Chen Tiffany See Nok, Sung Nicholas David, Fok Melissa Rachel, Tarce Mihai, Tavedhikul Kanoknadda, Pelekos Georgios
Division of Periodontology and Implant Dentistry, Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, 34 Hospital Road, Hong Kong SAR, China.
Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand.
Bioengineering (Basel). 2025 Jul 18;12(7):780. doi: 10.3390/bioengineering12070780.
Two-dimensional periapical radiographs (PAs) only offer limited information regarding three-dimensional periodontal infrabony defects. In contrast, cone beam computed tomography (CBCT) enables visualization of the entire defect morphology. This study aimed to evaluate the agreement between CBCT and direct intrasurgical measurements (ISs) regarding the characteristics of infrabony defects, including measurements of defect depth, width, the type of defect (one-wall, two-wall, three-wall), and defect extension. Intrasurgical and radiographic assessments were performed by two calibrated examiners on 26 infrabony defects in 17 patients who underwent periodontal surgery. The defect depth, width, type, and extension were compared between intrasurgical observations and PA or CBCT findings. The CBCT assessment was performed mainly using axial reconstructions. Angle measurements were compared between CBCT and PAs. The mean differences between CBCT and intrasurgical measurements were -0.11 ± 0.49 mm for depth and -0.07 ± 0.41 mm for width, with no significant differences. The ICC values were 0.938 and 0.923 for depth and width, respectively. The mean difference in width between PAs and ISs was significantly different (-0.36 ± 0.73 mm; = 0.002). CBCT demonstrated high agreement with intrasurgical observations for defect type (κ = 0.819) and defect extension (κ = 0.855), while lower agreements were found for PAs. CBCT is a valid assessment modality for infrabony defects. It demonstrated strong agreement with ISs-as the gold standard-for depth and width measurements, and its agreement with ISs regarding defect type and extension appeared to surpass that of PAs.
二维根尖片（PA）仅能提供关于三维牙周骨下袋缺损的有限信息。相比之下，锥形束计算机断层扫描（CBCT）能够显示整个缺损形态。本研究旨在评估CBCT与手术中直接测量（IS）在骨下袋缺损特征方面的一致性，包括缺损深度、宽度、缺损类型（单壁、双壁、三壁）和缺损范围的测量。两名经过校准的检查者对17例接受牙周手术患者的26个骨下袋缺损进行了手术中和影像学评估。比较了手术中观察结果与PA或CBCT检查结果之间的缺损深度、宽度、类型和范围。CBCT评估主要使用轴向重建。比较了CBCT与PA之间的角度测量值。CBCT与手术中测量的深度平均差值为-0.11±0.49mm，宽度平均差值为-0.07±0.41mm，无显著差异。深度和宽度的组内相关系数（ICC）值分别为0.938和0.923。PA与IS之间的宽度平均差值有显著差异（-0.36±0.73mm；P=0.002）。CBCT在缺损类型（κ=0.819）和缺损范围（κ=0.855）方面与手术中观察结果显示出高度一致性，而PA的一致性较低。CBCT是一种用于评估骨下袋缺损的有效方法。它在深度和宽度测量方面与作为金标准的IS显示出高度一致性，并且在缺损类型和范围方面与IS的一致性似乎超过了PA。
