Alveolar bone loss in radiographic modalities for diagnosis of periodontal disease ; Periodonto ligų diagnozavimas: dantinės ataugos pokyčių analizė, taikant skirtingus rentgeninio tyrimo metodus

Jurga

Sujets

• Medicine

Informations

• Publié par: vilnius_university
• Publié le: 01 janvier 2011
• Nombre de lectures: 18
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

VILNIUS UNIVERSITY
Deimant Ivanauskait
ALVEOLAR BONE LOSS
IN RADIOGRAPHIC MODALITIES
FOR DIAGNOSIS OF PERIODONTAL DISEASE

Doctoral dissertation
Biomedical sciences, Medicine (07 B)
Vilnius, 2011 The research project was carried out at Malmö University, Sweden with the support of
grant ref nr 2419/1998 (380/123) from the Swedish Institute and Vilnius University,
Lithuania during the period 1999-2011.
Scientific consultants:
prof. dr. Madeleine Rohlin (Dept. of Oral and Maxillofacial Radiology, Malmö
University, Sweden)
prof. dr. Vytaut Peiulien (Vilnius University, Biomedical Sciences, Odontology
– 08B). CONTENT
ABBREVIATIONS............................................................................................................. 5
1. INTRODUCTION........................................................................................................... 6
1.1 Chronic periodontitis with alveolar bone loss ......................................................6
1.1.1 Definitions.......................................................................................................... 6
1.1.2 Prevalence ..........................................................................................................8
1.1.3 Treatment.......................................................................................................... 10
1.2 Diagnostic methods................................................................................................12
1.2.1 In general.......................................................................................................... 12
1.2.2 How can we evaluate diagnostic methods?......................................................12
1.2.3 Imaging methods for examination of the oral and maxillofacial region ..........24
1.3 Examination of the periodontal tissues ...............................................................27
1.3.1 Clinical methods for the examination of the periodontal tissues .....................27
1.3.2 Radiographic methods for the examination of the periodontal tissues ............28
1.4 Systematic reviews................................................................................................. 36
2. AIMS............................................................................................................................. 38
2.1 Relevance of theme................................................................................................38
2.2 Purpose ................................................................................................................... 40
2.3 Tasks .......................................................................................................................40
2.4 Statements to be defended ....................................................................................41
3. MATERIAL AND METHODS .................................................................................... 42
3.1 Panoramic radiography and posterior bitewing radiography..........................42
3.1.1 Patients .............................................................................................................42
3.1.2 Radiographic examinations ..............................................................................43
3.1.3 Observations and observers..............................................................................45
3.1.4 Teeth and sites for assessment..........................................................................47
3.1.5 Visual grading analysis ....................................................................................50
3.1.6 Assessment of alveolar bone loss.....................................................................53
3.1.7 Analysis ............................................................................................................55
3.2 Evaluation of evidence on panoramic radiography by means of a systematic review
....................................................................................................................................... 58
3.2.1 Problem specifications and definitions of terms ..............................................59
3.2.2 Formulation of a plan for the literature search.................................................60
3.2.3 Literature search and retrieval of publications.................................................63
3.2.4 Data extraction, interpretation of data, and evaluation of evidence.................66
4. RESULTS...................................................................................................................... 67
4.1 Panoramic radiography and posterior bitewing radiography..........................67
4.1.1 Visual grading analysis ....................................................................................67
4.1.2 Assessment of the alveolar bone loss ...............................................................79
4.2 Evaluation of evidence on panoramic radiography for the assessment of alveolar
bone loss........................................................................................................................ 89
4.2.1 Literature search and retrieval of publications.................................................89
4.2.2 Evidence from studies of visual grading analysis ............................................ 94
34.2.3 Evidence from studies of assessment of alveolar bone loss...........................107
4.2.4 Evidence from studies of observer performance............................................110
5. DISCUSSION ............................................................................................................. 114
5.1 Methodological considerations...........................................................................114
5.1.1 Radiographic methods.................................................................................... 114
5.1.2 Sample............................................................................................................ 116
5.1.3 Observers........................................................................................................119
5.1.4 Reading conditions.........................................................................................120
5.1.5 Visual grading analysis ..................................................................................122
5.1.6 Assessment of alveolar bone loss...................................................................123
5.1.7 Systematic review...........................................................................................126
5.1.8 Statistical methods..........................................................................................127
5.2 Discussion of Results ...........................................................................................128
5.2.1 Visual grading analysis for assessment of alveolar bone loss........................128
5.2.2 Assessment of alveolar bone loss...................................................................133
5.2.3 Observer performance .................................................................................... 141
6. CONCLUSIONS......................................................................................................... 146
7. RECOMMENDATIONS ............................................................................................ 148
7.1 For clinical practice............................................................................................. 148
7.2 For research ......................................................................................................... 148
8. REFERENCES............................................................................................................ 150
9. PUBLICATIONS ON THEME OF DOCTORAL DISSERTATION........................ 170
10. PRESENTATIONS ON THEME OF DOCTORAL DISSERTATION AT CONFERENCES
......................................................................................................................................... 171
APPENDICIES ............................................................................................................... 172
Appendix 1 Protocol “Observer Instructions” .......................................................173 2 Protocol “Assessment of radiographs” ...............................................177
Appendix 3 Protocol “Inclusion or exclusion of publications in the systematic review”
..................................................................................................................................... 178
Appendix 4 Protocol based on the QUADAS-tool “Interpretation of publications in the
systematic review”.....................................................................................................179
ACKNOWLEDGEMENTS ............................................................................................ 180
4ABBREVIATIONS
AB – alveolar bone
AC – alveolar crest
BL – bone level
CBCT – Cone Beam Computed Tomography
CEJ – cemento-enamel junction
CT – Computed Tomography
ICC – intra-class correlation coefficients
ICRP – International Commission on Radiological Protection
ICRU – International Commission on Radiation Units
MeSH – Medical Subject Heading used for indexing articles for PubMed
MRI – Magnetic Resonance Imaging
MSCT –Multislice Computed Tomography