Yazdizadeh Mohammad, Alavinezhad Parniyan, Sadrishahrezaei Abtin, Sharifishoshtari Sanaz
Department of Endodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Oral and Maxillofacial Radiology, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Dent Res J (Isfahan). 2023 Sep 27;20:103. eCollection 2023.
A successful endodontic treatment requires a comprehensive knowledge of the root canal morphology. This study compared the diagnostic accuracy of cone-beam computed tomography (CBCT) and the sectioning technique for the assessment of mandibular first molar (MFM) root canal morphology.
In this , experimental study, 48 eligible MFMs were mounted in 12 blocks (groups of 4) made of acrylic resin and sheep bone powder and underwent CBCT. Next, the teeth were mounted in transparent self-cure acrylic blocks, and their roots were sectioned at three points with 3 mm intervals. Images underwent multiplanar reconstruction in NNT Viewer software and were analyzed by one radiologist with the cooperation of an endodontist. The sections were also evaluated by an endodontist under a stereomicroscope (gold standard). The frequency and percentage of single-canal, and two-canal roots were determined by each technique. The agreement between CBCT and the Gold standard was analyzed by calculating the kappa coefficient ( < 0.05).
The diagnostic accuracy of CBCT for the assessment of the MFM root canal morphology was 80% on the mesial surface, 99% in the distal surface, and 96% in total. In the mesial surface, 94.2% of two-canal roots and 66.7% of single-canal roots were correctly detected by CBCT. These values were 100% and 97.4% in the distal surface, and 95.2% and 95.8% in total, respectively. A significant agreement was noted between CBCT and the Gold standard with κ =0.412 for the mesial, 0.939 for the distal, and 0.907 for the total surfaces ( < 0.001).
CBCT can be reliably used for the assessment of the complex root canal morphology of MFMs when other modalities fall short.
成功的根管治疗需要全面了解根管形态。本研究比较了锥形束计算机断层扫描（CBCT）和切片技术在下颌第一磨牙（MFM）根管形态评估中的诊断准确性。
在本实验研究中，将48颗符合条件的MFM安装在由丙烯酸树脂和羊骨粉制成的12个模块（每组4颗）中，并进行CBCT扫描。接下来，将牙齿安装在透明的自固化丙烯酸模块中，并在牙根上每隔3毫米的三个点进行切片。图像在NNT Viewer软件中进行多平面重建，并由一名放射科医生在内科牙髓病医生的配合下进行分析。切片也由一名牙髓病医生在体视显微镜下进行评估（金标准）。通过每种技术确定单根管和双根管牙根的频率和百分比。通过计算kappa系数（<0.05）分析CBCT与金标准之间的一致性。
CBCT评估MFM根管形态的诊断准确性在近中面为80%，远中面为99%，总体为96%。在近中面，CBCT正确检测出94.2%的双根管牙根和66.7%的单根管牙根。这些值在远中面分别为100%和97.4%，总体分别为95.2%和95.8%。CBCT与金标准之间存在显著一致性，近中面κ=0.412，远中面κ=0.939，总体κ=0.907（<0.001）。
当其他方法不足时，CBCT可可靠地用于评估MFM复杂的根管形态。
