Saini Ravinder S, Vaddamanu Sunil Kumar, Kanji Masroor Ahmed, Mosaddad Seyed Ali, Heboyan Artak
Department of Allied Dental Health Sciences, COAMS, King Khalid University, Abha, Saudi Arabia.
Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
Clin Exp Dent Res. 2025 Aug;11(4):e70169. doi: 10.1002/cre2.70169.
The present systematic review and meta-analysis aimed to compare the efficacy of three-dimensional (3D) imaging techniques in terms of accuracy and precision for periodontal disease assessment.
A literature search was conducted across multiple databases (PubMed, Scopus, Web of Science, Google Scholar, and ScienceDirect) following Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocols. The primary outcomes focused on comparing the accuracy and precision of 3D versus two-dimensional (2D) imaging techniques. Furthermore, it assessed their performance in determining periodontal diseases. Quality assessment was performed using the risk of bias (RoB)-2 for randomized controlled trials (RCTs) and ROB in nonrandomized studies-Intervention (ROBINS-I) for non-RCTs. Meta-analysis was conducted using RevMan 5.4 with a significance level set at 0.01. While meta-regression was performed using OpenMEE.
After screening, 22 studies met the eligibility criteria for qualitative and quantitative analysis. Qualitatively, 3D imaging, particularly cone-beam computed tomography (CBCT), showed superior accuracy and precision over 2D techniques. The meta-analysis revealed significant differences in several areas: overall (p = 0.00001, Mean Difference (MD) = -0.36, 95% confidence interval [CI]: -0.96 to 0.24, I² = 93%), horizontal measurements (p = 0.00001, MD = -0.75, 95% CI: -2 to -0.49, I² = 92%), and vertical measurements (p = 0.00001, MD = -0.59, 95% CI: -2.40 to 1.23, I² = 92%). Nonsignificant differences were found for furcation height, width, and depth. Most studies showed good quality with a low risk of bias. Age of the participants and study quality were found to be the sources of heterogeneity.
Consistent trends highlight the advantages of 3D imaging in assessing both periodontal and nonperiodontal diseases. However, given the nonsignificant differences in furcation height, width, and depth, the recommended approach is to combine CBCT with digital intraoral radiography for more comprehensive periodontal bone assessment.
本系统评价和荟萃分析旨在比较三维（3D）成像技术在牙周疾病评估的准确性和精确性方面的疗效。
按照系统评价和荟萃分析的首选报告项目（PRISMA）方案，在多个数据库（PubMed、Scopus、科学网、谷歌学术和ScienceDirect）中进行文献检索。主要结局集中于比较3D与二维（2D）成像技术的准确性和精确性。此外，评估它们在确定牙周疾病方面的表现。使用随机对照试验（RCT）的偏倚风险（RoB）-2和非随机研究-干预（ROBINS-I）评估非RCT的质量。使用RevMan 5.4进行荟萃分析，显著性水平设定为0.01。同时使用OpenMEE进行荟萃回归。
筛选后，22项研究符合定性和定量分析的纳入标准。定性分析显示，3D成像，尤其是锥形束计算机断层扫描（CBCT），在准确性和精确性方面优于2D技术。荟萃分析在几个方面显示出显著差异：总体（p = 0.00001，平均差（MD）= -0.36，95%置信区间[CI]：-0.96至0.24，I² = 93%）、水平测量（p = 0.00001，MD = -0.75，95% CI：-2至-0.49，I² = 92%）和垂直测量（p = 0.00001，MD = -0.59，95% CI：-2.40至1.23，I² = 92%）。在根分叉高度、宽度和深度方面未发现显著差异。大多数研究质量良好，偏倚风险较低。参与者年龄和研究质量被发现是异质性的来源。
一致的趋势突出了3D成像在评估牙周和非牙周疾病方面的优势。然而，鉴于根分叉高度、宽度和深度方面无显著差异，推荐的方法是将CBCT与数字化口内放射摄影相结合，以进行更全面的牙周骨评估。
