| 邱吟枫,屠淑贞,周培刚,刘超,沈忆芬,顾永春.两种不同分辨率下CBCT诊断下颌第一恒磨牙近中根管形态的研究[J].口腔材料器械杂志,2021,30(2):74-79. |
| 两种不同分辨率下CBCT诊断下颌第一恒磨牙近中根管形态的研究 |
| Detection of root canal morphology in the mesial roots of permanent mandibular first molars using CBCT at two different resolutions |
| 投稿时间：2020-04-14 修订日期：2020-05-07 |
| DOI：10.11752/j.kqcl.2021.02.03 |
| 中文关键词: 锥形束CT 显微CT 下颌第一恒磨牙 近中根 根管系统 |
| 英文关键词:Cone-beam computed tomography Micro-computed tomography Permanent madibular first molars Mesial root Root canal system |
| 基金项目:苏州市第九人民医院院级科研项目（编号：201725） |
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| 中文摘要: |
| 目的 探讨牙科锥形束CT （CBCT）在不同分辨率下诊断下颌第一恒磨牙近中根根管系统形态的准确性。方法 从口腔科临床上采集拔除的下颌第一恒磨牙31颗，用牙科CBCT分别以300 μm及200 μm分辨率进行扫描，接着用显微CT以9 μm分辨率进行扫描并三维重建。然后由两名口腔科医师按照分辨率由低到高的顺序分析CT图像资料，并对近中根根管系统的形态进行诊断；每个分辨率下观察诊断2次（间隔2周）。Kappa检验评估观察者自身及观察者间的一致性。以显微CT为标准，评估CBCT在300 μm及200 μm分辨率下的准确性。结果 在CBCT的分辨率分别为300 μm和200 μm时，2个观察者之间一致性检验Kappa值分别为0.64与0.76；CBCT与显微CT数据之间一致性检验Kappa值分别为0.62、0.56（观察者A和B，300 μm）与0.76、0.84（观察者A和B，200 μm）。在CBCT的分辨率为300 μm时，观察不到侧副根管；在CBCT分辨率为200 μm时，对侧副根管的诊断率为21.7%（10/46支）。结论 CBCT在200 μm分辨率下对下颌第一恒磨牙近中根主根管的形态的诊断具有良好的准确性和重复性，而对侧副根管的诊断仍显不足；300 μm分辨率的CBCT对根管系统的诊断准确性、重复性较差。 |
| 英文摘要: |
| Objective The aim of this study was to evaluate the accuracy of CBCT at different resolations in diagnosis of root canal anatomy in the mesial roots of permanent mandibular first molars. Method A total of 31 extracted madibular first molars were collected from the dental clinics. Then the teeth were scanned by a CBCT system with resolution of 300 μm and 200 μm, respectively. After that, the teeth were scanned by a micro-CT with resolution of 9 μm and reconstructed three-dimensionally. The root canal morphology of the mesial roots was examined by 2 dental clinicians according to the CT images data from low to high resolution. Each examination was performed twice, with two weeks interval. Kappa index was used to assess intro- and inter-observer agreement and reproducibility. The micro-CT data were regarded as the golden standard, and the accuracy of CBCT in resolution of 300 μm and 200 μm were evaluated. Results As the CBCT resolution increased from 300 to 200 μm, the Kappa value of inter-observer agreement increased from 0.64 to 0.76 accordingly; while as compared with the micro-CT data, the Kappa value of the agreement test increased from 0.62 and 0.56 (observer A and B, 300 μm) to 0.76 and 0.84 (observer A and B, 200 μm). CBCT with 300 μm resolution failed to detect the accessory canals, and with resolution of 200 μm, only 21.7% (10/46 canals) of total accessory canals could be detected. Conclusions CBCT with a resolution of 200 μm displayed good accuracy and reproducibility in diagnosis of the anatomy of the main root canal systems in the mesial roots of the mandibular first molars, whereas this resolution was still inadequate in detection of the accessory canals; while a resolution of 300 μm was inadequate in accuracy and reproducibility for diagnosis of the anatomy of root canal systems. |
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