不同扫描参数下口腔颌面锥形束CT的咬合面龋诊断准确性

Detection accuracy of occlusal caries by cone-beam computed tomography images scanned with different parameters

目的:比较口腔颌面锥形束CT(cone beam computed tomography,CBCT)在不同扫描参数下对咬合面龋诊断的准确性。方法:收集37颗离体前磨牙、磨牙,使用两台CBCT机器(DCT Pro,怡友公司,韩国;ProMax 3D,普兰梅卡公司,芬兰)在7种不同参数下进行扫描,得到7组CBCT影像,由10名观察者进行评估,得出受试者工作特征(receiver operating characteristic,ROC)曲线,用组织学切片确定金标准。结果:在37颗离体牙中,11颗(29.7%,11/37)无龋,13颗(35.1%,13/37)有牙釉质龋,13颗(35.1%,13/37)有牙本质龋;在对咬合面龋的诊断准确性方面,DCT Pro普通分辨率和高分辨率之间差异无统计学意义(0.698±0.064 vs.0.735±0.044,P>0.05),ProMax 3D低分辨率、普通分辨率和高分辨率之间差异无统计学意义(0.700±0.031 vs.0.700±0.054 vs.0.701±0.041,P>0.05);单独分析牙釉质龋和牙本质龋,DCT Pro普通分辨率和高分辨率之间差异无统计学意义(0.620±0.068 vs.0.659±0.048,0.776±0.078 vs.0.811±0.047,P>0.05),ProMax 3D低分辨率、普通分辨率和高分辨率之间差异无统计学意义(0.686±0.050 vs.0.685±0.063 vs.0.689±0.063,0.713±0.039 vs.0.685±0.063 vs.0.713±0.040,P>0.05);ProMax 3D不同球管电流组之间对咬合面龋诊断准确性的差异无统计学意义(0.653±0.065 vs.0.700±0.054 vs.0.670±0.062,P>0.05)。结论:分辨率不影响DCT Pro和ProMax3D对咬合面龋的诊断准确性,球管电流不影响ProMax3D对咬合面龋的诊断准确性。

Objective： To compare the detection accuracy of occlusal caries in cone-beam computed tomography（CBCT） images scanned with different scanning parameters.Methods： Thirty-seven extracted human premolars and molars without restorations or obvious cavities were selected for this study.The teeth 3 or 4 as a group were mounted in 12 plaster blocks and scanned with DCT Pro（VATECH,Co.,Ltd.,Yongin-Si,S.Korea） at normal and high resolution settings and with ProMax 3D（Planmeca Oy,Helsinki,Finland） at low,normal and high resolution settings.In addition,the tooth blocks were imaged with the ProMax 3D at three different tube currents.Ten doctoral candidates of Peking University School and Hospital of Stomatology evaluated all the images of the tooth blocks using a five-level confident scale.Actual presence and the extent of caries were established by histological examinations.The areas under the ROC curves（Az value） were analyzed.Results： Eleven（29.7%,11/37） teeth were sound,13（35.1%,13/37） had enamel caries and 13（35.1%,13/37） had dentine caries.There were no significant differences between normal re-solution and high resolution for DCT Pro on the detection accuracy of occlusal（enamel＋dentine） caries（0.698±0.064 vs.0.735±0.044,P0.05）.No significant differences were found for ProMax 3D among low,normal and high resolution（0.700±0.031 vs.0.700±0.054 vs.0.701±0.041,P0.05）.For dentinal caries,there were no significant differences between CBCT images scanned with different resolutions for DCT Pro（0.776±0.078 vs.0.811±0.047,P0.05） or ProMax 3D（0.713±0.039 vs.0.685±0.063 vs 0.713±0.040,P0.05）.No significant differences were found for enamel caries detection for DCT Pro（0.620±0.068 vs.0.659±0.048,P0.05）or ProMax 3D（0.686±0.050 vs.0.685 ±0.063 vs.0.689±0.063,P0.05）.For ProMax 3D,there were no significant differences among different tube currents on the detection accuracy of occlusal caries（0.653±0.065 vs.0.700±0.054 vs.0.67±0.062,P0.05）.Conclusion： Different resolutions did not have an impact on the detection accuracy of occlusal caries.The tube currents for ProMax 3D did not show any effect on occlusal caries detection.