目的：比较根尖周片与锥形束CT（Cone beam CT，CBCT）成像在牙周骨丧失中的检测与定位作用。方法：图像选自需进行牙周评价的患者牙片，样本共计51个测量位点，包括水平和垂直骨丧失，分别由三名检测者进行评价，主要通过测量骨丧失的线性高度、深度和宽度以及对X射线断层片上的联合骨缺损进行识别鉴定。结果：两种成像方式在定性骨缺损上差异无统计学意义（P>0.05），但在测量釉牙骨质界（CEJ）和牙槽脊顶（AC）间距离时两种成像方式差异有统计学意义（P<0.05）。在测量CEJ和缺损最深点间距和缺损的宽度时，两种方式差异无统计学意义（P>0.05）。在本研究的39颗牙中，30.8%有联合骨缺损。结论：两种测量方式在测量牙槽脊的高度时有差异，但在测量骨缺失的深度和宽度时结论相似。应用CBCT 成像方式能对颊侧和舌侧/腭侧进行全面分析，并对骨缺失的表面形态进行观察。%To compare periapical radiographs with cone beam CT(CBCT) imaging in detecting and localizing alveolar bone loss by comparing linear measurements of the height, depth and width of the defects and identifying combined bone defects in tomographic images. Methods: The images were selected from a secondary database containing images of patients referred for periodontal evaluation. The sample consisted of 51 sites showing both horizontal and vertical bone loss, assessed by 3 trained examiners. Results: The results showed that there were no statisticaly significant differences between the imaging methods in terms of identification of the patern of bone loss. However, there were differences between the two methods when the distance between the cemento-enamel junction (CEJ) and the alveolar crest (AC) was measured. When the distance between the CEJ and the deepest point and width of the defect were measured, the methods showed no statisticaly significant difference. In this study, 30.8% of the 39 teeth evaluated had combined bone defects. Conclusions: The two methods differ when detecting the height of the alveolar bone crest but present similar views of the depth and width of bone defects. CBCT was the only method that alowed for an analysis of the buccal and lingual/palatal surfaces and an improved visualization of the morphology of the defect.
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