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ORIGINALNI RAD / ORIGINAL ARTICLE

Dijagnostika periapikalnih lezija prednjih

zuba korišćenjem interneta

Dušan Živković

, Goran Tošić

, Branko Mihailović

Milan Miladinović

, Biljana Vujičić





         



PRIMLJEN / RECEIVED 11.09.2010

PRIHVAĆEN / ACCEPTED 22.11.2010

Diagnosis of periapical lesions

of the front teeth using the

internet

APSTRAKT

Cilj. Nove informacione tehnologije, ne samo što povećavaju

kvalitet zdravstvenog zbrinjavanja pacijenata, nego i omogućuju

njihovo potpuno ili delimično zbrinjavanje na hiljade kilometara

udaljenosti od zdravstvenog centra ili stomatologa. Potreba za

daljinskom dijagnostikom i planiranjem intervencija je posebno

velika kod vojnika, nepokretnih osoba, osobama sa posebnim

potrebama i drugim. Cilj našeg rada je bio istražiti praktičnu

upotrebljivost telestomatoloških metoda u dijagnostici i rutin-

skom zbrinjavanju endodonskih/oralno-hirurških pacijenata u

smislu pouzdanosti postavljanja telemedicinske dijagnoze i pro-

cene adekvatne terapije za endodonski ili oralnohirurški tretman

prednjih zuba.

Metod. U našoj eksperimentalnoj randomizovanoj studiji,

urađenoj od juna do decembra 2009 godine, učestvovalo je 250

pacijenata uzrasta od 9 do 67 godina, oba pola, koji su se javljali

zbog simptomima vezanih za probleme periapikalnih predela

prednjih zuba. Posmatrani zubi su bili zubi stalne denticije i pri-

likom pregleda za svaki zub na koji se pacijent žalio napravljeni su

foto i rtg snimci koji su uploadovani na XPA3 Online aplikacioni

server na Internetu odakle su ih preuzimali i pregledali udaljeni

konsultanti. Ispitana je dijagnostička saglasnost Kohenovim kap-

pa (k) koecijentom, dijagnostička senzitivnost (SE), specičnost

(SP) i ekasnost (EFF), i izvršen z-test i Mc Nemmar χ2 kvadrat

test za prag značajnosti od p=0.05.

Rezultati. Rezultati (k=0.97%, SE=0,99%, SP=0,99%, EFF=0,99

za 95% IP), pokazuju na postignutu skoro potpunu dijagnostičku

saglasnost. Dijagnostičke razlike nisu statistički značajne.

Zaključak. Telestomatologija bazirana na Internetu kao tele-

komunikacionom mediju može se uspešno koristiti u cilju dij-

agnostike periapikalnih lezija prednjih zuba, pritom smanjujući

troškove udaljenog pregleda i čineći dostupnom urgentnu pomoć.

Ključne reči: stomatologija; periapikalne bolesti; sistemi medi-

cinskih zapisa, kompjuterizovani; kompjuterizovane komunika-

cione mreže; telemedicina.

KORESPONDENCIJA / CORRESPONDENCE

Milan Miladinović, Bulevar dr Zorana Đinđića 25/1,18000 Niš, Tel. 0184536 636, E-mail: [email protected]

Milan Miladinović, Boulevard Dr Zoran Đinđić 25/1, 18000 Niš, Serbia, Phone *381184536636, Email: [email protected]

ABSTRACT

Objective. New information technologies not only raise the

degree of quality of patient health care but also enable their par-

tial or complete management over the distances of thousands of

kilometers away from the health care centers or dentists. The need

for distance diagnosis and planning of interventions is especially

important when caring for soldiers, bed-ridden individuals, those

with special needs and other patient subpopulations. Our aim

here was to investigate the practical usefulness of teledentistry

methods in the diagnosis and routine management of endodontic/

oral surgery patients in the sense of reliability of teledentistry

diagnosis and assessment of the most appropriate therapy in an

endodontic or oral surgery treatment of the front teeth.

Methods. In our experimental randomized study performed

from June to December 2009, there were 250 enrolled patients of

both genders, aged 9 to 67 years, visiting our department because

of the symptoms related to the problems with periapical regions

of their front teeth. The teeth observed constituted permanent

dentition, and for each of the teeth producing complaints, photo-

graphs and radiographs were taken and uploaded to XPA3 Online

application server on the Internet, from where they were down-

loaded and reviewed by distant consultants. Diagnostic agree-

ment was studied by way of Cohen’s kappa coefﬁcient, as well as

diagnostic sensitivity (SE), speciﬁcity (SP), and efﬁcacy (EFF), and

z-test and McNemmar X2 test were applied for the signiﬁcance

threshold of p=0.05.

Results. The results obtained (k=0.97%, SE=0,99%, SP=0,99%,

EFF=0,99 za 95% IP) indicate an almost complete diagnostic

agreement. Diagnostic differences were not statistically signiﬁ-

cant.

Conclusion. Teledentistry based on the Internet as a telecom-

munication medium can be successfully utilized in the diagnosis of

periapical lesions of the front teeth, reducing the costs associated

with distant visits and making urgent help available.

Key words: dentistry; periapical diseases; medical records

systems, computerized; computer communication networks; tele-

medicine.

138 strana / page

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