Vertikal İnterproksimal Kemik İçi Defektlerin Topografisinin Klinik ve Dijital Ölçüm Arasındaki İlişkinin Belirlenmesi

Yıl 2019, Cilt: 3 Sayı: 2, 135 - 142, 29.08.2019

Hakan Ozdemir , Alkan Bulduklu

https://doi.org/10.34084/bshr.600460

Öz

Amaç: Bu çalışmanın amacı, periodontal kemikiçi defektlerin belirlenmesinde klinik ölçümler ile ortopantomograf görüntüleme (OPG) ve konik ışınlı bilgisayarlı tomografi (KIBT) ile tanı değerini değerlendirmek ve sonuçları karşılaştırarak klinikte rutin olarak teşhis ve tedaviye yardımcı olan dijital radyografilerin güvenilirliğini sorgulamaktır.

Materyal ve Metod: Eskişehir Osmangazi Üniversitesi Diş Hekimliği Fakültesi Periodontoloji Anabilim Dalına Ekim 2015 - Nisan 2016 tarihleri arasında başvuran hastalardan kronik periodontitis ve agresif periodontitis teşhisi konulmuş bireyler çalışmaya dahil edilmiştir. Radyografik ölçümlerde Alveoler kret (AK) projeksiyonunun kök yüzeyine temas ettiği en üst nokta defektin tavanı, periodontal ligamentin kök yüzeyinde izlendiği en apikal kontur defektin tabanı olarak belirlenmiştir. Mine-sement birleşimi (MSB) bu ölçümler için sabit koronal referans olarak alınmıştır. Radyografik ölçümler yukarıda belirtilen çizgiler çizildikten sonra yapılmıştır. Radyografik ölçümlerden sonra, klinik ölçümler flep ameliyatı esnasında ölçülmüştür. 

Bulgular: Bu çalışmanın bulgularına göre anterior bölgede OPG ve KIBT iyi düzeyde klinik bulguları temsil ederken, posterior bölgede ise KIBT ile yapılan ölçümler klinik ölçümlerde mükemmel oranda korelasyon bulunmuştur. Ayrıca tüm verilerin değerlendirilmesinde KIBT klinik ölçümleri OPG’ye oranla daha iyi temsil etmektedir.

Sonuç: Klinik olarak tespit edilmiş kritik kemik içi defektlerde daha kesin yargıya varabilmek ve daha radikal tedavi planlaması yapabilmek amaçlandığında KIBT’den yararlanmak daha avantajlıdır.

Anahtar Kelimeler

Konik ışınlı bilgisayarlı tomografi, ortopantomograf görüntüleme, vertikal interproksimal kemik içi defekt

Destekleyen Kurum

Eskişehir Osmangazi Üniversitesi Bilimsel Araştırma Projeleri Komisyonu

Proje Numarası

61690618-604-99/1929

Teşekkür

Çalışmamız Eskişehir Osmangazi Üniversitesi Bilimsel Araştırma Projeleri Komisyonu tarafından 16 Ekim 2015 tarihli ve 61690618-604-99/1929 sayılı proje desteği ile gerçekleştirilmiştir.

Determination Of Vertical Interproximal Bone Loss Topography: Correlation Between Digital Measurement And Clinıcal Measurement

Öz

Objectives: The aim
of this study is to evaluate the clinical value of periodontal bone defects
determined by Orthopanthomograph (OPG) and Cone Beam Computed Tomography
(CBMT). And to question the reliability of digital radiographs that routinely
aid diagnosis and treatment in the clinic by comparing the results.

Materials
and Methods: Eskişehir Osmangazi University Faculty of Dentistry Department of
Periodontology October 2015 - April 2016 to date of patients who were placed
among individuals diagnosed with chronic periodontitis and aggressive
periodontitis were included in the study. Radiographic measurements the peak of
the defect at the root of the alveolar crest (AC) projection was determined as
the base of the apical contour (BD) defect at the root surface of the
periodontal ligament. The enamel cementation (CEJ) is taken as a fixed coronal
reference for these measurements. Radiographic measurements were made after the
above lines were drawn. After radiographic measurements, clinical measurements
were made correctly during flap surgery.

Results: According to the findings of
this study, OPG and CBCT in the anterior region represented good clinical
findings, whereas in the posterior region, measurements with CBCT were found to
have excellent correlation in clinical measurements. In addition, CBCT
represents better clinical measurements than OPG in evaluating all data.
Conclusion: It is more advantageous to use CBCT when it is aimed to make a more
accurate judgment in clinically determined critical intrabony defects and to
plan more radical treatment.

Anahtar Kelimeler

cone beam computed tomography, orthopanthomograph, vertical interproximal bone loss

