Estudio de la relación de los terceros molares superiores retenidos y el seno maxilar en radiografías panorámicas y tomografía (CBCT) / Study of the relationship of retained upper third molars and maxillary sinus in panoramic radiographs and tomography (CBCT)

Objetivo: Evaluar la eficacia de la radiografía panorámica para establecer la relación de los terceros molares superiores y la cortical inferior del seno maxilar, en comparación con la tomografía computarizada de haz cónico (CBCT). Material y métodos: El trabajo incluyó 72 pacientes, se estudiaron 34 terceros molares superiores retenidos izquierdos y 38 derechos. Se realizaron mediciones con el programa para establecer la distancia entre la cortical inferior del seno maxilar y el ápice del tercer molar superior a partir de la imagen de la radiografía panorámica en lo que se estableció como parámetros: «a distancia, en contacto y dentro del piso de seno maxilar¼. Luego, con los cortes oblicuos o paraaxiales de la tomografía computarizada (CBCT) se observó la verdadera ubicación en el plano bucopalatino. Resultados: Del total de los terceros molares superiores 34 fueron izquierdas (47.22%) y 38 derechas (52.78%). En la Rx. Panorámica, 18 casos (25%) se encontraron a distancia al seno maxilar, 12 en contacto (16.7%) y 42 por dentro (58.3%) del seno maxilar. En la tomografía se observaron 20 casos (27.8%) a distancia del conducto, 16 (22.2%) en contacto y 36 (50%) por dentro del seno maxilar. Se observaron diferencias estadísticamente significativas (p < 0.05) entre la Rx. panorámica y la tomografía (CBCT) de los terceros molares que se hallan por dentro del seno maxilar. Conclusión: A partir de los resultados obtenidos, podemos establecer que la radiografía panorámica no permite conocer la verdadera relación entre la cortical inferior del seno maxilar y los terceros molares superiores (AU)

Objective: To evaluate the effectiveness of panoramic radiography to establish the relationship of the upper third molars and the inferior cortical of the maxillary sinus, in comparison with the Cone Beam Computed Tomography (CBCT). Material and methods: The work included 72 patients, 34 upper left maxillary molars and 38 rights were studied. Measurements were made with the program to establish the distance between the lower cortex of the maxillary sinus and the apex of the upper third molar from the image of the panoramic radiograph in what was established as parameters: «at a distance, in contact and inside the floor of maxillary sinus¼. Then with the oblique or paraaxial slices of the computed tomography (CBCT) the true location in the bucco-palatal plane was observed. Results: Of the total upper third molars, 34 were left (47.22%) and 38 right (52.78%). In the panoramic X-ray 18 cases (25%) were found at distance to the maxillary sinus, 12 in contact (16.7%) and 42 inside (58.3%) of the maxillary sinus. The tomography showed 20 cases (27.8%) at a distance from the canal, 16 (22.2%) in contact and 36 (50%) inside the maxillary sinus. Statistically significant differences were observed (p < 0.05) between the Rx. panoramic and tomography (CBCT) of the third molars that are inside the maxillary sinus. Conclusion: From the results obtained, we can establish that the panoramic radiograph does not allow knowing the true relationship between the inferior cortical of the maxillary sinus and the upper third molars (AU)

Análise volumétrica do septo no seio maxilar exibida por tomografia computadorizada feixe cônico na população peruana ­ estudo retrospectivo transversal / Volumetric analysis of the maxillary sinus septa by CBCT in a Peruvian population ­ cross-sectional retrospective study

Objetivos: avaliar a presença do septo sinusal na população peruana. Materiais e métodos: um estudo transversal foi realizado em 298 seios maxilares de pacientes encaminhados ao Serviço de Radiologia Oral e Maxilofacial do Hospital Nacional Arzobispo Loayza, em Lima, Peru. A presença do septo, o número, a localização, o comprimento e a orientação dos avaliados, bem como idade, sexo e tipo de dentulismo, foram quantificados nas imagens da tomografi a computadorizada feixe cônico (TCFC), usando o software CS 3D Imaging. O teste Qui-quadrado foi realizado para tentar identifi car associações entre a presença do septo, condição dentária, idade e sexo, com 5% de significância, usando-se o SPSS20. Resultados: o septo no seio maxilar foi visto em 36,2% dos casos e estava ausente em 63,8%. Quanto à localização, 49,4% dos septos estavam no lado direito e 50,6% no lado esquerdo. Houve septos completos em 22,9% e incompletos em 77,1% dos casos. A localização do septo em maior proporção foi encontrada na parede basal, com 48,2%, seguido pelo setor anterior e medial do seio maxilar. O comprimento médio foi de 6,86 mm. Houve associação entre a frequência do septo e o sexo dos pacientes (teste Qui-quadrado de Pearson, p=0,015, graus de liberdade 1, ᵪ2= 5,894). Conclusão: cada população apresentará variações na localização e tamanho do septo do seio maxilar que devem ser cuidadosamente estudadas por TCFC para evitar rompimento da membrana e outras intercorrências que levam ao insucesso das terapias regenerativas e restauradoras.

