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1.
Article in Spanish | LILACS, CUMED | ID: biblio-1550859

ABSTRACT

Introducción: El conocimiento adecuado de la configuración de conductos radiculares es fundamental en endodoncia; la evaluación tomográfica permite una correcta evaluación de su disposición radicular. Objetivo: Determinar la prevalencia de conductos en C de segundos molares mandibulares, evaluados en tomografía de haz cónico. Métodos: Se realizó un estudio descriptivo y de corte transversal; la muestra estuvo conformada por 200 segundos molares mandibulares permanentes de una población peruana, observadas en tomografías cone beam, donde se registró la presencia del conducto en C, su configuración según la clasificación de Fan y el sexo del paciente. Resultados: La prevalencia de la configuración radicular en forma de C en segundos molares inferiores fue del 65,5 por ciento; según la Clasificación de Fan se observó mayor prevalencia en el tercio cervical del conducto radicular el tipo C1 con 85,7 por ciento; en el tercio medio el tipo C2 con 42,9 por ciento; a nivel apical fue el tipo C3C con 72,1 por ciento; según el sexo, el 65,2 por ciento de los conductos en C correspondió al femenino. Conclusión: La prevalencia de los conductos en C de los segundos molares mandibulares evaluados en tomografías de haz cónico fue de 65,5 por ciento con mayor predominio en el sexo femenino. La evaluación tomográfica permite una mejor identificación y configuración interna de los conductos radiculares(AU)


Introduction: Adequate knowledge of the configuration of root canals is fundamental in endodontics; tomographic evaluation allows a correct assessment of their radicular arrangement. Objective: To determine the prevalence of C-shaped canals in mandibular second molars, evaluated by cone beam tomography. Methods: A descriptive and cross-sectional study was carried out; the sample consisted of 200 permanent mandibular second molars from a Peruvian population, observed in cone beam tomography, where the presence of the C-shaped canal, its configuration according to Fan's classification and the patient's gender were recorded. Results: The prevalence of the C-shaped root canal configuration in lower second molars was 65.5 percent; according to the Fan classification, the highest prevalence was observed in the cervical third of the root canal, type C1 with 85.7 percent; in the middle third, type C2 with 42.9 percent; at the apical level it was type C3C with 72.1 percent; according to gender, 65.2 percent of the C-shaped canals corresponded to females. Conclusion: The prevalence of C-shaped canals in mandibular second molars evaluated in cone beam tomography was 65.5% with a higher predominance in the female gender. The tomographic evaluation allows a better identification and internal configuration of the root canals(AU)


Subject(s)
Humans , Dental Pulp Cavity/abnormalities , Cone-Beam Computed Tomography/methods , Epidemiology, Descriptive
2.
Int. j. odontostomatol. (Print) ; 17(3): 255-263, sept. 2023. ilus
Article in Spanish | LILACS | ID: biblio-1514379

ABSTRACT

Aquellos casos en que se excede la fórmula dentaria normal primaria de 20 dientes o definitiva de 32 dientes se conocen como dientes supernumerarios o hiperodoncia. Los supernumerarios se pueden presentar de manera única o múltiple y de forma heteromórfica o eumórfica. El supernumerario más prevalente es el mesiodens, se da más en hombres, en dentición permanente y en el maxilar. Su etiología no está confirmada, pero puede deberse a una hiperactividad de la lámina dental. El tratamiento varía de acuerdo a cada paciente según si está afectando a la dentición normal o no y el desarrollo que tengan las estructuras dentarias. El siguiente reporte de caso habla de un paciente de 6 años, no sindrómico, en donde se presentó con un mesiodens erupcionado y se encontraron más supernumerarios gracias a la radiografía complementaria.


Those cases in which the primary normal dental formula of 20 teeth or the final one of 32 teeth is exceeded are known as supernumerary teeth or hyperdontia. The supernumeraries can be presented in a single or multiple way and in a heteromorphic or eumorphic way. The most prevalent supernumerary is the mesiodens, it occurs more in men, in the permanent dentition and in the maxilla. Its etiology is not confirmed, but it may be due to hyperactivity of the dental lamina. The treatment varies according to each patient depending on whether it is affecting the normal dentition or not and the development of the dental structures. The following case report talks about a 6-year-old, non- syndromic patient, who presented with an erupted mesiodens and more supernumeraries were found thanks to the complementary radiography.


