锥形束CT与根尖片对实验性根尖周炎根管治疗结果的评估

Outcome of root canal treatment of experimental apical periodontitis determined by periapical radiography and cone beam computed tomography scans

目的观察一次法根管治疗的短期临床疗效,并比较锥形束CT(CBCT)与根尖片在根管治疗结果评估中的差异。方法选择4只比格犬的24颗上颌前磨牙(56个根管)为研究对象,所有牙齿形成实验性根尖周炎后,随机分为2组,一组采用一次法根管治疗,另一组采用两次法根管治疗,术后6个月应用CBCT和根尖片评估根管治疗疗效。结果 CBCT显示:一次法根管治疗成功率为28.57%,二次法根管治疗成功率为53.57%,两组间的成功率差异无统计学意义(P=0.057)。根尖片显示:一次法根管治疗成功率为67.86%,二次法成功率为78.57%,两组间差别无统计学意义(P=0.365)。CBCT显示的根管治疗总成功率为41.07%,根尖片显示的总成功率为73.21%,CBCT与根尖片在根管治疗后疗效评估中的差异有统计学意义(P=0.001)。结论在针对实验性根尖周炎的治疗中,一次法根管治疗的近期治愈率与两次法根管治疗的近期治愈率相比较,其差异无统计学意义;然而,CBCT与根尖片的检查结果,在根管治疗后的疗效评估上,存在着一定差异。由此可见,CBCT这种三维检查手段相较于根尖片的二维影像来说,在根管治疗后对疾病的诊断评估中的准确性以及灵敏度更高。

Objective To compare the favorable outcome of one- and two-visit endodontic treatment determined by periapical radiograph（PR） and cone beam computed tomography（CBCT） scans. Methods Fifty-six roots of dogs＇ teeth were used to form two groups. All root canals were infected until apical periodontitis was radiographically confirmed. Roots were treated by one-visit therapy in group 1, by two-visit therapy in group 2, the radiolucent area in the PR and the volume of CBCT-scanned periapical lesions were measured after 6 months of the treatment. Results The 28.57% teeth in the one-visit group and 53.57% teeth in the two-visit group were classified as success in CBCT scans, the statistical analysis of the results did not show any significant difference between the groups（P=0.057）. 67.86% teeth in the onevisit group and 78.57% teeth in the two-visit group were classified as success in PR, the statistical analysis of the results did not show any significant difference between the groups（P=0.365）. A favorable outcome（lesions absent or reduced） was shown in 73.21% roots using PR but only in 41.07% roots using CBCT scans（P=0.001）. Conclusion The present study give evidence that similar healing results might be obtained through one- and two-visit endodontics. Our findings provide evidences of the superiority of CBCT scans for the detection of periapical disease compared with PR.