Arora Khyati, Kanakkath Harikumar, Kumar Nileena R, Sankunni Smitha P, Vadakkekuttikal Rosamma Joseph
Periodontics, Government Dental College, Kozhikode, Kerala University of Health Sciences, Thrissur, IND.
Oral Medicine and Radiology, Government Dental College, Kozhikode, Kerala University of Health Sciences, Thrissur, IND.
Cureus. 2025 Jul 8;17(7):e87515. doi: 10.7759/cureus.87515. eCollection 2025 Jul.
The intricate anatomy and challenging accessibility of furcation involvement often complicate diagnosis, leading to tooth loss. This study evaluated the efficacy of cone-beam computed tomography (CBCT) for the early detection and management of furcation defects, particularly Grade II buccal furcations of maxillary first molars. CBCT measurements of width, depth, and height were compared with direct intrasurgical measurements to determine diagnostic accuracy.
Thirty patients with 41 maxillary first molars with Grade II buccal furcations were clinically diagnosed using Nabers' probe and intraoral periapical radiographs. CBCT scans were performed before surgery, recording measurements for furcation morphology. Intrasurgical measurements were obtained using endodontic files and a digital Vernier caliper.
CBCT measurements for all parameters were consistently lower than intrasurgical measurements, with statistically significant differences (p < 0.001). Most deviations ranged between -0.50 and 0.50 mm, indicating minimal clinical discrepancies. CBCT demonstrated excellent reliability for depth and height assessments, good reliability for width, and sensitivity in detecting furcation dimensions under 3 mm.
CBCT and intrasurgical measurements for furcation width, depth, and height differ significantly but remain clinically irrelevant (<1 mm). Strong agreement and correlation between CBCT and intrasurgical measurements support its use in pre-treatment diagnosis to improve surgical outcomes. Low-Field-of-view (FOV) CBCT reduces radiation exposure while enhancing image quality, making it ideal for diagnosing furcation defects. Despite differences between CBCT and intrasurgical values, CBCT proves to be a reliable diagnostic tool for predicting furcation morphology.
根分叉病变复杂的解剖结构和难以到达的部位常使诊断复杂化，导致牙齿缺失。本研究评估了锥形束计算机断层扫描（CBCT）在早期检测和处理根分叉缺损方面的有效性，特别是上颌第一磨牙的Ⅱ度颊侧根分叉病变。将CBCT测量的宽度、深度和高度与手术中的直接测量值进行比较，以确定诊断准确性。
对30例患有41颗上颌第一磨牙Ⅱ度颊侧根分叉病变的患者，使用纳伯斯探针和口腔根尖片进行临床诊断。在手术前进行CBCT扫描，记录根分叉形态的测量值。使用根管锉和数字游标卡尺进行手术中的测量。
所有参数的CBCT测量值均始终低于手术中的测量值，差异具有统计学意义（p < 0.001）。大多数偏差在-0.50至0.50毫米之间，表明临床差异极小。CBCT在深度和高度评估方面显示出极好的可靠性，在宽度评估方面具有良好的可靠性，并且在检测3毫米以下的根分叉尺寸方面具有敏感性。
CBCT与手术中测量的根分叉宽度、深度和高度存在显著差异，但在临床上仍不相关（<1毫米）。CBCT与手术中测量值之间的高度一致性和相关性支持其在治疗前诊断中的应用，以改善手术效果。低视野（FOV）CBCT在提高图像质量的同时减少了辐射暴露，使其成为诊断根分叉缺损的理想选择。尽管CBCT与手术中的值存在差异，但CBCT被证明是预测根分叉形态的可靠诊断工具。
