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1.
Brent M. Hiebert Kenneth Abramovitch Dwight Rice Mahmoud Torabinejad 《Journal of endodontics》2017,43(10):1711-1715
Introduction
The purpose of this study was to determine the prevalence of the second mesiobuccal canal (MB2) in 100 maxillary first molars using 3 independent methods and a combination method.Methods
One hundred extracted human maxillary first molars were collected. The teeth were mounted in the maxillary first molar extraction sockets of a human cadaver head. A cone-beam computed tomographic (CBCT) scan was taken of each tooth. Two radiology faculty independently evaluated the CBCT volume for the presence of an MB2 canal. Additionally, teeth were accessed. If a canal was not found, a preoperative CBCT scan was viewed followed by a second attempt to locate an MB2 canal. Lastly, the mesiobuccal root was dissected by grinding in a coronal plane.Results
A review of CBCT volumes found the presence of an MB2 canal 69% of the time. Accessing the tooth led to an MB2 detection of 78%. When a CBCT scan was viewed, this brought the access detection rate up to 87%. Coronal plane root grinding had an MB2 canal detection rate of 92%. Differences between each method were statistically significant.Conclusions
The results of this study show that an MB2 canal is present up to 92% of the time. Direct access of teeth found statistically significant more MB2 canals than viewing CBCT volumes alone (P = .032). Therefore, exposing every patient to a preoperative CBCT scan may not be appropriate. However, taking a CBCT scan when an MB2 canal is not found clinically can significantly increase the chances of finding an MB2 canal (P < .001). 相似文献2.
Adrià Clé-Ovejero Alba Sánchez-Torres Octavi Camps-Font Cosme Gay-Escoda Rui Figueiredo Eduard Valmaseda-Castellón 《Journal of the American Dental Association (1939)》2017,148(8):575-583
Background
Clinicians generally use panoramic radiographic (PR) images to assess the proximity of the mandibular third molar to the inferior alveolar nerve (IAN). However, in cases in which a patient needs to undergo a third-molar extraction, many clinicians also assess computed tomographic (CT) images to prevent nerve damage.Types of Studies Reviewed
Two of the authors independently searched MEDLINE (through PubMed), Cochrane Library, Scopus, and Ovid. The authors included randomized or nonrandomized longitudinal studies whose investigators had compared the number of IAN injuries after third-molar extraction in patients who had undergone preoperative CT with patients who had undergone only PR.Results
The authors analyzed the full text of 26 of the 745 articles they initially selected. They included 6 studies in the meta-analysis. Four of the studies had a high risk of bias, and the investigators of only 1 study had used blinding with the patients. The authors observed no statistically significant differences between groups related to the total number of nerve injuries (risk ratio, 0.96; 95% confidence interval, 0.50 to 1.85; P = .91). The prognosis of the injuries was similar for both groups.Conclusions and Practical Implications
Although having preoperative CT images might be useful for clinicians in terms of diagnosing and extracting mandibular third molars, having these CT images does not reduce patients’ risk of experiencing IAN injuries nor does it affect their prognosis. 相似文献3.
Introduction
The aim of this study was to evaluate the accuracy of working length determination by using an electronic apex locator, periapical radiography, and cone-beam computed tomographic (CBCT) imaging obtained at different voxel sizes and field of views (FOVs) in extracted human teeth.Methods
Thirty extracted human mandibular premolar teeth were used. The electronic working length measurements were performed by using an electronic apex locator (Root ZX; J Morita Corp, Kyoto, Japan). Five different image sets were obtained as follows:(1) CBCT imaging: 40 × 40 mm FOV, 0.080 mm3 (FOV40);(2) CBCT imaging: 60 × 60 mm FOV, 0.125 mm3 (FOV60);(3) CBCT imaging: 80 × 80 mm FOV, 0.160 mm3 (FOV80);(4) CBCT imaging: 100 × 100 mm FOV, 0.250 mm3 (FOV100); and(5) periapical digital radiography. Direct measurements performed with an electronic digital caliper were considered as the gold standard and compared with the electronic apex locator, CBCT, and periapical image measurements. Data were analyzed using a 2-way analysis of variance test. Significance level was set at P < .05.Results
There was no significant difference between or within operators in intraoral radiographs (P > .05 and the Gage R&R value was <30%). There were significant differences between and within operators for CBCT images (P < .05 and Gage R&R value was >30%). There were significant differences in the methods in terms of mean differences from the gold standard (P < .05).Conclusions
This study showed that available CBCT scans with different FOVs can be used for working length measurement. 相似文献4.
