基于根尖周图像和锥形束 CT 的外牙颈部吸收的长期预后：一项临床研究。

IF 5.4 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE International endodontic journal Pub Date : 2024-07-08 DOI:10.1111/iej.14122

Julie Suhr Villefrance, Lise-Lotte Kirkevang, Ann Wenzel, Michael Væth, Louise Hauge Matzen

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引用次数: 0

摘要

目的：与根尖周（PA）图像相比，评估 CBCT 的补充信息是否会改变外牙颈部吸收（ECR）牙齿的长期预后。此外，评估 PA 图像中的预测结果，并评估 CBCT 中的哪些结果会影响 ECR 患牙的长期预后：共纳入 194 名患者，平均年龄 41.2 岁，年龄范围 13-81 岁，有 244 颗 ECR 牙齿。根据口内图像初步确定了良好或不良的长期预后。随后，患者接受了 CBCT 检查，并确定了最终的长期预后。根据 PA 图像和 CBCT，采用 Heithersay 的分类系统对 ECR、牙髓受累情况和 ECR 的扩展情况进行了评估。在 CBCT 中，还评估了表面病变的数量。描述性统计评估了 CBCT 检查后长期预后的变化。逻辑回归分析检验了 PA 图像和 CBCT 的结果是否会影响长期预后：根据 CBCT，在 244 颗牙齿中，173 颗（70.9%）牙齿的长期预后被评估为不良，71 颗（29.1%）牙齿的长期预后被评估为良好。76颗（31.1%）牙齿的长期预后在CBCT检查后发生了变化；5颗（2.0%）牙齿的长期预后从较差变为良好，71颗（29%）牙齿的长期预后从良好变为较差。评估 CBCT 后，81（33.2%）颗牙齿的 H 级上升，10（4.1%）颗牙齿的 H 级下降。在 70 颗（28.7%）牙齿中，CBCT 检查后牙髓从未受损伤变为受损伤；8 颗（3.3%）牙齿的变化方向相反。与 H 级 3 相比，PA 图像中的 H 级 2 和 4 显著增加了长期预后发生变化的概率（p 结论：H 级 2 和 4 增加了长期预后发生变化的概率，而 H 级 3 增加了长期预后发生变化的概率：来自 CBCT 的补充信息改变了近三分之一患有 ECR 的牙齿的长期预后。在大多数情况下，长期预后从良好变为不良。PA 图像中的 H 级 3 对长期预后的改变有显著影响。CBCT 中的一些发现影响了不良的长期预后。

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Long-term prognosis for teeth with external cervical resorption based on periapical images and cone beam CT: A clinical study

Aim

To evaluate whether supplemental information from CBCT changed long-term prognosis for teeth with external cervical resorption (ECR) compared to periapical (PA) images. Furthermore, to assess predictive findings in PA images and evaluate which findings in CBCT affected the long-term prognosis of teeth with ECR.

Methodology

One hundred and ninty-four patients, mean age 41.2, range 13–81, having 244 teeth with ECR were included. An initial long-term prognosis determined either good or poor was established based on intraoral images. Afterwards, the patients underwent CBCT, and final long-term prognosis was decided. From the PA images and CBCT, ECR using Heithersay's classification system, pulp involvement and extension of ECR was assessed. In CBCT, the number of surface lesion(s) was additionally assessed. Descriptive statistics evaluated changes in long-term prognosis after CBCT. Logistic regression analyses tested if findings in PA images and CBCT affected the long-term prognosis.

Results

Based on CBCT, out of 244 teeth the long-term prognosis was assessed to be poor for 173 (70.9%) teeth and good for 71 (29.1%) teeth. The long-term prognosis changed in 76 (31.1%) teeth after CBCT; 5 (2.0%) changed from poor to good, and 71 (29%) changed from good to poor long-term prognosis. In 81 (33.2%) teeth the H-class increased, and in 10 (4.1%) teeth the H-class decreased after assessing CBCT. In 70 (28.7%) teeth, there was a change from no pulp involvement to involvement of the pulp after CBCT; eight (3.3%) teeth changed in the opposite direction. H-class 2 and 4 in PA images significantly increased the probability for a change in long-term prognosis compared to an H-class 3 (p < .05). H-class 4, pulp involvement, ECR in the oral 1/3 of the root, and more than two surface lesions seen in CBCT significantly influenced a poor long-term prognosis (p < .05).

Conclusions

Supplemental information from CBCT changed long-term prognosis in almost one third of teeth with ECR. In most cases, the long-term prognosis changed from good to poor. H-class 3 in PA images had a significant influence on change in long-term prognosis. Several findings in CBCT influenced a poor long-term prognosis.

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来源期刊

International endodontic journal 医学-牙科与口腔外科

CiteScore

10.20

自引率

28.00%

发文量

195

审稿时长

4-8 weeks

期刊介绍： The International Endodontic Journal is published monthly and strives to publish original articles of the highest quality to disseminate scientific and clinical knowledge; all manuscripts are subjected to peer review. Original scientific articles are published in the areas of biomedical science, applied materials science, bioengineering, epidemiology and social science relevant to endodontic disease and its management, and to the restoration of root-treated teeth. In addition, review articles, reports of clinical cases, book reviews, summaries and abstracts of scientific meetings and news items are accepted. The International Endodontic Journal is essential reading for general dental practitioners, specialist endodontists, research, scientists and dental teachers.