Subject(s)
Humans , Female , Child , Tooth, Supernumerary/diagnostic imaging , Cone-Beam Computed Tomography/methods , Tooth, Supernumerary/pathology
3.
Int. j. odontostomatol. (Print) ; 17(3): 372-383, sept. 2023. ilus, tab
Article in Spanish | LILACS | ID: biblio-1514383

ABSTRACT

Canalis sinuosus, canal intraóseo localizado en región maxilar anterior, contiene elementos vasculonerviosos alveolares anterosuperiores. Diversas intervenciones en región maxilar anterior como colocación de implantes, exodoncias, instalación de microtornillos ortodóncicos, procedimientos quirúrgicos, entre otros, pueden comprometer al Canalis sinuosus y/o sus canales accesorios dañando los elementos contenidos en su interior causando complicaciones como hemorragias, parestesia, disestesia, etc. Dado el gran desconocimiento de su existencia, el Canalis sinuosus frecuentemente es confundido con lesiones patológicas y/o endodónticas. Clásicamente la literatura lo describe como una variación anatómica variación anatómica, sin embargo, presenta elevadas prevalencias (51,7 %-100 %), siendo cuestionada esta aseveración. Determinar prevalencia y característica s anatómicas del Canalis sinuosus mediante Cone Beam CT en pacientes chilenos del centro radiológico IMAPROX® entre 2017- 2021. Análisis retrospectivo de 220 CBCT maxilares anonimizados, considerando variables sexo, presencia del Canalis sinuosus, Canalis sinuosus uni/bilateral, diámetro mayor del Canalis sinuosus, presencia/número de accesorios. Análisis estadístico uni y bivariado. 100 % de prevalencia del Canalis sinuosus en ambos sexos, presencia bilateral 100 %. Diámetro mayor promedio del Canalis sinuosus: 2,58 mm. El 76,8 % presentó accesorios, siendo más prevalente la presencia de 2 CA (34,1 %). Una estructura anatómica normal habitual debe presentar sobre 50 % de prevalencia para ser considerada como tal, pero no hay consensos en criterios empleados para definir variación anatómica o estructura anatómica normal habitual. Literatura describe al Canalis sinuosus como variación anatómica, pero estudios actuales muestran elevadas prevalencias: Rusia 67 %, Brasil 88 %, Turquía, Colombia y Chile 100 %. Este estudio encontró 100 % de prevalencia, sugiriendo que Canalis sinuosus es una estructura anatómica normal habitual. Sin embargo, Canalis sinuosus es poco conocido asociándose a numerosas complicaciones por procedimientos odontológicos y/o quirúrgicos en RMA pudiendo generar hemorragias, parestesia/disestesia, dolor agudo, etc. Elevadas prevalencias reportadas sugieren que Canalis sinuosus es una estructura anatómica normal habitual y no una variación anatómica, pero se requieren más estudios y consensos para aseverarlo. Es de relevancia clínica conocer la existencia y localización del Canalis sinuosus para evitar complicaciones.


Canalis sinuosus, an intraosseous canal located in the anterior maxillary region, contains anterosuperior alveolar vascular-nervous elements. Various interventions in anterior maxillary region such as implant placement, extractions, installation of orthodontic microscrews, surgical procedures, among others, can compromise the Canalis sinuosus and/or its accessory canals, damaging the elements contained inside, causing complications such as bleeding, paresthesia, dysesthesia, etc. Given the great ignorance of its existence, Canalis sinuosus is frequently confused with pathological and/or endodontic lesions. Classically, the literature describes it as an anatomical variation, however, it presents high prevalence (51.7 %-100 %), this assertion being questioned. Objective: to determine the prevalence and anatomical characteristics of Canalis sinuosus using Cone Beam CT in Chilean patients from the IMAPROX® radiological center between 2017-2021. Retrospective analysis of 220 anonymous maxillary CBCT, considering variables sex, presence of Canalis sinuosus, uni/bilateral Canalis sinuosus, largest diameter of Canalis sinuosus, presence/number of accessory canals. Univariate and bivariate statistical analysis. The 100 % prevalence of Canalis sinuosus in both sexes, 100 % bilateral presence. Canalis sinuosus average major diameter: 2.58 mm, 76.8 % presented accessory canals, with the presence of 2 accessory canals being more prevalent (34.1 %). A habitual normal anatomical structure must have a prevalence of over 50 % to be considered as such, but there is no consensus on the criteria used to define anatomical variation or normal anatomical structure. Literature describes Canalis sinuosus as anatomical variation, but current studies show high prevalence: Russia 67 %, Brazil 88 %, Turkey, Colombia and Chile 100 %. This study found 100 % prevalence, suggesting that Canalis sinuosus is an normal anatomical structure. However, Canalis sinuosus is little known as it is associated with numerous complications from dental and/or surgical procedures in anterior maxillary region, which can cause bleeding, paresthesia/ dysesthesia, acute pain, etc. High reported prevalences suggest that Canalis sinuosus is an normal anatomical structure and not an anatomical variation, but more studies and consensus are required to confirm this. It is clinically relevant to know the existence and location of Canalis sinuosus to avoid complications.


