School of Dentistry, Complutense University of Madrid, Madrid, Spain.
BIOCRAN, Craniofacial Biology and Orthodontics Research Group, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
J Evid Based Dent Pract. 2023 Mar;23(1):101803. doi: 10.1016/j.jebdp.2022.101803. Epub 2022 Nov 8.
This review analyses the diagnostic performance of cone-beam computed tomography (CBCT) for the in vivo/in vitro detection of external root resorption (ERR) and critically analyses current and past methods of measuring or classifying ERR in vivo/in vitro in terms of radiation doses and cumulative radiation risks.
A diagnostic test accuracy (DTA) protocol was used for a systematic review of diagnostic methods following PRISMA guidelines. The protocol was registered with PROSPERO (ID: CRD42019120513). A thorough and exhaustive electronic search of 6 core electronic databases was performed, applying the ISSG Search Filter Resource. The eligibility criteria were designed [problem-intervention-comparison-outcomes (PICO) statement: Population, Index test, Comparator, Outcome] and methodological quality was assessed by QUADAS-2.
Seventeen papers were selected from a total of 7841 articles. Six in vivo studies were assessed as having a low risk of bias. The overall sensitivity and specificity of CBCT for diagnosis of ERR was 78.12% and 79.25%, respectively. The highest and lowest sensitivity and specificity of CBCT for diagnosis of external root resorption are 42%-98% and 49.3%-96.3%.
Most of the selected studies reported quantitative diagnoses with single linear measurements of ERR even though multislice radiographs were available. The cumulative radiation dose (μS) to radiation-sensitive structures, such as the bone marrow, brain and thyroid, was observed to increase using the 3-dimensional (3D) radiography methods reported.
The highest and lowest sensitivity and specificity of CBCT for diagnosis of external root resorption are 42%-98% and 49.3%-96.3%. The minimum and maximum effective doses of dental CBCT for external root resorption diagnosis are 34 μSv and 1073 μSv.
本综述分析了锥形束计算机断层扫描(CBCT)在体外/体内检测外部根吸收(ERR)方面的诊断性能,并根据辐射剂量和累积辐射风险,对当前和过去的体外/体内 ERR 测量或分类方法进行了批判性分析。
采用 PRISMA 指南下的诊断测试准确性(DTA)方案对诊断方法进行系统综述。该方案已在 PROSPERO(ID:CRD42019120513)中注册。对 6 个核心电子数据库进行了全面和详尽的电子搜索,应用了 ISSG 搜索过滤器资源。根据 [问题-干预-比较-结果(PICO)声明:人群、指标测试、比较、结果] 设计了入选标准,并通过 QUADAS-2 评估了方法学质量。
从总共 7841 篇文章中筛选出 17 篇论文。6 项体内研究被评估为低偏倚风险。CBCT 诊断 ERR 的总体敏感性和特异性分别为 78.12%和 79.25%。CBCT 诊断外部根吸收的最高和最低敏感性和特异性分别为 42%-98%和 49.3%-96.3%。
大多数入选的研究报告了定量诊断,即使有多层射线照片,也仅采用 ERR 的单次线性测量。观察到使用报告的三维(3D)射线照相方法,对骨髓、大脑和甲状腺等辐射敏感结构的累积辐射剂量(μS)增加。
CBCT 诊断外部根吸收的最高和最低敏感性和特异性分别为 42%-98%和 49.3%-96.3%。诊断外部根吸收的牙科 CBCT 的最小和最大有效剂量分别为 34μSv 和 1073μSv。