Victor Aquino Wanderley Frederico Sampaio Neves Monikelly Carmo Chagas Nascimento Gabriela Queiroz de Melo Monteiro Natália Siqueira Lobo Matheus Lima Oliveira Joao Batista Sobrinho Nascimento Neto Luciane Farias Araujo 《Journal of endodontics》2017,43(10):1720-1724
Introduction
The purpose of this study was to compare different high-resolution cone-beam computed tomographic (CBCT) imaging protocols in the diagnosis of incomplete root fractures of endodontically treated teeth.Methods
Twenty single-rooted human teeth were endodontically treated, and an incomplete root fracture was induced. The teeth were scanned with the CBCT unit PreXion 3D (Teracom, San Mateo, CA) operating at 2 different protocols: high resolution/standard (HI-STD) (19 seconds and 512 basis images) and high resolution/high density (HI-HI) (37 seconds and 1024 basis images). Three oral radiologists evaluated all images using multiplanar reconstructions. The diagnostic tests and the receiver operating characteristic (ROC) curve were calculated.Results
The HI-STD and HI-HI protocols presented an accuracy of 0.90 and 0.93, respectively, and both protocols had a sensitivity of 0.97. The HI-HI protocol showed a higher positive predictive value and slightly higher areas under the ROC curve.Conclusions
Both high-resolution imaging protocols presented high accuracy in the detection of incomplete root fracture of endodontically teeth. Thus, the HI-STD protocol should be indicated this reduces the radiation dose. 相似文献5.
Navid Akbarzadeh Anita Aminoshariae Navid Khalighinejad J. Martin Palomo Ali Syed James C. Kulild Ghazal Sadeghi Andre Mickel 《Journal of endodontics》2017,43(11):1797-1801
Introduction
The present study aimed to determine the incidence and anatomic variation of the middle mesial (MM) canal in mandibular permanent first molars using cone-beam computed tomographic imaging and to evaluate the association between the presence of MM canals and anatomic landmarks of the pulp chamber floor in the mesial root.Methods
In this in vivo cross-sectional study, 210 CBCT scans of mandibular fist molars from 210 patients were included. CBCT scans were evaluated in 3 sections, and the following data were collected for further analysis: identification of the MM canal, the distance between the mesiobuccal (MB) and mesiolingual (ML) orifices, the presence of any isthmus between the MB and ML orifices, and the MB and ML root canal system (RCS) configurations. Binary logistic regression was performed to assess the effect of pulp floor anatomic characteristics as an independent variable on the outcome variable (the presence of an MM canal).Results
The overall prevalence of the identification of an MM canal regardless of age was 14.7%. Mandibular first molars with an isthmus between the MB and ML RCS configurations were almost 5 times more likely to show an MM canal (P < .05, odds ratio [OR] = 4.9). The MB-ML intraorifice distance was inversely associated with the presence of an MM canal (P < .05, OR = 0.73). Patients less than 42 years old were 4 times more likely to have an MM canal in their CBCT scans compared with patients older than 42 years old (P < .05, OR = 3.9).Conclusions
The suggested anatomic landmarks of the pulp chamber floor could act as a reliable predictive factor for the presence of an MM canal. This knowledge of anatomic clues may serve to better direct endodontists in locating an MM canal, which could prevent excessive removal of tooth structures. 相似文献6.
Daniel Vaz de Souza Elia Schirru Francesco Mannocci Federico Foschi Shanon Patel 《Journal of endodontics》2017,43(1):121-125
Introduction
The aim of this study was to compare the diagnostic efficacy of 2 cone-beam computed tomographic (CBCT) units with parallax periapical (PA) radiographs for the detection and classification of simulated external cervical resorption (ECR) lesions.Methods
Simulated ECR lesions were created on 13 mandibular teeth from 3 human dry mandibles. PA and CBCT scans were taken using 2 different units, Kodak CS9300 (Carestream Health Inc, Rochester, NY) and Morita 3D Accuitomo 80 (J Morita, Kyoto, Japan), before and after the creation of the ECR lesions. The lesions were then classified according to Heithersay's classification and their position on the root surface. Sensitivity, specificity, positive predictive values, negative predictive values, and receiver operator characteristic curves as well as the reproducibility of each technique were determined for diagnostic accuracy.Results
The area under the receiver operating characteristic value for diagnostic accuracy for PA radiography and Kodak and Morita CBCT scanners was 0.872, 0.99, and 0.994, respectively. The sensitivity and specificity for both CBCT scanners were significantly better than PA radiography (P < .001). There was no statistical difference between the sensitivity and specificity of the 2 scanners. The percentage of correct diagnoses according to the tooth type was 87.4% for the Kodak scanner, 88.3% for the Morita scanner, and 48.5% for PA radiography.The ECR lesions were correctly identified according to the tooth surface in 87.8% Kodak, 89.1% Morita and 49.4% PA cases. The ECR lesions were correctly classified according to Heithersay classification in 70.5% of Kodak, 69.2% of Morita, and 39.7% of PA cases.Conclusions
This study revealed that both CBCT scanners tested were equally accurate in diagnosing ECR and significantly better than PA radiography. CBCT scans were more likely to correctly categorize ECR according to the Heithersay classification compared with parallax PA radiographs. 相似文献7.
