Biel Philippe, Jurt Alice, Chappuis Vivianne, Suter Valerie G A
Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
Oral Radiol. 2024 Apr;40(2):207-218. doi: 10.1007/s11282-023-00723-5. Epub 2023 Dec 15.
To investigate the prevalence of incidental findings and need for further dental treatment and analyse the influence of size of field-of-view (FOV) and age in cone beam computed tomography (CBCT) for pre-implant planning.
404 CBCT scans were examined retrospectively for incidental findings and need for further dental treatment. Incidental finding-frequencies and need for further treatment were assessed for different age (< 40 years, 40-60 years, > 60 years) and FOV groups (small, medium, large). Intraexaminer and interexaminer agreements were evaluated.
In 82% of the scans at least one incidental finding was found, with a total of 766 overall. More incidental findings were found in scans with large FOV (98% vs. 72%, OR = 22.39 large vs. small FOV, p < 0.0001) and in scans of patients > 60 years (OR = 5.37 patient's age > 60 years vs. < 40 years, p = 0.0003). Further dental treatment due to incidental findings was needed in 31%. Scans with large FOV were more likely to entail further treatment (OR = 3.55 large vs. small FOV, p < 0.0001). Partial edentulism and large FOV were identified as risk factors for further treatment (p = 0.0003 and p < 0.0001). Further referral of the patient based on incidental findings was judged as indicated in 5%. Intra- and inter-examiner agreements were excellent (kappa = 0.944/0.805).
A considerable number of incidental findings with need for further dental treatment was found in partially edentulous patients and in patients > 60 years. In pre-implant planning of elderly patients, the selection of large FOV CBCT scans, including dentoalveolar regions not X-rayed recently, help to detect therapeutically relevant incidental findings.
研究种植前计划中锥束计算机断层扫描（CBCT）偶然发现的发生率及进一步牙科治疗的需求，并分析视野（FOV）大小和年龄对其的影响。
回顾性检查404例CBCT扫描，以确定偶然发现及进一步牙科治疗的需求。评估不同年龄组（<40岁、40 - 60岁、>60岁）和FOV组（小、中、大）的偶然发现频率及进一步治疗的需求。评估了检查者内和检查者间的一致性。
82%的扫描中至少发现了一项偶然发现，总共766项。大FOV扫描中发现的偶然发现更多（98%对72%，大FOV与小FOV的OR = 22.39，p < 0.0001），60岁以上患者的扫描中也是如此（60岁以上患者与<40岁患者的OR = 5.37，p = 0.0003）。31%的患者因偶然发现需要进一步牙科治疗。大FOV扫描更有可能需要进一步治疗（大FOV与小FOV的OR = 3.55，p < 0.0001）。部分牙列缺失和大FOV被确定为进一步治疗的危险因素（p = 0.0003和p < 0.0001）。基于偶然发现进一步转诊患者的情况被判定为有指征的占5%。检查者内和检查者间的一致性极佳（kappa = 0.944/0.805）。
在部分牙列缺失患者和60岁以上患者中发现了相当数量的需要进一步牙科治疗的偶然发现。在老年患者的种植前计划中，选择大FOV的CBCT扫描，包括近期未进行X线检查的牙槽区域，有助于发现具有治疗意义的偶然发现。
