Radiographic Characteristics of Soft Tissue Calcification on Digital Panoramic Images

Abstract Objective: To assess the prevalence of soft tissue calcifications and their panoramic radiographic characteristics. Material and Methods: This descriptive retrospective study evaluated 2027 panoramic radiographs. The type and location of calcifications and the age and gender of patients were evaluated by two radiologists. Data were analyzed via SPSS and the Chi-square, Fisher's exact and Kappa tests were used to compare the categorical demographic variables among the groups. The confidence interval was set to 95% and p<0.05 was considered statistically significant. Results: The prevalence of calcified stylohyoid ligament was 11.24%. This value was 3.99% for tonsillolith, 1.33% for calcified carotid plaque, 0.69% for antrolith, 0.39% for calcified lymph node, 0.29% for phleboliths, and 0.19% for sialoliths. The prevalence of these conditions had no significant association with gender or age (p=0.102). The prevalence of bilateral calcified stylohyoid ligament, tonsillolith, and a calcified carotid plaque was significantly higher (p<0.001). The most prevalent type of calcified stylohyoid ligament, according to O'Carroll's classification, belonged to types 1, 4, 3 and 2 (p<0.001). The most commonly observed radiographic pattern was multiple, well-defined tonsilloliths (75.3%, p<0.001). Conclusion: The prevalence of soft tissue calcifications on panoramic radiographs was relatively low in this Iranian population. The most calcifications were respectively calcified stylohyoid ligament, tonsillolith, calcified carotid plaque, antrolith, calcified lymph node, phleboliths and sialoliths. Calcified stylohyoid ligament, tonsillolith and calcified carotid plaque were more bilaterally. Thereby panoramic imaging can help in primary assessment, epidemiologic and screening evaluation of these calcifications.

Root morphology and number of canals in mandibular central and lateral incisors using cone beam computed tomography

Abstract Most failures in endodontic treatment of mandibular incisors are due to the presence of a missed canal specifically the lingual. This investigation aimed to examine the root morphology and number of canals in mandibular incisors using cone beam computed tomography (CBCT). Two hundred and seven patients were assessed in terms of their mandibular central and lateral incisors of CBCT. The inclusion criteria were absence of root resorption, coronal restoration or root filling and clarity and optimal resolution of images. According to the Vertucci's classification, number of roots and canals and type of canal were evaluated by two oral and maxillofacial radiologists. In order to data analysis SPSS version 16 and descriptive statistics were implemented. All mandibular incisors had one root. Most central (84.5%) and lateral (78.2%) incisors had a single canal (p= 0.065). The majority of central (54.5%) and lateral (56.5%) incisors were Vertucci's type I (p= 0.102). Prevalence of one canal in males: central (84.8%), lateral (77.9%) and in females: central (84.2%), lateral (78.5%) (p= 0.518). Prevalence of Vertucci's type I in males: central (52.3%), lateral (45.3%) and in females: central (56.1%), lateral (64.4%) (p=0.188). The prevalence of two canals was 15.5% (central) and 21.8% (lateral) in mandibular incisors. The Vertucci's type I was the most typical kinds of mandibular incisors. Considering the limitations of periapical radiography in determining canal morphology, CBCT can be helpful in case of any concern regarding root canal morphology.

Resumo A maioria das falhas no tratamento endodôntico dos incisivos mandibulares é devida à presença de um canal perdido, especificamente do lingual. Esta investigação teve como objetivo analisar a morfologia radicular e o número de canais nos incisivos inferiores utilizando a tomografia computadorizada de feixe cônico (TCFC). Duzentos e sete pacientes foram avaliados em termos de seus incisivos centrais e laterais mandibulares de TCFC. Os critérios de inclusão foram ausência de reabsorção radicular, restauração coronária ou preenchimento radicular e clareza e resolução ótima das imagens. De acordo com a classificação de Vertucci, o número de raízes e canais e o tipo de canal foram avaliados por dois radiologistas orais e maxilo-faciais. Para análise dos dados, o SPSS versão 16 e análise estatística descritiva foram implementados. Todos os incisivos inferiores tinham uma raiz. A maioria dos incisivos centrais (84,5%) e laterais (78,2%) apresentava um único canal (valor de P: 0,065). A maioria dos incisivos centrais (54,5%) e laterais (56,5%) eram do tipo I de Vertucci (valor de P: 0,102). Prevalência de um canal no sexo masculino: central (84,8%), lateral (77,9%) e no feminino: central (84,2%), lateral (78,5%) (valor de P: 0,518). Prevalência de Vertucci tipo I em homens: central (52,3%), lateral (45,3%) e feminina: central (56,1%), lateral (64,4%) (valor de P: 0,188). A prevalência de dois canais foi de 15,5% (central) e 21,8% (lateral) nos incisivos inferiores. O tipo I de Vertucci era dos tipos mais comuns de incisivos inferiores. Considerando as limitações da radiografia periapical na determinação da morfologia do canal, a TCFC pode ser útil em caso de qualquer preocupação com relação à morfologia do canal radicular.