8.
Damien Brezulier Victor Fau Olivier Sorel 《Journal of the American Dental Association (1939)》2017,148(12):903-912
Background
Through a systematic literature review, the authors assess the effect of premolar extractions on third-molar (M3) eruption considering eruption rate, retromolar space, and molar angulation.Types of Studies Reviewed
The authors performed a systematic search using MEDLINE and Web of Science databases up through April 2017 to identify quality studies available comparing M3 eruption between a group with premolar extraction and a group without premolar extraction.Results
Twelve comparative retrospective cohort studies met all the inclusion criteria. The authors found in 5 studies comparing the rate of M3 eruption that there were significantly higher results in the group with extractions. They found in 5 studies comparing the evolution of the retromolar space significantly higher results in the group with extractions. Lastly, concerning the uprighting of the M3 during treatment, the authors found only 2 studies showing significant differences between the 2 groups, each time in favor of the group with extractions.Conclusions and Practical Implications
The dental literature on premolar extraction related to the eruption of the M3 is composed of average-quality retrospective studies. Premolar extraction significantly improves the chances of M3 eruption, but the level of evidence of comparative retrospective cohort studies is low. Clinicians must continue to rely on their judgment regarding premolar extraction on a case-by-case basis until the evidence is stronger. Retrospective studies with standardized protocols and more detailed methodologies are required to obtain higher levels of evidence. 相似文献9.
Takamasa Ogawa Yuji Sato Noboru Kitagawa Momoe Nakatsu 《The Journal of prosthetic dentistry》2017,117(4):524-531
Statement of problem
Although the retention force of maxillary complete dentures has been measured in numerous studies with different devices, the biomechanical mechanism associated with the generation of this retention force cannot be determined.Purpose
The purpose of this clinical study was to investigate whether 3-dimensional finite-element analysis can be used to estimate the retention force of maxillary complete dentures.Material and methods
The study included 12 participants (6 men and 6 women, mean 77.5 years of age). Replicas of the maxillary complete dentures of all the participants were made using scanning resin. The denture replicas were scanned using cone-beam computed tomography (CBCT), and 3-dimensional finite-element models were constructed (dentures, mucosa, and jig). The tensile site was located 5 mm anterior from the central point of the denture’s posterior border, and the loading site was located at the central point of the central incisor edge and the right first premolar buccal cusp. The load was 10 N and perpendicular to the occlusal plane. One-way ANOVA was calculated to determine any differences in the maximum principal stress value among the 3 sites. The Games-Howell test for multiple comparisons was applied to determine which sites were different. A Spearman rank correlation coefficient was used to determine any correlation between the retention force and maximum principal stress at measurement posterior site, and a Pearson correlation coefficient was used at the central incisor edge and premolar buccal cusp (all α=.05). Comparative investigations of the association between the maximum principal stress generated and the denture retention force were carried out.Results
The stress distribution of the maximum principal stress at each measurement point was similar for each participant. The maximum principal stress at the posterior site measurement was significantly higher than measurements at the incisor edge and posterior buccal cusp (P<.01). The maximum principal stress the posterior and incisor edge sites were found to be correlated (P<.05).Conclusions
This study results suggest that although more factors need to be considered, a 3-dimensional finite-element analysis may be used to estimate the retention force of maxillary complete dentures. 相似文献10.
