Candemil Amanda Pelegrin, Alves Dos Santos Guilherme Nilson, Oliveira Matheus L, Gatti Filippo, Silva-Sousa Yara T C, Silva-Sousa Alice C, Mazzi-Chaves Jardel Francisco, Sousa-Neto Manoel Damião
Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil; CentraleSupélec, Ecole Normale Supérieure Paris-Saclay, Centre national de la recherche scientifique, Laboratoire de Mécanique Paris-Saclay, Université Paris-Saclay, Gif-sur-Yvette, France.
Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
J Endod. 2024 Apr;50(4):434-449. doi: 10.1016/j.joen.2024.01.014. Epub 2024 Jan 28.
The development of dedicated coils and new magnetic resonance imaging (MRI) sequences has led to an increase in image resolution and a reduction in artifacts. Consequently, numerous studies have demonstrated the utility of MRI as a nonionizing alternative to cone-beam computed tomographic imaging. The aim of this systematic review was to evaluate the accuracy of MRI in clinical applications in endodontics.
A literature search was conducted using PubMed, Embase, Scopus, and Web of Science. The inclusion criteria encompassed studies evaluating MRI applications in endodontics, covering tooth and root canal anatomy, root canal working length, pulp vitality and regeneration, the effect of caries on dental pulp, guided endodontics, periapical lesions, and root cracks/fractures. The selected studies examined both ex vivo and in vivo human teeth using clinical MRI units. Two researchers independently screened the studies, applied the eligibility criteria, and assessed the potential risk of bias using the revised QUADAS-2 tool (Bristol Medical School, University of Bristol, UK).
A total of 18 studies were included in this systematic review, demonstrating that the use of MRI has a high diagnostic value in endodontics. In the evaluation of tooth and root canal anatomy, pulp vitality and regeneration, the effect of caries on dental pulp, periapical lesions, and root cracks/fractures, MRI's accuracy is comparable to or even higher than reference standards such as cone-beam computed tomographic imaging, micro-computed tomographic imaging, and histology.
MRI has high potential accuracy for diagnosing various clinical endodontic tasks, except for root canal length, size of caries, and periapical lesion dimensions, which are overestimated in MRI.
专用线圈和新的磁共振成像（MRI）序列的发展提高了图像分辨率并减少了伪影。因此，大量研究证明了MRI作为锥束计算机断层扫描成像的非电离替代方法的实用性。本系统评价的目的是评估MRI在牙髓病学临床应用中的准确性。
使用PubMed、Embase、Scopus和Web of Science进行文献检索。纳入标准包括评估MRI在牙髓病学中的应用的研究，涵盖牙齿和根管解剖结构、根管工作长度、牙髓活力与再生、龋齿对牙髓的影响、引导性牙髓治疗、根尖周病变以及牙根裂纹/骨折。所选研究使用临床MRI设备对离体和体内人类牙齿进行了检查。两名研究人员独立筛选研究、应用纳入标准，并使用修订后的QUADAS-2工具（英国布里斯托大学布里斯托医学院）评估潜在的偏倚风险。
本系统评价共纳入18项研究，表明MRI在牙髓病学中具有较高的诊断价值。在评估牙齿和根管解剖结构、牙髓活力与再生、龋齿对牙髓的影响、根尖周病变以及牙根裂纹/骨折方面，MRI的准确性与锥束计算机断层扫描成像、微型计算机断层扫描成像和组织学等参考标准相当，甚至更高。
除了根管长度、龋损大小和根尖周病变范围在MRI中被高估外，MRI在诊断各种临床牙髓病学任务方面具有较高的潜在准确性。
