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目的:探讨锥形束CT(CBCT)检查对牙根纵裂的诊断价值。方法:选择临床检查疑似牙根纵裂38例(38颗患牙),分别利用CBCT和X线牙根尖片进行诊断,记录为明确牙根纵裂、不明确牙根纵裂和明确无牙根纵裂,再将两种影像学检查结果进行比较。结果:CBCT扫描提示明确有牙根纵裂患牙20颗(根尖片判定13颗),拔除后体外均证实有牙根纵裂;CBCT和牙根尖片判定牙根纵裂的诊断符合率均为100%。CBCT扫描不确定有无牙根纵裂8颗,体外证实存在根纵裂但裂纹细微5颗,其余3颗为牙周牙髓联合病变或单纯根尖周病变。CBCT扫描明确无牙根纵裂10颗(牙根尖片判定8颗),经牙髓和牙周治疗痊愈6颗,其余4颗经牙髓和牙周治疗失败拔除后均未见牙根纵裂。在明确有和明确无牙根纵裂组中,CBCT诊断牙根纵裂的诊断符合率为78.9%,显著高于牙根尖片的55.3%(P<0.05)。结论:CBCT对于牙根纵裂的诊断价值较高。
Objective: To investigate the diagnostic value of cone beam computed tomography (CBCT) in root longitudinal root fracture. Methods: Thirty-eight patients (38 teeth) with suspected root canal longitudinal rupture were selected and diagnosed by CBCT and X-ray respectively. The records were definite root longitudinal split, unclear root longitudinal split and definite root deciduous rupture. The two imaging findings were compared. Results: The CBCT scan showed that there were 20 teeth with root fractures (13 pieces of root tip pieces were determined), and the rupture of the root canal was confirmed in vitro after the removal of CBCT. The diagnostic coincidence rates of CBCT and root tips were 100% . CBCT scan is not sure there are 8 root longitudinal splits, in vitro root rupture is confirmed but the crack is fine 5, and the remaining 3 are combined periodontal and endodontic lesions or simple periapical lesions. The CBCT scans 10 pieces of rootless root longitudinal cleft (8 pieces of root tip piece), 6 pieces after pulp and periodontal treatment, and the other 4 pieces have no root longitudinal split after tooth pulp and periodontal treatment failure. In a clear and clear group of root erectile cleft, the diagnostic accuracy of CBCT in the diagnosis of root rupture was 78.9%, which was significantly higher than 55.3% of the root tips (P <0.05). Conclusion: CBCT is more valuable for the diagnosis of root rupture.