Walter Iared Edina Mariko Koga da Silva Wagner Iared Cristiane Rufino Macedo 《Journal of the American Dental Association (1939)》2017,148(1):9-16
Background
The authors conducted a systematic review to assess changes in patients’ facial profiles resulting from orthodontic treatment with and without extraction of 4 premolars and to identify cephalometric parameters that can assist decision making in borderline cases.Types of Studies Reviewed
The authors conducted a systematic review of randomized clinical trials and observational studies comparing the 2 types of treatment (with and without premolar extraction) in terms of the changes in facial profile. The authors conducted an electronic search of the databases the Cochrane Library, PubMed MEDLINE, Embase, and Latin-American and Caribbean Health Sciences Literature.Results
The authors identified 1 clinical trial with 26 participants and 5 observational cohort studies, collectively involving 362 participants. The authors assessed cephalometric parameters and esthetic outcomes. Four studies used linear regression analysis to investigate esthetic interaction between treatment strategy and initial lower lip protrusion. The 4 studies determined that if the initial lip protrusion was beyond a determined point, esthetic preferences favored extraction, and if the initial lip protrusion was not to that point, esthetic preferences favored conservative treatment.Conclusions and Practical Implications
The results of the authors’ systematic review found no significant differences between the groups in terms of the esthetic outcomes. The cephalometric parameter of initial lip protrusion can help with decision making in borderline cases. 相似文献11.
12.
Hugo Gaêta-Araujo Gabriela Queiroz Silva de Souza Deborah Queiroz Freitas Christiano de Oliveira-Santos 《Journal of endodontics》2017,43(10):1668-1673
Introduction
There is no consensus about the accuracy of cone-beam computed tomography (CBCT) for detecting vertical root fractures (VRFs), nor is there certainty about the isolated effect of different tube current parameters on the diagnosis of VRF through CBCT scans. This study aimed to evaluate how tube current affects the detection of VRF on CBCT examinations in the absence of intracanal materials and in the presence of gutta-percha (GP) and metal (MP) or fiberglass (FP) intracanal posts.Methods
The sample consisted of 320 CBCT scans of tooth roots with and without VRF divided into 8 groups: no fracture/no intracanal material; no fracture + GP; no fracture + MP; no fracture + FP; fracture/no intracanal material; fracture + GP; fracture + MP; fracture + FP. The scans were acquired with an OP300 unit using 4 different milliamperes (4 mA, 8 mA, 10 mA, 13 mA). Five oral radiologists analyzed the images. The area under the receiver operating characteristic curve (Az), sensitivity, specificity, positive and negative predictive values, and interobserver agreement were calculated.Results
Diagnostic performance for the different milliamperes tested was similar for teeth without root filling materials or with FP. Teeth with GP and MP showed the highest Az values for 8 mA and 10 mA, respectively. For teeth with MP, specificity was significantly higher when 10 mA was used.Conclusions
For teeth without root filling materials or with FP, the use of a reduced milliampere does not seem to influence the detection of VRF in a significant manner. For teeth with GP and MP, an increased milliampere may lead to increased diagnostic performance. 相似文献13.
Introduction
Mandibular premolars that have rare and complex anatomies may have the highest failure rate in nonsurgical endodontic treatment. Awareness of rare and complex anatomies of mandibular second premolars would aid in better outcomes of the treatment. This study aimed to evaluate the success of nonsurgical root canal treatment of mandibular second premolar teeth with complex apical branching.Methods
Twenty-six mandibular second premolar teeth with complex apical branching treated with multiple-visit nonsurgical root canal treatment or nonsurgical retreatment were retrospectively evaluated.Results
For the clinical outcomes, 9 subjects had complete healing, 1 subject had functional healing, and no subject had no healing scores out of 10 root canal treatment subjects. Six subjects had complete healing, 8 subjects had functional healing, and 2 subjects had no healing scores out of 16 retreatment subjects. For the radiographic outcomes, 7 subjects had complete healing, 3 subjects had incomplete healing, and no subject had no healing scores out of 10 root canal treatment subjects. Six subjects had complete healing, 8 subjects had incomplete healing, and 2 subjects had no healing scores out of 16 retreatment subjects. The clinical outcome of root canal treatment subjects was significantly different than retreatment subjects (P < .05). Similarly, the radiographic outcome of root canal treatment subjects was also significantly different than retreatment cases (P < .05).Conclusions
The outcome of endodontic treatment of mandibular second premolars may be influenced by treatment type. 相似文献14.
