口腔曲面体层片判断上颌牙根突入上颌窦的敏感度与特异度分析

上海口腔医学 ›› 2016, Vol. 25 ›› Issue (3): 306-309.

口腔曲面体层片判断上颌牙根突入上颌窦的敏感度与特异度分析

米晓晖¹, 刘加强², 吴勇²

1.同济大学口腔医学院,同济大学附属口腔医院口腔正畸科,上海牙组织修复与再生工程技术研究中心,上海 200072;
2.上海交通大学医学院附属第九人民医院·口腔医学院口腔颅颌面科, 上海市口腔医学重点实验室,上海 200011

收稿日期:2016-01-15 修回日期:2016-03-07 出版日期:2016-06-25 发布日期:2016-07-22
通讯作者: 吴勇,E-mail：amelobla@163.com E-mail:xiaomihui@yeah.net
作者简介:米晓晖(1978-),女,博士,主治医师
基金资助:
国家自然科学基金青年项目（11402175）; 上海市科学技术委员会医学引导项目（124119a9200）; 上海市卫生局（原）项目（20134273）

Diagnostic sensitivity and specificity of panoramic radiography in detection of maxillary teeth roots projecting into the maxillary sinus

MI Xiao-hui¹, LIU Jia-qiang², WU Yong²

1. Department of Orthodontics, School &
Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration. Shanghai 200072;
2. Department of Oral and Craniomaxillofacial Science, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine;Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2016-01-15 Revised:2016-03-07 Online:2016-06-25 Published:2016-07-22

摘要/Abstract

摘要： 目的评价口腔曲面体层片判断上颌牙根突入上颌窦的敏感度与特异度。方法纳入110例患者,男42例,女68例;年龄15~36岁,上颌第二磨牙已完全萌出,拍摄全牙列锥形束CT（CBCT）及口腔曲面体层片。分别根据2种影像数据观察上颌尖牙、上颌第一前磨牙、上颌第二前磨牙、上颌第一磨牙及上颌第二磨牙牙根是否突入上颌窦。以CBCT观察结果为金标准,收集四格表资料,计算口腔曲面体层片进行判断的敏感度、特异度、准确度、阳性似然比、阴性似然比及牙根进入上颌窦的发生率。结果口腔曲面体层片判断牙根是否突入上颌窦的敏感度分别为上颌尖牙100%,上颌第一前磨牙100%,上颌第二前磨牙96%,上颌第一磨牙99%,上颌第二磨牙96%。特异度分别为上颌尖牙94%,上颌第一前磨牙92%,上颌第二前磨牙84%,上颌第一磨牙55%,上颌第二磨牙67%。结论口腔曲面体层片判断上颌牙根是否进入上颌窦的敏感度高,但是对于第二前磨牙、第一磨牙及第二磨牙判断的特异度较低。正畸临床不能以之作为上颌后牙支抗设计的依据。

关键词: 口腔曲面体层片, 锥形束CT, 上颌窦, 敏感度, 特异度

Abstract: PURPOSE: To evaluate the diagnostic sensitivity and specificity of panoramic radiography in detection of maxillary teeth roots projecting into the maxillary sinus. METHODS: Paired panoramic radiographs and cone-beam CT (CBCT) images of maxilla from 110 subjects were analyzed. 42 males and 68 females (15~36 years old) with the second molars erupted completely were included. The 2 radiographic techniques were used to observe if the roots of maxillary teeth project into the sinus, including canine, the first premolar, the second premolar, the first molar and the second molar. With CBCT as a gold standard, the diagnostic sensitivity and specificity of panoramic radiography were evaluated, as well as the accuracy, prevalence, positive likehood ratio, and negtive likehood ratio. RESULTS: The sensitivity for canine, the first premolar, the second premolar, the first molar, and the second molar was 100%, 100%, 96%, 99%, and 96%, respectively. The specificity for canine, the first premolar the second premolar, the first molar, and the second molar was 94%, 92%, 84%, 67%, and 67%, respectively. CONCLUSIONS: Panoramic radiography has a high diagnostic sensitivity in detection of the teeth roots projecting into the maxillary sinus for maxillary teeth. However, it can't afford sufficient proof for orthodontic anchorage design because of low specificity, especially for the second premolar, the first molar and the second molar.

Key words: Panoramic radiography, Cone-beam CT, Maxillary sinus, Sensitivity, Specificity

中图分类号:

R783.5

米晓晖, 刘加强, 吴勇. 口腔曲面体层片判断上颌牙根突入上颌窦的敏感度与特异度分析[J]. 上海口腔医学, 2016, 25(3): 306-309.

MI Xiao-hui, LIU Jia-qiang, WU Yong. Diagnostic sensitivity and specificity of panoramic radiography in detection of maxillary teeth roots projecting into the maxillary sinus[J]. Shanghai Journal of Stomatology, 2016, 25(3): 306-309.

