The journal of evidence-based dental practice · 2026
DIAGNOSTIC PERFORMANCE OF HIGH-RESOLUTION 3D DENTAL MRI FOR DETECTION AND VOLUMETRIC ASSESSMENT OF SEVERE PERIODONTITIS.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Tekiki Nouha, Lauer Arne, Schulte Luisa, Juerchott Alexander, Sohani Meysam, Herpel Christopher, Ruetters Maurice, Schwindling Franz Sebastian, Rammelsberg Peter, Heiland Sabine, Bendszus Martin, Hilgenfeld Tim
Аннотация
BACKGROUND AND OBJECTIVES: To evaluate the potential of dental MRI (dMRI) for identification and volumetric assessment of periodontal lesions compared to cone-beam computed tomography (CBCT).
MATERIALS AND METHODS: Twenty-two patients with severe periodontitis prospectively underwent pre-treatment isotropic CBCT (0.16 mm) and 3T-dMRI (0.7 mm) with a T1-weighted gradient-echo sequence before and after intravenous-contrast (T1W/T1WC+). Blinded analyses of 1377 teeth were performed for lesion identification and volumetry. Reliability was assessed using Cohen's kappa (κ) and intraclass correlation coefficient (ICC), and diagnostic agreement using Cochran's Q-, Friedman-, and Kruskal-Wallis tests.
RESULTS: Reliability of dMRI was comparable to CBCT for periodontal lesion identification (κ-range: 0.820-1) and volumetric assessment (ICC-range: 0.841-0.974). Nearly all CBCT-identified lesions (289) were detected on dMRI (T1W/T1WC+: 284/285). A total of 281 concordant lesions were detected across all imaging, while 73/75 were detected only on T1W/T1WC+ and not on CBCT (discordant lesions). Lesion volumes were considerably larger on T1WC+, but within a similar range on T1W compared to CBCT (mean volume in CBCT/T1WC+/T1W: 0.046 ± 0.057/0.059 ± 0.063/0.048 ± 0.056 cc, median difference [%] CBCT vs. T1WC+/T1W: 42.9/16.2%). Discordant lesions were smaller than concordant lesions (T1W/T1WC+: 0.048 ± 0.056 vs 0.017 ± 0.009 / 0.059 ± 0.062 vs 0.027 ± 0.013 cc; P < .001).
CONCLUSION: Reliability of dMRI and CBCT for periodontal lesion identification and volumetric assessment is comparable. Agreement in lesion identification and volumetric bone loss between T1W and CBCT is high, with no added value observed from contrast agents. MRI identified more periodontal lesions than CBCT, likely reflecting superior sensitivity for periodontal disease detection.
MATERIALS AND METHODS: Twenty-two patients with severe periodontitis prospectively underwent pre-treatment isotropic CBCT (0.16 mm) and 3T-dMRI (0.7 mm) with a T1-weighted gradient-echo sequence before and after intravenous-contrast (T1W/T1WC+). Blinded analyses of 1377 teeth were performed for lesion identification and volumetry. Reliability was assessed using Cohen's kappa (κ) and intraclass correlation coefficient (ICC), and diagnostic agreement using Cochran's Q-, Friedman-, and Kruskal-Wallis tests.
RESULTS: Reliability of dMRI was comparable to CBCT for periodontal lesion identification (κ-range: 0.820-1) and volumetric assessment (ICC-range: 0.841-0.974). Nearly all CBCT-identified lesions (289) were detected on dMRI (T1W/T1WC+: 284/285). A total of 281 concordant lesions were detected across all imaging, while 73/75 were detected only on T1W/T1WC+ and not on CBCT (discordant lesions). Lesion volumes were considerably larger on T1WC+, but within a similar range on T1W compared to CBCT (mean volume in CBCT/T1WC+/T1W: 0.046 ± 0.057/0.059 ± 0.063/0.048 ± 0.056 cc, median difference [%] CBCT vs. T1WC+/T1W: 42.9/16.2%). Discordant lesions were smaller than concordant lesions (T1W/T1WC+: 0.048 ± 0.056 vs 0.017 ± 0.009 / 0.059 ± 0.062 vs 0.027 ± 0.013 cc; P < .001).
CONCLUSION: Reliability of dMRI and CBCT for periodontal lesion identification and volumetric assessment is comparable. Agreement in lesion identification and volumetric bone loss between T1W and CBCT is high, with no added value observed from contrast agents. MRI identified more periodontal lesions than CBCT, likely reflecting superior sensitivity for periodontal disease detection.