尖端歯周炎の検出のためのデジタルパノラマX線撮影の電子処理．

Electronic processing of digital panoramic radiography for the detection of apical periodontitis.

• Cosimo Nardi
• Linda Calistri
• Michele Pietragalla
• Chiara Vignoli
• Chiara Lorini
• Valentina Berti
• Francesco Mungai
• Stefano Colagrande

抄録

はじめに:

本研究の目的は、歯内療法の有無にかかわらず、臨床的・手術的に確認された無症候性歯周炎（AP）病変の検出におけるパノラマX線撮影（PAN）のデジタル完全部分と小部分の両方の精度を評価することである。

INTRODUCTION: This study aimed to evaluate the accuracy of both digital complete and small portion of panoramic radiography (PAN) in the detection of clinically/surgically confirmed asymptomatic apical periodontitis (AP) lesions with and without endodontic treatment.

方法:

歯内治療の有無にかかわらず、歯周病患者120名と歯周病治療の有無にかかわらず、健康な歯周病患者120名を含む合計480名の患者/歯を、歯周病指標システムを用いたCBCTで検出した。各疾患患者と健常者は、まずPAN検査を受け、40日以内にCBCT検査を受けた。全480例を、それぞれ各歯の臨床検査が可能な完全PAN、不可能な歯の臨床検査が可能な完全PAN、歯冠のある歯根と歯冠のない歯根が表示された小部分PANの4つの方法で評価した。また、PANによるAPの評価にはPereriapical Index systemを用いた。また，CBCTに対するPANの完全部分と小部分の精度を解析した．

METHODS: A total of 480 patients/teeth including 120 AP with and without endodontic treatment, and 120 healthy periapex with and without endodontic treatment were detected via CBCT using the periapical index system. Each diseased and healthy patient underwent PAN first and a CBCT scan within 40 days. All 480 cases were assessed by four different methods, as follows: complete PAN with clinical examination of each tooth available and not available, respectively, and small portion of PAN in which a root with crown and root without crown were displayed, respectively. Periapical index system was also used to assess AP by PAN. Accuracy for both complete and small portion of PAN with respect to CBCT was analyzed.

結果:

歯内療法を行った歯（73.4）は，歯内療法を行っていない歯（66.6）に比べて，4つの方法の総合的な精度が高かった．完全PANの精度は71.3，PANの一部の精度は68.7であった．歯内療法を行っていない歯では，上下切歯部の完全PANと上顎臼歯部の一部PANの精度が高かった．歯内療法を行った歯では差は認められなかった．

RESULTS: The overall accuracy of the four methods for teeth with endodontic treatment (73.4) was higher than teeth without endodontic treatment (66.6). Accuracy of complete PAN and portion of PAN was 71.3 and 68.7, respectively. As regards teeth without endodontic treatment, accuracy was higher for complete PAN in the upper/lower incisive area and for small portion of PAN in the upper molar area. No difference was found in teeth with endodontic treatment.

結論:

PANの完全部分と小部分は、未治療の歯では上下切歯部と上臼歯部でそれぞれ精度が高かったのに対し、治療した歯では差が見られなかった。

CONCLUSION: Complete and small portion of PAN showed greater accuracy in the upper/lower incisive area and upper molar area of untreated teeth, respectively, whereas no difference was found in treated teeth.