杨晓飞 杨昱藩

[摘要] 目的 比较锥形束CT（CBCT）与DR对复合树脂Ⅱ类洞充填后效果的评价，进一步探讨CBCT在窝洞充填中的优势及应用价值。 方法 选取经临床诊断需要进行复合树脂Ⅱ类洞充填治疗的50颗患牙，复合树脂Ⅱ类洞充填后同步拍摄根尖片与CBCT，术后分别由2位经验丰富的临床医生从窝洞充填的边缘密合性与邻面的悬突两方面进行读片，运用卡方检验比较2种方法是否在评价结果上存在差异性。 结果 总计复合树脂Ⅱ类洞充填治疗的50颗患牙，在边缘密合性与邻面的悬突两方面，分别约有 28.00%和 34.00%的充填物在数字化根尖片与 CBCT的评价结果上未能达成一致意见，经过统计学检验，数字化根尖片与CBCT在上述两方面的评价均有高度显著性差异（P<0.01）。 结论 CBCT较根尖片复合树脂Ⅱ类洞充填的边缘密合性与邻面的悬突方面的评价更为灵敏及准确，在复杂或疑难复合树脂Ⅱ类洞充填治疗的中拥有很高的临床应用价值。

[关键词] 锥形束 CT;数字化根尖片;Ⅱ类洞充填

Abstract Objective  To compare the effect of cone beam computed tomography （CBCT） and digital radiography （DR） in the evaluation of composite resin class II cavity filling， and to further explore the advantages and application value of CBCT in cavity filling.Methods  a total of 50 teeth with class II cavity filled with composite resin were selected. The apical film and CBCT were taken simultaneously after the filling of class II cavity filled with composite resin， Chi square test was used to compare whether there were differences in the evaluation results between the two methods. Conclusion  CBCT is more sensitive and accurate in the evaluation of marginal tightness and adjacent surface overhang than apical composite resin class II cavity filling. It has high clinical application value in the treatment of complex or difficult composite resin class II cavity filling.

根尖片作为龋齿诊断中首选的影像学检查，又是龋齿充填治疗后质量评估的标准之一[1]。 但作为二维的平面图像，临床上经常因为影像的重叠及变形给读片带来难度[2]。 近年来随着锥形束CT（ Cone Beam Computer Tomography，CBCT）的面世逐渐弥补了传统影像学所存在的局限性[3]。 有研究证实CBCT在诊断深龋、继发龋等牙体疾病中具有更明显的优势[4-5]。 本次实验通过比较 CBCT和根尖片对窝洞充填后效果的评价，进一步探讨CBCT在龋病治疗中的优势和应用价值[6]。……