Fahd Ali, Hussien Aya A, Ellabban Mohamed T, Shatat Zein A
Department of Oral and Maxillofacial Radiology, Faculty of Oral and Dental Medicine, Egyptian Russian University, Cairo, Egypt.
Department of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Oral and Dental Medicine, Egyptian Russian University, Cairo, Egypt.
Imaging Sci Dent. 2024 Dec;54(4):354-361. doi: 10.5624/isd.20240073. Epub 2024 Aug 12.
This study was performed to introduce, evaluate, and compare various novel assessment protocols designed for straightforward, reliable, and reproducible measurement of alveolar bone levels. These protocols are intended for standardized periodontal assessment and follow-up, utilizing cone-beam computed tomography (CBCT) images and manipulation of Digital Imaging and Communications in Medicine (DICOM) viewer software.
Two experienced oral and maxillofacial radiologists developed 5 distinct radiographic measurement protocols. These techniques were established to assess the alveolar bone level of a periodontally affected upper central incisor using a method that is consistently repeatable across observers. Two additional assessors, blinded to the details of the study, independently applied the protocols to retrieved DICOM files that met the eligibility criteria. A scoring system with 3 subscores was created and used to compare the protocols.
Statistically excellent inter-observer reliability was observed for all protocols, other than protocol 1, which demonstrated moderate reliability. The average discrepancy between measurements taken by the 2 observers was 1.2 mm for protocol 1, 0.81 mm for protocol 2, and less than 0.5 mm for the remaining 3 protocols. All approaches except protocol 4 were straightforward to apply.
This study introduces multiple reliable protocols for the evaluation of periodontal bone levels that ensure consistency across observers. Based on the findings, the double axial lines and incisocrestal distance protocols are recommended. These new assessment approaches, along with any future modifications, may be useful in periodontal assessment, dental implant follow-up, orthodontic evaluation, research, and artificial intelligence model generation.
本研究旨在介绍、评估和比较为直接、可靠且可重复地测量牙槽骨水平而设计的各种新型评估方案。这些方案旨在利用锥形束计算机断层扫描（CBCT）图像和医学数字成像与通信（DICOM）查看器软件进行标准化牙周评估和随访。
两名经验丰富的口腔颌面放射科医生制定了5种不同的影像学测量方案。这些技术旨在使用一种在观察者之间可始终重复的方法来评估牙周病累及的上颌中切牙的牙槽骨水平。另外两名对研究细节不知情的评估者独立地将这些方案应用于检索到的符合纳入标准的DICOM文件。创建了一个带有3个子评分的评分系统并用于比较这些方案。
除方案1显示出中等可靠性外，所有方案均观察到具有统计学意义的观察者间高可靠性。观察者1和观察者2测量结果之间的平均差异，方案1为1.2毫米，方案2为0.81毫米，其余3个方案小于0.5毫米。除方案4外，所有方法应用起来都很简单。
本研究介绍了多种用于评估牙周骨水平的可靠方案，可确保观察者之间的一致性。基于研究结果，推荐双轴线和切嵴距方案。这些新的评估方法以及未来的任何改进，可能在牙周评估、牙种植体随访、正畸评估、研究和人工智能模型生成中有用。