Objectives: to evaluate the presence of the sinus septa in a Peruvian population. Materials and methods: a cross-sectional study was performed on 298 maxillary sinuses of patients referred to the Oral and Maxillofacial Radiology Service of the Arzobispo Loayza National Hospital, Lima, Peru. The presence of the septum, the number, location, length and orientation of the evaluated, as well as age, gender, type of dentulism were quantified in conical beam computed tomography (CTT) images using CS 3D Imaging software. The Chi-square test was performed to try to identify associations between the presence of the septum, dental condition, age and sex, with 5% of signifi cance, using SPSS20. Results: the septum in the maxillary sinus was seen in 36.2% of the cases and absent in 63.8%. Regarding the location, 49.4% of the septa on the right side and 50.6% on the left side. There were complete septa in 22.9% and incomplete septa in 77.1% of the cases. The location of the septum in greater proportion was found in the basal wall with 48.2%, followed by the anterior and medial sector of the maxillary sinus. The average length was 6.86 mm. There was an association between septum frequency and patients' gender (Pearson's Chi-Square test, p=0.015, degrees of freedom 1, ᵪ2 = 5.894). Conclusions: each population will present variations in the location and size of the septum of the maxillary sinus that must be carefully studied by CBCT to avoid membrane rupture and other intercurrences that lead to the failure of regenerative and restorative therapies.

Anatomía radicular, una mirada desde la micro-cirugía endodóntica: Revisión / Root anatomy, a view from the microsurgery endodontic: Review

Resumen El conocimiento de ia anatomía radicular de cada uno de los grupos de dientes, es un aspecto importante que contribuye juntos con otros aspectos clínicos, a un mejor resultado de los procedimientos de micro-cirugía endodóntica (MCE). Variaciones anatómicas entre individuos de una misma población, suscitan para el endodoncista, una evaluación diagnóstica detallada de cada caso en particular para facilitar el abordaje quirúrgico. El objetivo de esta revisión es realizar una descripción de la anatomía radicular y del sistema de conductos radiculares de los diferentes grupos de dientes y sus variaciones anatómicas según la literatura científica disponible a la fecha, que permitirá al clínico tener una visión más amplia y detallada, que podrá aplicar para la planeación y ejecución de los procedimientos de MCE.

Knowing the root anatomy of each groups of teeth, it is an important aspect that contributes with other clinical aspects, to a better outcome of the procedures in endodontic micro-surgery(MCE). Anatomical variations between individuals of the same population, arise in the endodontist, a detailed diagnostic evaluation of each particular case, which will facilitate the surgical approach. The objective of this review is to describe the anatomy and root canal system of different groups of teeth and anatomical changes according to available scientific literature to date, allowing the clinician to have a more comprehensive and detailed vision, you can apply for the planning and execution of procedures for MCE.

Peripheral osteoma in the ramus of mandible: report of case / Osteoma periférico en la rama mandibular: reporte de caso

The osteomas are benign rare neoplasms, generally asymptomatic which are characterized by the proliferation of a compact or spongy bone. When they are situated in the maxillofacial area, they affect mainly the mandible, the frontal bone and the paranasal sinus. We have described the case of a female caucasian patient who presented an increased volume in the posterior region of the oral vestibule on the left side. During the clinical examination an oral lesion was observed in the region of the left ramus of mandible. This lesion was motionless, consistent, and painless when palpated. In the image obtained from the computed tomography cone-beam (CBCT), we could observe an hyperdense, cylindrical region, with well defined borders, located in the medial surface of the left ramus of mandible, right below the mandibular notch. Based on clinical data and in the obtained images, we could confirm the presence of the peripheral osteoma in the left side of the ramus of mandible region.

Los osteomas son neoplasias benignas, raras, en la mayoría de los casos asintomáticas, que se constan principalmente de hueso maduro, compacto o esponjoso. De acuerdo a su ubicación en la región maxilofacial, la mandibula, el hueso frontal y los senos paranasales son preferentemente afectados. Describimos un caso de un paciente, sexo femenino, caucásica, que presentaba un aumento de volumen en la región posterior del vestíbulo oral en el lado izquierdo. Al examen clínico se observó una lesión inmóvil, consistente e indolora a la palpación. En la imagen obtenida a través del tomógrafo computado volumétrico Cone Beam (CBCT), se observó una región híperdensa, cilíndrica, con márgenes marcados, ubicada en la cara medial de la rama mandibular izquierda, inferior a la escotadura mandibular. Con base en los datos clínicos y las imágenes obtenidas se puede concluir la presencia de osteoma periférico en región de rama mandibular izquierda.