锥形束CT与数字化根尖片对根充效果的评价

Assessment of the canal fillings using cone beam computed tomography and digital periapical radiography

目的比较锥形束CT(CBCT)与根尖片对根管充填后效果的评价,进一步探讨CBCT在根管治疗中的优势及应用价值。方法选取经临床诊断需要进行根管治疗的100颗患牙(221例根管),根管充填后同步拍摄根尖片与CBCT,术后分别由2位经验丰富的临床医生从根管充填的有效长度与严密程度两方面进行读片,运用卡方检验比较2种方法是否在评价结果上存在差异性。结果总计充填根管214例,充填遗漏7例,在根管充填长度、严密程度及满意程度评价方面,分别约有34.58%、30.48%和37.58%的根管在数字化根尖片与CBCT的评价结果上未能达成一致意见,经过统计学检验,数字化根尖片与CBCT在上述三方面的评价均有高度显著性差异(P<0.01)。结论 CBCT较根尖片在根管治疗术的长度及严密程度评价方面更为灵敏及准确,在复杂或疑难的根管治疗术中拥有很高的临床应用价值。

Objective To compare the root filling quality assessed by cone-beam computed tomography（ CBCT） and periapical radiographs（ PA）,and to explore the advantage and application value of CBCT in the root canal treatment. Methods In total,100 teeth（ 221canals） were clinically diagnosed and received root canal therapy. After root canal filling,the length and density of root filling were assessed with PA and CBCT simultaneously by two experienced endodontists. Chi-square test was performed with the data from PA or CBCT to evaluate the quality of the root filling. Results In total,214 canals received root-canal treatment while 7 canals were omitted. In terms of length,density and satisfaction of the root filling,there were about 34. 58%,30. 48% and 37. 58% of canals demonstrated different results based on the evaluation from PA and CBCT respectively. According to the result of statistical test,PA and CBCT had significant differences（ P〈 0. 01） in the assessment of the three aspects mentioned above. Conclusions It is more sensible and accurate of CBCT in detecting the quality of the root filling compared with PA,thus it is of great value in the complex or difficult root canal treatment.