Sonia K. Makhija Daniel A. Shugars Gregg H. Gilbert Mark S. Litaker James D. Bader Rebecca Schaffer Valeria V. Gordan D. Brad Rindal Daniel J. Pihlstrom Rahma Mungia Cyril Meyerowitz 《Journal of the American Dental Association (1939)》2017,148(12):922-929
Background
A lesion on an occlusal tooth surface with no cavitation and no radiographic radiolucency but in which caries is suspected owing to surface roughness, opacities, or staining can be defined as a suspicious occlusal carious lesion (SOCL). The authors' objective was to quantify the characteristics of SOCLs and their relationship to lesion depth and activity after these lesions were opened surgically.Methods
Ninety-three dentists participated in the study. When a consenting patient had an SOCL, information was recorded about the tooth, lesion, treatment provided, and, if the SOCL was opened surgically, its lesion depth. The Rao-Scott cluster-adjusted χ2 test was used to evaluate associations between lesion depth and color, roughness, patient risk, and luster.Results
The authors analyzed 1,593 SOCLs. Lesion color varied from yellow/light brown (40%) to dark brown/black (47%), with 13% other colors. Most (69%) of SOCLs had a rough surface when examined with an explorer. Over one-third of the SOCLs (39%) were treated surgically. Of the 585 surgically treated SOCLs, 61% had dentinal caries. There were statistically significant associations between lesion depth and color (P = .03), luster (P = .04), and roughness (P = .01). The authors classified 52% of the patients as being at elevated caries risk. The authors found no significant associations between lesion depth and patient risk (P = .07).Conclusions
Although statistically significant, the clinical characteristics studied do not provide accurate guidance for making definitive treatment decisions and result in high rates of false positives.Practical Implications
Given that 39% of the opened lesions did not have dentinal caries or were inactive, evidence-based preventive management is an appropriate alternative to surgical intervention. 相似文献15.
Ronald E. Goldstein Wendy Auclair Clark 《Journal of the American Dental Association (1939)》2017,148(6):387-391
Background
Awake bruxism is a common clinical condition that often goes undetected, often leading to pain or damaged teeth and restorations.Methods
The authors searched electronic databases regarding the treatment and effects of awake bruxism compared with those of sleep bruxism. The authors used the search terms diurnal bruxism and oral parafunction. The authors combined information from relevant literature with clinical experience to establish a recommended protocol for diagnosis and treatment.Results
The authors found articles regarding the diagnosis and treatment of bruxism. The authors combined information from the articles with a review of clinical cases to establish a treatment protocol for awake bruxism.Conclusions
Literature and clinical experience indicate a lack of patient awareness and, thus, underreporting of awake bruxism. As a result, myriad dental consequences can occur from bruxism. The authors propose a need for increased awareness, for both patients and professionals, particularly of the number of conditions related to awake bruxism.Practical Implications
Clinicians should look for clinical signs and symptoms of awake bruxism and use minimally invasive treatment modalities. 相似文献16.
Ricardo Tangari-Meira José Ricardo Vancetto Lívia Nordi Dovigo Guilherme Monteiro Tosoni 《Journal of endodontics》2017,43(10):1701-1705
Introduction
This study assessed the influence of tube current settings (milliamperes [mA]) on the diagnostic detection of root fractures (RFs) using cone-beam computed tomographic (CBCT) imaging.Method
Sixty-eight human anterior and posterior teeth were submitted to root canal preparation, and 34 root canals were filled. The teeth were divided into 2 groups: the control group and the fractured group. RFs were induced using a universal mechanical testing machine; afterward, the teeth were placed in a phantom. Images were acquired using a Scanora 3DX unit (Soredex, Tuusula, Finland) with 5 different mA settings: 4.0, 5.0, 6.3, 8.0, and 10.0. Two examiners (E1 and E2) classified the images according to a 5-point confidence scale. Intra- and interexaminer reproducibility was assessed using the kappa statistic; diagnostic performance was assessed using the area under the receiver operating characteristic curve (AUROC).Results
Intra- and interexaminer reproducibility showed substantial (κE1 = 0.791 and κE2 = 0.695) and moderate (κE1 × E2 = 0.545) agreement, respectively. AUROC was significantly higher (P ≤ .0389) at 8.0 and 10.0 mA and showed no statistical difference between the 2 tube current settings.Conclusions
Tube current has a significant influence on the diagnostic detection of RFs in CBCT images. Despite the acceptable diagnosis of RFs using 4.0 and 5.0 mA, those settings had lower discrimination abilities when compared with settings of 8.0 and 10.0 mA. 相似文献17.
