根尖周指数在慢性根尖周炎诊断中的应用

摘要

目的 比较新根尖周指教( N-PAI)与旧根尖周指数(O-PAI)在慢性根尖周炎诊断中的应用.方法 收集中国医科大学附属口腔医院牙体牙髓门诊具有锥形束CT(CBCT)图像和X线片的患者63例,共95颗前牙,包括无症状牙40颗,诊断为慢性牙髓炎15颗,慢性根尖周炎35颗(包括根管治疗后患牙7颗),根管治疗后表现正常5颗,根据新、旧根尖周指数评判分级,并对所得2组数据进行统计分析.结果 X线片与CBCT图像的根尖周炎检出率分别为38.95％( 37/95)和58.95％(56/95),差异有统计学意义(X2=7.60,P＜ 0.01).CBCT图像O-PAI为1、2时,N-PAI可有不同程度分级；当O-PAI为3、4、5时,由于分级界限不清导致评片重复性不佳,而N-PAI可通过病损大小明确分级.结论 N-PAl通过病变的大小评定根尖周炎的分级,同时包括骨皮质的破坏情况,而O-PAI相邻2个级别之间的划分界限不明确,前者更能体现根尖周炎的实际情况.%Objective To compare the application of the old-periapical index (O-PAI) and the new-periapical index (N-PAI) in diagnosis of chronic apical periodontitis. Methods The clinic diagnosis of 95 anterior teeth in 63 patients,which were examined by periapical radiography and CBCT, consisted of asymptomatic teeth (40 teeth),chronic pulpitis (15 teeth),chronic apical periodonlitis (35 teeth,including 7 cases with root canal therapy), remnant root with normal apical images after root canal therapy (5 teeth). All images were evaluated based on the O-PAI and N-PAI. Then the results were analyzed statistically. Results Apical periodontitis (AP) was identified in 37 cases and 56 cases out of 95 cases by radiography and CBCT respectively,so the difference had remarkable significance (x2=7.60,P<0.01). When the 0-PA1 of CBCT images was 1 and 2,the N-PAI presented different classifications;when the O-PAI was 3,4,and 5,the classification was indefinite but the N-PAI was clear. Conclusion the use of O-PAI for the classifications was ambiguous. The rule of the N-PAI which even could show the destruction of cortical bone was definite, and more accurate than the O-PAI.