数字口内X线片和口腔颌面锥形束CT对邻面龋诊断准确性的研究

目的 比较锥形束CT( cone beam computed tomography,CBCT)与数字口内X线片对邻面龋诊断的准确性,为临床提供适宜的检查手段.方法 5名观察者对45颗离体牙CBCT图像和数字口内片影像进行评估后得出受试者工作特征(receiver operating characteristic,ROC)曲线.结果 邻面龋(牙釉质+牙本质)诊断中CBCT与数字口内片比较,差异无统计学意义(P =0.186)；单纯分析牙本质龋:CBCT与数字口内片比较差异有统计学意义(P =0.004)；单纯分析牙釉质龋:CBCT与数字口内片比较差异无统计学意义(P =0.885).结论 虽然诊断邻面牙本质龋时CBCT优于数字口内片,但因其辐射剂量因素,故不推荐使用CBCT诊断邻面龋.

Detection accuracy of proximal caries by cone-beam CT and digital intraoral radiography

Objective To compare the accuracy of cone-beam computed tomography (CBCT) and digital intraoral radiography in the detection of proximal caries.Methods Forty-five non-restored human premolars or molars were selected for the study.The teeth,4 or 5 as a group,were mounted in 11 plaster blocks.The CBCT images of the tooth blocks were acquired with the ProMax 3D and the DCT Pro imaging systems,while the digital intraoral radiographs were obtained by a digital imaging system Digora Optime.Five postgraduates evaluated all the images for carious lesion in the 90 proximal surfaces using a five-level scale.With the histological examination serving as the reference standard,observers' performances were evaluated by receiver operating characteristic (ROC) curves.Results Fifty-eight proximal surfaces were sound,18 had enamel caries and 14 had dentine caries.No significant differences was found among the three modalities for the proximal caries detection ( P =0.186 ).When only the dentine caries was analyzed,significant difference was found between CBCT and digital intraoral radiography (P =0.004).No significant difference was noted when only enamel caries was analyzed (P =0.885 ).Conclusions Although CBCT was better than digital intraoral radiography in the detection accuracy of proximal caries,however,considering the relatively higher radiation dose,CBCT should not be used routinely to diagnose proximal caries in clinic.