Vasiliki P. Koidou Stephen F. Rosenstiel Robert G. Rashid 《The Journal of prosthetic dentistry》2017,117(5):636-641
Statement of problem
Whether deviations in the angulation discrepancy between the intercanine and interpupillary line significantly affect attractiveness is unknown.Purpose
The purpose of this prospective study was to quantify dental and facial esthetics to determine whether smile angulation discrepancies in individuals identified as having attractive smiles are smaller than those in the average population.Material and methods
An Internet search for “best smile” and “celebrity” identified 108 celebrities (Test group). Photographs showing smiles within 10 degrees of a frontal view were gathered. In mannequin testing, small head rotation (<10 degrees) was found not to affect the measurements. Photographs of dental students were used for the control group. The angulation discrepancy between the intercanine and interpupillary line was measured using computer software. Groups were compared using the Mann-Whitney U test (α=.05).Results
Usable photographs were obtained for 94 celebrities (62 women, 32 men) and were compared with photographs of 97 dental students (54 women, 43 men). Significant (P<.01) differences in angulation discrepancy were found, with celebrities having smaller mean angulation discrepancies (0.97 degrees) than dental students (1.33 degrees). The differences between men and women were not statistically significant (P>.05).Conclusions
Celebrities identified as having “best smile” had significantly smaller mean angulation discrepancies than the control group. 相似文献18.
Yooseok Shin Sungho Park Jeong-Won Park Kwang-Mahn Kim Young-Bum Park Byoung-Duck Roh 《The Journal of prosthetic dentistry》2017,117(1):109-115
Statement of problem
The marginal and internal discrepancies of computer-aided design and computer-aided manufacturing (CAD-CAM) endocrowns are unknown.Purpose
The purpose of this in vitro study was to evaluate the marginal and internal discrepancies of endocrowns with different cavity depths by measuring them with microcomputed tomography (μCT).Material and methods
Endocrowns (n=48) of 2 different cavity depths (2 mm and 4 mm) were fabricated in 2 different chairside CAD-CAM systems (CEREC AC and E4D). A μCT scan was made before and after cementation. For analysis of the marginal and internal discrepancies, reference points were selected in 2-dimensional views of 3 buccolingual cross-sections and 3 mesiodistal cross-sections. To calculate the total discrepancy volume, the μCT sections were reconstructed 3-dimensional views, and changes in volume and surface area were examined. Statistical analysis was performed using 2-way ANOVA with Bonferroni correction (α=.05).Results
An endocrown with a 4-mm cavity showed a larger marginal and internal volume than one with a 2-mm cavity. Cementation did not show significant differences in total discrepancy thickness. Discrepancies on the pulpal floor were largest in other sites. Both chairside CAD-CAM systems showed similar discrepancy in the endocrowns.Conclusions
Based on the present study, marginal and internal discrepancies increased depending on cavity depth. Cementation did not increase the dimension of the discrepancy between the restoration and the cavity wall. The discrepancy on the pulpal floor appeared to affect these results. 相似文献19.
Cosimo Nardi Linda Calistri Silvia Pradella Isacco Desideri Chiara Lorini Stefano Colagrande 《Journal of endodontics》2017,43(10):1640-1646
Introduction
This study aimed to evaluate the diagnostic accuracy of orthopantomography (OPT) for the detection of clinically/surgically confirmed apical periodontitis (AP) without endodontic treatment using cone-beam computed tomographic (CBCT) imaging as the reference standard.Methods
One hundred twenty patients without endodontically treated AP (diseased group) were detected via CBCT imaging using the periapical index system. They were divided into groups of 10 each according to the size of the lesion (2–4.5 mm and 4.6–7 mm) and the anatomic area (incisor, canine/premolar, and molar) in both the upper and lower arches. Another 120 patients with a healthy root and periapex (healthy group) were selected. Each diseased and healthy patient underwent OPT first and a CBCT scan within 40 days of the OPT. The periapical index system was also used to assess AP by OPT. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for OPT images with respect to CBCT imaging were analyzed. The k value was calculated to assess both the interobserver reliability for OPT and the agreement between OPT and CBCT imaging.Results
OPT showed low sensitivity (34.2), negative predictive value (59.3), and diagnostic accuracy (65.0) and high specificity (95.8) and positive predictive value (89.1). Interobserver reliability for OPT was substantial (k = 0.71), and agreement between OPT and CBCT imaging was fair (k = 0.30). The best and worst identified AP were located in the lower molar area and the upper/lower incisor area, respectively.Conclusions
OPT showed high specificity and positive predictive value. However, overall, it was not an accurate imaging technique for the detection of untreated AP, especially in the incisor area. 相似文献20.