参考文献

[1] Park JH, Tai K, Kanao A, et al. Space closure in the maxillary posterior area through the maxillary sinus [J]. Am J Orthod Dentofacial Orthop, 2014, 145(1): 95-102.
[2] Oh H, Herchold K, Hannon S, et al. Orthodontic tooth movement through the maxillary sinus in an adult with multiple missing teeth [J]. Am J Orthod Dentofacial Orthop, 2014, 146(4): 493-505.
[3] Livas C, Halazonetis DJ, Booij JW, et al. Maxillary sinus floor extension and posterior tooth inclination in adolescent patients with ClassⅡ division 1 malocclusion treated with maxillary first molar extractions[J]. Am J Orthod Dentofacial Orthop, 2013,143(4): 479-485.
[4] Sharan A, Madjar D. Correlation between maxillary sinus floor topography and related root position of posterior teeth using panoramic and cross-sectional computed tomography imaging [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006,102(3): 375-381.
[5] Kosalagood P, Silkosessak OC, Pittayapat P, et al. Linear measurement accuracy of eight cone beam computed tomography scanners [J]. Clin Implant Dent Relat Res, 2015, 17(6): 1217-1227.
[6] Ilgüy D, Ilgüy M, Dolekoglu S, et al. Evaluation of the posterior superior alveolar artery and the maxillary sinus with CBCT [J]. Braz Oral Res, 2013, 27(5): 431-437.
[7] 王家良. 临床流行病学—临床科研设计、测量与评价[M]. 第4版. 上海: 上海科学技术出版社, 2014: 320-337.
[8] Re S, Cardaropoli D, Corrente G, et al. Bodily tooth movement through the maxillary sinus with implant anchorage for single tooth replacement [J]. Clin Orthod Res, 2001, 4(3): 177-181.
[9] Savi de Carvalho R, Consolaro A, Francischone CE, Jr., et al. Sinus augmentation by orthodontic movement as an alternative to a surgical sinus lift: a clinical report [J]. J Prosthet Dent, 2014, 112(4): 723-726.
[10] 付升旗, 范锡印, 刘恒兴, 等. 上颌窦与上颌后牙的位置关系及临床意义 [J]. 中国临床解剖学杂志, 2010, 28(2): 142-145.
[11] Oberli K, Bornstein MM, von Arx T. Periapical surgery and the maxillary sinus: radiographic parameters for clinical outcome[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2007, 103(6): 848-853.
[12] 张云鹏, 文勇, 唐翠竹, 等. 上颌后牙牙根与毗邻解剖结构关系的锥形束CT分析 [J]. 山东大学学报(医学版), 2014, 52(10): 66-71.
[13] Tadinada A, Fung K, Thacker S, et al. Radiographic evaluation of the maxillary sinus prior to dental implant therapy: A comparison between two-dimensional and three-dimensional radiographic imaging [J]. Imaging Sci Dent, 2015, 45(3): 169-174.

[1]	卢雨桐, 史俊宇, 赖红昌. Astra锥形种植体在上颌窦穿牙槽嵴顶提升术中的短期效果评价[J]. 上海口腔医学, 2023, 32(3): 302-307.
[2]	王文丽, 傅亚婷, 刘华, 马潇. 上颌前牙美学区牙龈三维形态的锥形束CT测量分析[J]. 上海口腔医学, 2023, 32(2): 177-182.
[3]	张薇, 陈威, 陈志方. 可调式活动牵引器治疗上颌唇侧倒置阻生中切牙效果评价[J]. 上海口腔医学, 2023, 32(2): 193-197.
[4]	胡宁, 李凤丹, 江银华. 植骨与否对上颌窦底内提升同期种植术临床疗效的影响[J]. 上海口腔医学, 2023, 32(1): 101-104.
[5]	宋珏, 刘好好, 刘嘉靓, 陈美华. 上颌磨牙与上颌窦黏膜增厚发生的相关性分析[J]. 上海口腔医学, 2022, 31(6): 638-642.
[6]	吕云松, 李朝晖. 颞下颌关节紊乱综合征伴偏侧咀嚼患者锥形束CT特征分析[J]. 上海口腔医学, 2022, 31(6): 653-656.
[7]	周子芊, 陈振琦. 上颌窦底对上颌第一磨牙近中移动的影响[J]. 上海口腔医学, 2022, 31(6): 661-667.
[8]	林翔, 傅裕杰, 任根强, 温佳欢, 陈宇飞, 张旗. U-Net神经网络分割锥形束CT影像中下颌磨牙牙体与牙髓腔及其准确性验证[J]. 上海口腔医学, 2022, 31(5): 454-459.
[9]	马智菲, 周梦琪, 王丽珍, 承清, 洪瑾. Er:YAG 激光在小型猪牙髓血运重建术中的应用效果评价[J]. 上海口腔医学, 2022, 31(4): 367-373.
[10]	黄锦程, 赵华强, 李国菊. Stafne骨腔影像学特征：基于CBCT的回顾性分析[J]. 上海口腔医学, 2022, 31(4): 439-444.
[11]	林怡君, 鄢洁雅, 王天鸽, 周志捷, 廖盛轩, 毛丽霞, 刘加强. 减数正畸治疗中中切牙牙根及牙槽骨形态变化的锥形束CT测量分析[J]. 上海口腔医学, 2022, 31(2): 211-216.
[12]	杜悦, 彭笑, 韩瑞, 王栋, 胡洁, 高廷益, 张凯. 颌骨囊肿开窗治疗临床特征动态研究[J]. 上海口腔医学, 2021, 30(6): 658-662.
[13]	马晓晴, 赵宁, 董晛, 钱文昊. 2种锥形束CT转化头颅侧位片的定点一致性探讨[J]. 上海口腔医学, 2021, 30(5): 522-525.
[14]	毛晓燕, 杨佳音, 李佳, 徐睿. 成人骨性Ⅱ类错畸形上气道与上、下颌骨形态分析[J]. 上海口腔医学, 2021, 30(4): 419-423.
[15]	郑美里, 吕政展, 朱柏恺, 汪席均, 瞿然奕, 樊林峰, 江凌勇. 成人上颌骨性扩弓疗效评价及对面中部相邻骨块的影响[J]. 上海口腔医学, 2021, 30(3): 316-322.