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使用锥形束计算机断层扫描(CBCT)对宫颈磨损进行新型三维分类:综合分析

Novel 3-dimensional classification of cervical abrasion using CBCT: A comprehensive analysis.

作者信息

Singh Tarun Kumar, Johnson Ashish J, Gupta Aakash, Gill Ikroop

机构信息

Division of Conservative Dentistry and Endodontics Department of Dentistry All India Institute of Medical Sciences, Bathinda, India.

出版信息

J Oral Biol Craniofac Res. 2024 Sep-Oct;14(5):638-644. doi: 10.1016/j.jobcr.2024.08.007. Epub 2024 Aug 28.

DOI:10.1016/j.jobcr.2024.08.007
PMID:39279920
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11401166/
Abstract

INTRODUCTION

Tooth cervical abrasion (CA) is a prevalent non-carious cervical lesion that poses challenges for accurate diagnosis from periapical radiographs due to difficulties in assessing the lesion's extent, associated bone loss, and pulpal involvement. The presence of overlying bone structures on the palatal side when lesions are located on the buccal side, or vice versa, further complicates radiographic interpretation. So it is important to define the lesions in all three dimensions.

OBJECTIVE

To provide a three-dimensional descriptive classification for cervical abrasion lesions using Cone Beam Computed Tomography (CBCT).

METHOD

A total of 50 patients with cervical abrasion were selected for the study. From these patients, teeth (n = 10) from each of the four different quadrants were chosen. A CBCT scan with a 6 × 6 cm field of view (FOV) was performed, and the DICOM files of the cervical lesions were transferred to 3-D imaging software. The CBCT images of the cervical abrasion lesions were assessed at the level of the deepest point of the lesion along the long axis of the tooth in both axial and sagittal planes. The height (A), buccolingual dimension (B), circumferential spread (C), and remaining dentine thickness (D) were evaluated and classified using new scoring criteria for each dimension. The reliability and reproducibility of the classification were assessed to ensure its clinical applicability.

CONCLUSION

CBCT can be utilized to classify tooth cervical abrasion in endodontics, enhancing diagnosis, analysis, and treatment outcomes. This three-dimensional view facilitates easier communication among clinicians, allows for tailored treatment approaches, and opens new avenues for research.

摘要

引言

牙齿颈部磨损(CA)是一种常见的非龋性颈部病变,由于在评估病变范围、相关骨质流失和牙髓受累情况方面存在困难,通过根尖片进行准确诊断具有挑战性。当病变位于颊侧时,腭侧存在覆盖的骨结构,反之亦然,这进一步使影像学解释变得复杂。因此,在三个维度上定义病变很重要。

目的

使用锥形束计算机断层扫描(CBCT)为颈部磨损病变提供三维描述性分类。

方法

共选择50例颈部磨损患者进行研究。从这些患者中,选取四个不同象限中每个象限的牙齿(n = 10)。进行视野为6×6 cm的CBCT扫描,并将颈部病变的DICOM文件传输到三维成像软件中。在轴向和矢状平面上,沿着牙齿长轴在病变最深点水平评估颈部磨损病变的CBCT图像。使用每个维度的新评分标准评估并分类高度(A)、颊舌径(B)、周向扩展(C)和剩余牙本质厚度(D)。评估分类的可靠性和可重复性,以确保其临床适用性。

结论

CBCT可用于牙髓病学中牙齿颈部磨损的分类,提高诊断、分析和治疗效果。这种三维视图便于临床医生之间更轻松地交流,允许采用量身定制的治疗方法,并为研究开辟新途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11ba/11401166/1bd704459a8e/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11ba/11401166/d620bc54818a/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11ba/11401166/c9257c8c21b0/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11ba/11401166/1fc517aab5c3/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11ba/11401166/c7968478ccc1/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11ba/11401166/1bd704459a8e/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11ba/11401166/d620bc54818a/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11ba/11401166/c9257c8c21b0/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11ba/11401166/1fc517aab5c3/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11ba/11401166/c7968478ccc1/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11ba/11401166/1bd704459a8e/gr4.jpg

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本文引用的文献

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Int Endod J. 2024 Feb;57(2):133-145. doi: 10.1111/iej.14000. Epub 2023 Nov 16.
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Applying the American Association of Endodontists and American Academy of Oral and Maxillofacial Radiology guidelines for cone-beam computed tomography prescription: Impact on endodontic clinical decisions.应用美国牙根管学会和美国口腔颌面放射学会的锥形束计算机断层扫描规定指南:对根管临床决策的影响。
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The Cervical Abrasion Index of Treatment Needs (CAITN) Procedure for Population Groups and Individuals.
针对人群和个体的宫颈治疗需求磨损指数(CAITN)程序
Cureus. 2023 Mar 18;15(3):e36324. doi: 10.7759/cureus.36324. eCollection 2023 Mar.
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Can non-carious cervical lesions depth affect clinical response in pain intensity and remaining dentin thickness?非龋性颈壁缺损的深度是否会影响疼痛强度和剩余牙本质厚度的临床反应?
Braz Dent J. 2022 Sep-Oct;33(5):108-115. doi: 10.1590/0103-6440202204789.
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J Pharm Bioallied Sci. 2022 Jul;14(Suppl 1):S384-S389. doi: 10.4103/jpbs.jpbs_627_21. Epub 2022 Jul 13.
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