Proje Numarası

61690618-604-99/1929

Kaynakça

• 1. Newman MG, Takei H, Klokkevold PR, Carranza FA. Carranza’s Clinical Periodontology. 11th ed. St. Louis Mosby: Elsevier Saunders; 2012.
• 2. Armitage GC. Periodontal diagnoses and classification of periodontal diseases. Periodontol 2000 2004;34:9-21.
• 3. Hienz SA, Paliwal S, Ivanovski S. Mechanisms of Bone Resorption in Periodontitis. J Immunol Res 2015;615486.
• 4. Sanz M, Giovannoli JL. Focus on furcation defects: guided tissue regeneration. Periodontol 2000 2000;22:169-89.
• 5. Cortellini P, Tonetti MS. Focus on intrabony defects: guided tissue regeneration. Periodontol 2000 2000;22:104-32.
• 6. Albert DGM, Gomes ACA, Vasconcelos BCE, Silva EDO, Holanda GZ. Comparison of orthopantomographs and conventional tomography images for assessing the relationship between impacted lower third molars and the mandibular canal. J Oral Maxillofac Surg 2006;64:1030-7.
• 7. White SC, Pharoah MJ. Oral Radiology Principles and Interpretation 5th ed. USA: St. Louis, Mosby; 2004.
• 8. Gröndahl HG, Gröndahl K. Subtraction Radiography for the Diagnosis of Periodontal Bone Lesions. Oral Surgery Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1983;55:208-13.
• 9. Bianchi J, Goggins W, Rudolph M. In vivo, thyroid and lens surface exposure with spiral and conventional computed tomography in dental implant radiography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000:90(2);249-253.
• 10. Kim TS, Obst C, Zehaczek S, Geenen C. Detection of bone loss with different x-ray techniques in periodontal patients. J Periodontol 2008;79:1141-9.
• 11. Tugnait A, Carmichael F. Use of radiographs in the diagnosis of periodontal disease. Dent Update 2005;32:36-8.
• 12. Harorlı A, Akgül HM, Dağistan S. Dişhekimliği Radyolojisi. Erzurum: Atatürk Üniversitesi Yayınları No:950, Dişhekimliği Fakültesi Yayınları No:5, Ders kitapları serisi No:3, 2006.
• 13. Kim TS, Obst C, Zehaczek S, Geenen C. Detection of bone loss with different X-ray techniques in periodontal patients. J Periodontol 2008;79:1141-9.
• 14. Persson RE, Tzannetou S, Feloutzis AG, Bragger U, Persson GR, Lang NP. Comparison between panoramic and intra-oral radiographs for the assessment of alveolar bone levels in a periodontal maintenance population. J Clin Periodontol 2003;30:833-9.
• 15. Shah MA, Shah SS, Dave DH. CBCT-A Positive Amelioration In Periodontics. NJIRM 2013;4:144-8.
• 16. Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc 2006;72:75-80.
• 17. Shah MA, Shah SS, Dave DH. CBCT-A Positive Amelioration In Periodontics. NJIRM 2013;4:144-8.
• 18. Jervøe-Storm PM, Hagner M, Neugebauer J, Ritter L, Zöller JE, Jepsen S, Frentzen M. Comparison of cone-beam computerized tomography and intraoral radiographs for determination of the periodontal ligament in a variable phantom. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:e95-e101
• 19. Loubele M, Van Assche N, Carpentier K, Maes F, Jacobs R, van Steenberghe D, Suetens P. Comparative localized linear accuracy of small-field cone-beam CT and multislice CT for alveolar bone measurements. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:512-8
• 20. Mol A, Balasundaram A. In vitro cone beam computed tomography imaging of periodontal bone. Dentomaxillofac Radiol 2008; 37: 319-24.
• 21. Vandenberghe B, Jacobs R, Yang J. Diagnostic validity (or acuity) of 2D CCD versus 3D CBCT-images for assessing periodontal breakdown. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104:395-401.
• 22. de Faria Vasconcelos K, Evangelista KM, Rodrigues CD, Estrela C, de Sousa TO, Silva MA. Detection of periodontal bone loss using cone beam CT and intraoral radiography. Dentomaxillofac Radiol 2012;41:64-9.
• 23. Mengel R, Candir M, Shiratori K, Flores-de-Jacoby L. Digital volume tomography in the diagnosis of periodontal defects: an in vitro study on native pig and human mandibles. J Periodontol 2005;76:665-73.
• 24. Noujeim M, Prihoda T, Langlais R, Nummikoski P. Evaluation of high-resolution cone beam computed tomography in the detection of simulated interradicular bone lesions. Dentomaxillofac Radiol 2009;38:156-62.
• 25. Misch KA, Yi ES, Sarment DP. Accuracy of cone beam computed tomography for periodontal defect measurements. J Periodontol 2006;77:1261-6
• 26. Lang NP, Tonetti MS, Suter J, Sorrell J, Duff GW, Kornman KS. Effect of interleukin-1 gene polymorphisms on gingival inflammation assessed by bleeding on probing in a periodontal maintenance population. J Periodontal Res 2000;35:102-7.
• 27. Persson RE, Tzannetou S, Feloutzis AG, Bragger U, Persson GR, Lang NP. Comparison between panoramic and intra-oral radiographs for the assessment of alveolar bone levels in a periodontal maintenance population. J Clin Periodontol 2003;30:833-9.
• 28. K de Faria Vasconcelos, KM Evangelista, CD Rodrigues, C Estrela, TO de Sousa, MAG Silva. Detection of periodontal bone loss using cone beam CT and intraoral radiography. Dentomaxillofac Radiol 2012;41:64-9.
• 29. Fuhrmann RA, Bucker A, Diedrich PR. Assessment of alveolar bone loss with high resolution computed tomography. J Periodontal Res 1995;30:258-63.
• 30. Tyndall AA, Brooks SL. Selection criteria for dental implant site imaging: A position paper of the American Academy of Oral and Maxillofacial Radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 89:630-7.
• 31. Honda K, Arai Y, Iwai K, Hashimoto K, Saitou T, Shinoda K. Fundamental efficiency of new-style limited cone-beam CT (3DX): Comparison with helical CT. Jpn J Tomogr 2001;27:193-8.
• 32. Scaf G, Lurie AG, Mosier KM, Kantor ML, Ramsby GR, Freedman ML. Dosimetry and cost of imaging osseointegrated implants with film-based and computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83:41-8.
• 33. Avendanio B, Frederiksen NL, Benson BW, Sokolowski TW. Effective dose and risk assessment from detailed narrow beam radiography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82;713-9