Dental volümetrik tomografinin çocuk diş hekimliğinde klinik tanıya ve tedavi planlamasına katkısının değerlendirilmesi
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmanın amacı 6-14 yaş arası 200 çocuk hastanın panoramik ve/veya periapikal röntgenleri ile dental volümetrik tomografi (DVT) görüntülerini karşılaştırılarak, çocuk diş hekimliğinde klinik tanı ve tedavi planlamasına etkisinin retrospektif olarak değerlendirilmesidir. Yöntem: Araştırmada, Ege Üniversitesi Diş Hekimliği Fakültesi arşivinden alınan olguların radyografik değerlendirilmesi amacıyla olgular arasında gömük diş, dental travma, endodontik-periodontal nedenler, patolojik oluşum, süpernümerer diş, hipodonti ve ortodontik nedenler olarak gruplandırma yapıldı. Bu grupların 2B ve 3B görüntülerinin değerlendirilmesi için literatür destekli ve her grup için ayrı ayrı ölçekler hazırlandı. Bu ölçeklerde tanı, tedavi yöntemleri, tedaviye karar verilme zorluğu ve olguya özgü değerlendirilmesi gereken uygun radyografik görüntüler kaydedildi. Sırasıyla 2B görüntüleme ve 3B görüntüleme yöntemleri incelenerek ölçekler kaydedildi. 200 çocuk hastaya ait toplam 302 olgunun tamamını bir gözlemci, %15'ini (n=30) alanında uzman 4 gözlemci değerlendirdi. 2B ve 3B görüntüleme yöntemlerinin karşılaştırılması ve gözlemciler içi uyumun değerlendirilmesi için toplanan verilerin SPSS 25.0 programı ile istatistiksel analizleri yapıldı. İstatistiksel analizde Pearson Ki Kare testi, Çoklu Ki Kare Testi ve Fisher's Exact Testi kullanıldı. Bulgular: Çalışmada incelenen 200 hastaya ait toplam 302 olguda en çok gömük diş nedeniyle (%40,7) radyografik görüntü alındığı, bunu sırasıyla süpernümerer diş (%22,2), patolojik oluşum (%12,7), endodontik-periodontal nedenler (%7,9), dental travma (%6,6), ortodontik nedenler (%5,3) ve hipodontinin (%4,6) takip ettiği gözlendi. Gömük diş olgularında; gömük diş ile ilişkili anatomik yapılar, gömük dişte rezorpsiyon, gömük dişe komşu dişte rezorpsiyon ve tedaviye karar verme zorluğu parametreleri arasında istatistiksel olarak anlamlı bir fark bulundu (p<0,05). Gömük diş lokalizasyonu ve etkilenen komşu diş ile 2B ve 3B radyografik görüntüleme yöntemlerinin karşılaştırılmasında istatistiksel olarak anlamlı ilişkiler elde edilmedi (p>0,05). Dental travma olgularında 'Travma nedeni', 'Apeks gelişimi', 'Kök kırığı' ve 'Tedaviye karar verme zorluğu'nun 2B ve 3B radyografik görüntülerinin değerlendirilmesinde istatistiksel olarak anlamlı bir ilişki saptanmadı (p>0,05). Endodontik-Periodontal nedenler grubunda 'Tedavi sonucu dişte rezorpsiyon oluşumu' 2B ve 3B görüntüleri karşılaştırıldığında istatistiksel olarak anlamlı bir ilişki bulundu (p<0,05). Dental volümetrik tomografi görüntüleme yönteminde rezorpsiyonların saptandığı, 2B görüntülemede ise saptanmadığı belirlendi. Patolojik nedenler grubunda 'Rezorpsiyon' ve 'Tedaviye karar verme zorluğu'nun 2B ve 3B görüntüleri değerlendirildiğinde istatistiksel olarak anlamlı bir ilişki saptandı (p<0,05). Süpernümerer diş grubunda 'Tedaviye karar verme zorluğu'nun 2B ve 3B görüntüleri incelendiğinde istatistiksel olarak anlamlı bir fark bulundu (p<0,05). Hipodonti ve Ortodontik nedenler gruplarında değerlendirilen parametrelerin 2B ve 3B görüntüleri karşılaştırıldığında istatistiksel olarak anlamlı bir fark gözlenmedi (p>0,05). Sonuç; 2B ve 3B görüntüleme yöntemleri karşılaştırılan olgularda; gömük diş ve süpernümerer diş gruplarında tedaviye karar vermede, endodontik-periodontal nedenler ve patolojik oluşumlarda rezorpsiyon oluşumlarının saptandığı durumlarda DVT görüntüleme yöntemlerinin uygulanması önerilmektedir. Dental travma, hipodonti ve ortodontik problemler için olguya özgü değerlendirme yapılarak DVT görüntülemesine başvurulabileceği düşünülmektedir.
