%。两种技术之间的一致性较差（kappa=-0.025）。
在本研究中，CBCT扫描在检测未充填根管穿孔方面比EAL扫描更敏感、更具特异性。
