Ruetters Maurice, Gehrig Holger, Awounvo Sinclair, Kim Ti-Sun, Doll Sara, Alexandrou Korallia, Felten Anna, Lux Christopher, Sen Sinan
Heidelberg University, Department of Operative Dentistry, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
University Hospital Heidelberg, Institute of Medical Biometry, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
J Orofac Orthop. 2024 Oct 24. doi: 10.1007/s00056-024-00558-7.
Three-dimensional imaging has become an increasingly important component of orthodontics. Associated with this, however, is a higher radiation exposure for patients. New cone-beam computed tomography (CBCT) devices have been developed that can provide low-dose CBCT (LD-CBCT). We hypothesized that LD-CBCT is as precise and reproducible as standard high-dose CBCT (HD-CBCT) in segmenting roots and crowns as well as measuring tooth length.
HD-CBCT and LD-CBCT scans were taken of four human cadaveric heads. Thirty single-rooted teeth were segmented twice by one investigator. The length of each tooth was also measured. Lin's concordance correlation coefficient (CCC) was calculated to assess the agreement of HD-CBCT and LD-CBCT measurements and the intraclass correlation coefficient (ICC) was calculated to assess intrarater reliability. Analyses were supported by Bland-Altman plots.
Volume measurements obtained using HD-CBCT were significantly higher than those obtained using LD-CBCT (p < 0.001). CCC was 0.975 (95% confidence interval [CI] = 0.956-0.986) indicating excellent agreement between the two modalities. Intrarater reliability between the two sets of LD-CBCT and HD-CBCT volume measurements was excellent (ICC = 0.998, 95%CI = 0.995-0.999 [HD-CBCT], ICC = 0.997, 95%CI = 0.992-0.998 [LD-CBCT]). CCC for tooth length measurements was 0.991 (95% CI = 0.983-0.995), indicating excellent agreement between HD-CBCT and LD-CBCT. Intrarater reliabilities between the two sets of tooth length measurements were also excellent for both methods (ICC = 0.998, 95%CI = 0.995-0.999 [HD-CBCT], ICC = 0.997, 95%CI = 0.992-0.998 [LD-CBCT]).
Within the limitations of this experimental setting, LD-CBCT is as valid as HD-CBCT for measuring tooth length. Regarding the volume differences, in vivo studies are required to determine their clinical relevance.
三维成像已成为正畸学中日益重要的组成部分。然而，与此相关的是患者的辐射暴露增加。已开发出新型锥形束计算机断层扫描（CBCT）设备，可提供低剂量CBCT（LD-CBCT）。我们假设在分割牙根和牙冠以及测量牙长方面，LD-CBCT与标准高剂量CBCT（HD-CBCT）一样精确且可重复。
对四个人类尸体头部进行HD-CBCT和LD-CBCT扫描。一名研究人员对30颗单根牙进行了两次分割。还测量了每颗牙的长度。计算林氏一致性相关系数（CCC）以评估HD-CBCT和LD-CBCT测量结果的一致性，并计算组内相关系数（ICC）以评估测量者内部的可靠性。通过Bland-Altman图进行分析。
使用HD-CBCT获得的体积测量值显著高于使用LD-CBCT获得的值（p <0.001）。CCC为0.975（95%置信区间[CI]=0.956 - 0.986），表明两种方式之间具有极好的一致性。两组LD-CBCT和HD-CBCT体积测量值之间的测量者内部可靠性极佳（ICC = 0.998，95%CI = 0.995 - 0.999[HD-CBCT]，ICC = 0.997，95%CI = 0.992 - 0.998[LD-CBCT]）。牙长测量的CCC为0.991（95%CI = 0.983 - 0.995），表明HD-CBCT和LD-CBCT之间具有极好的一致性。两种方法的两组牙长测量值之间的测量者内部可靠性也都极佳（ICC = 0.998，95%CI = 0.995 - 0.999[HD-CBCT]，ICC = 0.997，95%CI = 0.992 - 0.998[LD-CBCT]）。
在本实验设置的局限性内，LD-CBCT在测量牙长方面与HD-CBCT一样有效。关于体积差异，需要进行体内研究以确定其临床相关性。