Aim: The aim of this study is to retrospectively evaluate the effect of DVT images on clinical diagnosis and treatment planning in pediatric dentistry by comparing panoramic and/or periapical x-rays and DVT images of 200 patients between the ages of 6-14. Method: In the study, to evaluate the cases taken from the archives of Ege University Faculty of Dentistry, the cases were grouped as impacted teeth, dental trauma, endodontic-periodontal causes, pathological formation, supernumerary teeth, hypodontia and orthodontic causes. To evaluate the 2D and 3D images of these groups, literature-supported scales were prepared separately for each group. In these scales, diagnosis, treatment methods, difficulty in deciding on treatment, and appropriate radiographic images that should be evaluated specifically for the case were recorded. The scales were recorded by examining 2D imaging and 3D imaging methods, respectively. A total of 302 cases of 200 pediatric patients were evaluated by one observer, and 15% (n=30) by 4 expert observers. Statistical analysis of the collected data was performed with the SPSS 25.0 program to compare 2D and 3D imaging methods and evaluate interobserver agreement. Pearson Chi Square test, Multiple Chi Square Test and Fisher's Exact Test were used in statistical analysis. Results: In a total of 302 cases of 200 patients examined in the study, radiographic images were taken mostly due to impacted teeth (40.7%), followed by supernumerary teeth (22.2%), pathological formation (12.7%), endodontic-periodontal reasons (7%). ,9), dental trauma (6.6%), orthodontic reasons (5.3%) and hypodontia (4.6%). In cases of impacted teeth; a statistically significant difference was found between the parameters of anatomical structures related to the impacted tooth, resorption in the impacted tooth, resorption in the tooth adjacent to the impacted tooth, and difficulty in deciding on treatment (p<0.05). No statistically significant relationships were obtained when comparing 2D and 3D radiographic imaging methods with the impacted tooth localization and the affected adjacent tooth (p>0.05). No statistically significant relationship was detected in the evaluation of 2D and 3D radiographic images of 'Cause of trauma', 'Apex development', 'Root fracture' and 'Difficulty deciding on treatment' in dental trauma cases (p>0.05 When the 2D and 3D images of 'Tooth resorption as a result of treatment' were compared in the Endodontic-Periodontal causes group, a statistically significant relationship was found (p <0.05). It was determined that resorptions were detected in the dental volumetric tomography imaging method but could not be detected in 2D imaging. When the 2D and 3D images of 'Resorption' and 'Difficulty deciding on treatment' were evaluated in the pathological causes group, a statistically significant relationship was detected (p <0.05). When the 2D and 3D images of 'Difficulty deciding on treatment' were examined in the supernumerary tooth group, a statistically significant difference was found (p<0.05). When 2D and 3D images of the parameters evaluated in the Hypodontia and Orthodontic causes groups were compared, no statistically significant difference was observed (p>0.05). Conclusion: In cases where 2D and 3D imaging methods were compared; It is recommended to obtain DVT in deciding the treatment of impacted teeth and supernumerary tooth groups, and to apply DVT imaging methods in cases where endodontic-periodontal causes and resorption formations are detected in pathological formations. It is thought that DVT imaging can be used for dental trauma, hypodontia and orthodontic problems by making a case-specific evaluation.
Aim: The aim of this study is to retrospectively evaluate the effect of DVT images on clinical diagnosis and treatment planning in pediatric dentistry by comparing panoramic and/or periapical x-rays and DVT images of 200 patients between the ages of 6-14. Method: In the study, to evaluate the cases taken from the archives of Ege University Faculty of Dentistry, the cases were grouped as impacted teeth, dental trauma, endodontic-periodontal causes, pathological formation, supernumerary teeth, hypodontia and orthodontic causes. To evaluate the 2D and 3D images of these groups, literature-supported scales were prepared separately for each group. In these scales, diagnosis, treatment methods, difficulty in deciding on treatment, and appropriate radiographic images that should be evaluated specifically for the case were recorded. The scales were recorded by examining 2D imaging and 3D imaging methods, respectively. A total of 302 cases of 200 pediatric patients were evaluated by one observer, and 15% (n=30) by 4 expert observers. Statistical analysis of the collected data was performed with the SPSS 25.0 program to compare 2D and 3D imaging methods and evaluate interobserver agreement. Pearson Chi Square test, Multiple Chi Square Test and Fisher's Exact Test were used in statistical analysis. Results: In a total of 302 cases of 200 patients examined in the study, radiographic images were taken mostly due to impacted teeth (40.7%), followed by supernumerary teeth (22.2%), pathological formation (12.7%), endodontic-periodontal reasons (7%). ,9), dental trauma (6.6%), orthodontic reasons (5.3%) and hypodontia (4.6%). In cases of impacted teeth; a statistically significant difference was found between the parameters of anatomical structures related to the impacted tooth, resorption in the impacted tooth, resorption in the tooth adjacent to the impacted tooth, and difficulty in deciding on treatment (p<0.05). No statistically significant relationships were obtained when comparing 2D and 3D radiographic imaging methods with the impacted tooth localization and the affected adjacent tooth (p>0.05). No statistically significant relationship was detected in the evaluation of 2D and 3D radiographic images of 'Cause of trauma', 'Apex development', 'Root fracture' and 'Difficulty deciding on treatment' in dental trauma cases (p>0.05 When the 2D and 3D images of 'Tooth resorption as a result of treatment' were compared in the Endodontic-Periodontal causes group, a statistically significant relationship was found (p <0.05). It was determined that resorptions were detected in the dental volumetric tomography imaging method but could not be detected in 2D imaging. When the 2D and 3D images of 'Resorption' and 'Difficulty deciding on treatment' were evaluated in the pathological causes group, a statistically significant relationship was detected (p <0.05). When the 2D and 3D images of 'Difficulty deciding on treatment' were examined in the supernumerary tooth group, a statistically significant difference was found (p<0.05). When 2D and 3D images of the parameters evaluated in the Hypodontia and Orthodontic causes groups were compared, no statistically significant difference was observed (p>0.05). Conclusion: In cases where 2D and 3D imaging methods were compared; It is recommended to obtain DVT in deciding the treatment of impacted teeth and supernumerary tooth groups, and to apply DVT imaging methods in cases where endodontic-periodontal causes and resorption formations are detected in pathological formations. It is thought that DVT imaging can be used for dental trauma, hypodontia and orthodontic problems by making a case-specific evaluation.
Açıklama
Anahtar Kelimeler
Diş Hekimliği, Dentistry
