Elif Şener MD, TİMUR KÖSE, Hans-Göran GRÖNDAHL, Sinan HORASAN, B.Güniz BAKSI

Accuracy of Proximal Caries Depth Measurements: Comparison of Two Computed Cone Beam Tomography and Storage Phosphor Plate Systems

Amaç: Bu çalışmanın amacı, NewTom 9000 [konik ışınlı bilgisayarlı tomografisi (CBCT)] ve Accu-I-Tomo [sınırlı CBTC (LCBCT)] dental volümetrik tomografi sistemleri ile Digora Optime [Depolama fosfor tabakası (SPP)] fosfor plak görüntüleme sistemini, dişlerin ara yüzeylerinde oluşturulan farklı şekil ve boyutlardaki defekt derinlikleri açısından karşılaştırmalı olarak değerlendirmektir.Gereç ve Yöntemler: Çürük lezyonu bulunmayan 50 adet kesici dişin 30 tanesi 3 eşit gruba bölündü. Ara yüzeylerinde mekanik olarak farklı şekil ve boyutlarda defekt oluşturulan dişler aproksimal kontakta olacak şekilde akrilik bloklara yerleştirildi. Blokların CBCT, LCBCT ve SPP görüntüleme sistemleri ile görüntüleri alındı. Altmış adet defektin derinlik ölçümleri dijital görüntüler üzerinde 3 gözlemci tarafından gerçekleştirildi. Ölçümlerin altın standardı, mikroskobik kesitler üzerinde 3 gözlemcinin yaptığı ölçümlerin ortalaması alınarak belirlendi. Mikroskobik kesitler üzerinde hesaplanan gerçek ölçümler (altın standart) ile dijital görüntüler üzerinde yapılan ölçümlerin karşılaştırması aşamasında Bland-Altman yönteminden yararlanıldı. Gözlemciler arası uyum grup içi korelasyon katsayısı kullanılarak saptandı. Bulgular: CBCT sisteminde aksiyel ve sagittal kesitlerde gerçekleştirilen ölçümlerde, altın standarttan maksimum sapma sırasıyla 2 mm [%95 güven aralığı (GA) 2,60-0,60] ve 1,5 mm (%95 GA 0,30-2,30) iken, LCBCT sistemi için bu değer 0,66 mm (%95 GA 0,53-2,22) ve 0,37 mm (%95 GA 0,50-2,25) olarak bulundu. CBCT sisteminin aksiyel ve sagittal kesitlerine ait gözlemciler arası uyum değeri sırasıyla 0,487 ve 0,700 iken, LCBCT sistemi için bu değer 0,979 ve 0,985 olarak saptandı. SPP görüntüleme sistemi için ise bu değer 0,979 idi. Sonuç: Accu-I-Tomo LCBCT sistemi ile elde edilen görüntüler üzerinde gerçekleştirilen çürük derinliği ölçümleri; Newtom CBCT ve Digora SPP sistemlerine kıyasla daha doğru sonuçlar vermiştir. Gözlemciler arası uyum, LCBCT sistemi için CBCT ve SPP sistemlerine kıyasla daha yüksektir.

Arayüz Çürük Derinliği Ölçüm Doğruluğunda Farklı Dental Volümetrik Tomografi ve Fosfor Plak Sistemlerinin Karşılaştırılması

Objective: The aim of this study was to compare the accuracy of NewTom 9000 [cone beam computerized tomography (CBCT)], Accu-I-Tomo [limited CBTC (LCBCT)] and Digora Optime [storage phosphor plate (SPP)] imaging systems in assessing the depths of defects with different shapes and sizes on the proximal surfaces of teeth.MaterialsandMethods:Thirty out of 50 incisive teeth with sound proximal surfaces were divided into three equal groups. Mechanical defects of different sizes and depths were created on their proximal surfaces and teeth were placed in acrylic blocks with approximal contacts. Radiographs of the blocks were obtained with CBCT, LCBCT and SPP systems. The depth measurements of 60 artificial defects were performed by 3 radiologists in the digital radiographs. The gold standard (true measure) was defined as the mean of the 2 observers' measurements on the microscopic sections. Results from imaging systems and true depths were compared using Bland-Altman plots. The agreement was determined with intra-class correlation coefficient.Results: Maximum deviation from the true length in axial and sagittal slices of CBCT system was 2 mm [95% confidence interval (CI) 2.60-0.60] and 1.5 mm (95% CI 0.302.30) respectively while the deviation of LCBCT was 0.66 mm (95% CI 0.53-2.22) and 0.37 mm (95% CI 0.50-2.25). The deviation from truth for SPP was 0.66 mm (95% CI 0.33-2.25). Correlation among observers was 0.487 and 0.700 respectively, for CBCT axial and sagittal slices; while it was 0.979 and 0.985 for LCBCT and 0.979 for SPP.Conclusion: Images obtained with the Accu-I-Tomo LCBCT system were more accurate than Newtom CBCT and Digora SPP system for measurement of caries lesion depth. Correlation among observers was higher for LCBCT and SPP systems compared with CBCT system.

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