目的 探讨锥形束CT(CBCT)在诊断老年牙周炎骨丧失程度中的应用价值. 方法 对27例牙周炎患者的38颗患牙进行CBCT和X线根尖片检查,检测牙槽骨吸收位点,并对骨缺损进行线性测量,所有患者均行牙周翻瓣手术治疗,并以术中实际检测到的牙槽骨丧失位点数以及牙槽骨高度丧失测量值作为对照金标准. 结果 CBCT对骨缺损位点的诊断与翻瓣术中所见完全一致,准确率达100.0％ (72/72);而X线根尖片仅能检测出近远中骨缺损位点,不能检测出颊舌侧骨缺损位点,准确率为62.5％(45/72).CBCT测量的牙槽骨高度丧失值与术中测量值分别为(5.516±0.393) mm与(5.385±0.415) mm,差异无统计学意义(t=1.948,P＞0.05),而X线根尖片分别为(6.311±0.439)mm与(5.411±0.418) mm,差异有统计学意义(t=9.956,P＜0.05). 结论 CBCT能够为老年牙周炎骨缺损提供三维方向的诊断信息,对各个方位的牙槽骨吸收提供客观准确的评价,并具有更高的准确性和可靠性.%Objective To evaluate the accuracy and reliability of cone-beam computed tomography (CBCT) in the diagnosis of periodontal bone defects in the elderly.Methods The 38 teeth of 27 cases were collected and scanned both with CBCT technology and periapical radiography (PA).Periodontal bony defects were identified and linear measurements were made for all defects.All cases were treated with periodontal flap surgery with the bony defects and their linear measurements detected during operation as the gold standard.Results All periodontal bony defects were identified with CBCT with its accuracy rate of 100.0％ (72/72),but the buccal and lingual defects could not be measured by PA with its accuracy rate of 62.5％ (45/72).Linear measurements for all defects revealed no statistical differences between CBCT and direct measurement [(5.516 ± 0.393) mm vs.(5.385± 0.415) mm,t=1.948,P＞0.05],but there was a significant difference in linear measurement between PA and direct measurement [(6.311±0.439) mm vs.(5.411±0.418) mm,t=9.956,P＜0.05].Conclusions CBCT can offer the diagnostic information for periodontal bone defect from three dimensional direction in the elderly,provide objective and accurate assessment of alveolar bone resorption,and has higher accuracy and reliability.
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