A comparative study of the conventional and digital intraoral radiography methods for root canal length measurement / Comparação entre Radiografia intraoral convencional e digital para medição de comprimento do canal radicular: estudo in vitro

Objective: Measurement of root canal length is one of the most important stages of endodentic treatment, and any error at this stage can lead to the failure. This study aimed to compare conventional and digital intraoral radiography in measurement of root canal length. Material and Methods: In this study, 35 single-canal maxillary teeth were collected. Access cavities were prepared. An endodontic number 10#K- file was introduced into the canal, until the tip was visible at the apical foramen and the actual canal length (gold standard) was determined. After acquisition conventional radiographs using E-Ektaspeed and F-Insight film (Eastman-Kodak Co. Rochester, NY, USA) and digital radiographs using Photostimulable Phosphor Plates(PSP) (Soredex, Helsinki, Finland) and Charge Coupled Devices (CCD)(RVG, Trophy,NY,USA). they were examined separately with a two-week interval by two oral and maxillofacial radiologists. The data were analyzed with ANOVA and Tukey’s tests using SPSS-19 software (SPSS Inc., Chicago, IL, USA). Result: No statistically significant difference was observed between different radiographies, and different observers (P > 0.05). Nevertheless, in comparison with the gold standard, in all cases, the F-speed conventional radiography and the digital CCD radiography showed the highest and the lowest accuracy, respectively. Also, the PSP and the E-speed conventional radiography were in the second and third order of accuracy, respectively. Conclusion: The use of digital radiography does not improve the accuracy of the root canal length measurement,but the digital technique has advantages,such as the reduced patient exposure, eliminating the time consuming processing stages, and producing fast images...

Objetivo: A medição do comprimento do canal radicular é uma das etapas mais importantes de tratamento endodôntico, e qualquer erro nesta fase pode levar ao fracasso. Este estudo teve como objetivo comparar a radiografia intra-oral convencional e digital na medida do comprimento do canal radicular.Material e Métodos: Neste estudo, 35 dentes superiores com canal único foram coletados. Cavidades de acesso foram preparadas. Uma lima endodôntica tipo K, número 10 foi introduzida no canal, até que a ponta era visível no forame apical e o comprimento do canal real (padrão ouro) foi determinada. Após a aquisição de radiografias convencionais, utilizando os filmes E-Ektaspeed e F- Insight (Eastman Kodak Co.,Rochester, NY, EUA) e radiografias digitais utilizando placas foto estimuláveis de fósforo (PSP) (Soredex, Helsinki, Finlândia) e dispositivos de acoplamento (CCD) (RVG, Troféu, NY, EUA), as mesmas foram examinadas separadamente com um intervalo de duas semanas, por dois radiologistas oral maxilofaciais. Os dados foram analisados pelos Testes de ANOVA e Tukey utilizando o software SPSS-19 (SPSS Inc., Chicago, IL, EUA). Resultados: Não houve diferença estatisticamente significativa entre as diferentes radiografias, e observadores diferentes (P > 0,05). No entanto, em comparação com o padrão-ouro, em todos os casos, a radiografia convencional e a radiografia digital CCD apresentaram o maior e a menor precisão, respectivamente. Além disso, a PSP e a radiografia convencional estavam na segunda e terceira ordem de precisão, respectivamente. Conclusão: O uso da radiografia digital não melhora a precisão da medição do comprimento de canal, mas a técnica digital tem vantagens, tais como a exposição do paciente reduzida, eliminando o demorado estágio de processamento, produzindo assim, imagens mais rápidas...