Subject(s)
Humans , Male , Female , Cone-Beam Computed Tomography/methods , Maxilla/anatomy & histology , Chile/epidemiology , Prevalence , Anatomic Variation
4.
J.health med.sci. ; 9(3): 65-74, jul.2023. graf, ilus, tab
Article in Spanish | LILACS | ID: biblio-1524689

ABSTRACT

Las nuevas tecnologías para el tratamiento del cáncer con radiación ionizante tienen especial interés en mejorar la calidad de las imágenes para el posicionamiento adecuado del paciente con sistemas de radioterapia guiada por imagen IGRT. El sistema Halcyon cuenta con imágenes de tomografía computarizada de haz de cono CBCT. Estas imágenes podrían ser una opción para escenarios donde no se cuente con una Tomografía Computarizada CT o el equipo se encuentre en reparación o mantenimiento especialmente para escenarios de intensión paliativa. La diferencia en la distribución de dosis en imágenes CT y CBCT fue analizada en este estudio. Los resultados mostraron diferencias en las unidades Hounsfield UH, aunque no fueron estadísticamente significativas, el volumen irradiado mostro diferencias máximas de 3,92% que no supera el 4% permitido para tratamientos de intensión paliativa. En cuanto a las dosis dispersas al tejido sano la diferencia tampoco supera el 4%. Nuestro estudio mostro que las imágenes CBCT pueden ser una alternativa para el tratamiento de metástasis óseas, sin embargo, estas imágenes todavía no pueden remplazar las imágenes CT utilizadas para el cálculo de dosis en radioterapia


New technologies for the treatment of cancer with ionizing radiation are of particular interest in improving image quality for proper patient positioning with image-guided radiation therapy IGRT systems. IGRT image-guided radiation therapy systems. The Halcyon system features cone beam computed tomography CBCT imaging. These images could be an option for scenarios where a CT scan is not available or the equipment is under repair or maintenance especially for is under repair or maintenance, especially for palliative scenarios. The difference in the The difference in dose distribution in CT and CBCT images was analyzed in this study. The results showed differences in Hounsfield UH units, although not statistically significant, the irradiated volume showed maximum differences of 3.92%, which is the maximum difference of 3.92%. Differences of 3.92%, which does not exceed the 4% allowed for palliative treatments. As for the doses dispersed to healthy tissue the difference does not exceed the 4% allowed for palliative treatments. Our study showed that CBCT imaging can be an alternative for the treatment of metastases. an alternative for the treatment of bone metastases, however, these images cannot yet replace the CT images used for dose calculation. CT images used for dose calculation in radiotherapy


Subject(s)
Humans , Bone Neoplasms/radiotherapy , Radiotherapy, Image-Guided/methods , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted/methods , Tomography, X-Ray Computed/methods , Cone-Beam Computed Tomography/methods
5.
Rev. Fac. Odontol. (B.Aires) ; 38(88): 9-13, 2023. ilus
Article in Spanish | LILACS | ID: biblio-1551596

ABSTRACT

Se presentó a la Cátedra de Endodoncia de la Facultad de Odontología de la Universidad de Buenos Aires un paciente masculino de 62 años de edad que al examen clínico presentaba una fístula vestibular en la zona de la pieza 1.2 y dolor a la percusión. Al examen radiográ-fico se identificó una lesión apical extensa abarcando las piezas dentarias 1.2 y 1.1 endodónticamente trata-das con alteración severa de la anatomía del espacio endodóntico, así como la presencia de postes metáli-cos que no respetaban el eje del canal radicular. Ante el análisis tomográfico se observó una perforación de la pieza 1.2 y una lesión periapical extensa afectando ambas corticales (vestibular y palatina). Se decidió un abordaje microquirúrgico con técnicas de regenera-ción ósea guiada (ROG) y se realizaron los controles clínico-tomográficos a los 6, 12 y 24 meses. Por otro lado, se evaluó con micromografía de rayos X la ana-tomía de los ápices radiculares resecados. La lesión extirpada fue analizada histológicamente (AU)


A 62-year-old male patient attended the Endodontics department of the Buenos Aires University. He was examined clinically and a vestibular fistula in 1.2 area and pain under percussion were found. Radiographic examination identified an extended periapical lesion compromising teeth 1.2 and 1.1 with endodontic treatment severely altering the root canal anatomy, as well as metallic cast posts that did not preserve root canal axis. Regarding the tomographic analysis, a vestibular root perforation was observed (1.2), and both, vestibular and palatal corticals, were affected. We decided to perform a surgical approach with guided bone regeneration techniques (GBR). Clinical-CBCT controls were done at 6, 12 and 24 months. Furthermore, the anatomy of the resected root apex-es was evaluated with X ray microtomography. The removed lesion was histologically analyzed (AU)


Subject(s)
Humans , Male , Middle Aged , Periapical Periodontitis/surgery , Argentina , Schools, Dental , Cone-Beam Computed Tomography/methods , Membranes, Artificial
6.
West China Journal of Stomatology ; (6): 426-433, 2023.
Article in English | WPRIM | ID: wpr-1007924

ABSTRACT

OBJECTIVES@#This study aimed to investigate the feasibility of measuring the soft tissue height of bone cristae around implant by digital method.@*METHODS@#A total of 36 patients with dental implants were selected from the Dental Medicine Center of the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) from August 2022 to December 2022. A total of 43 dental implants were enrolled. All postoperative cone beam CT (CBCT) imaging data and intraoral digital impressions obtained before surgery were immediately obtained by the patients on the day of completion of oral implant surgery and they were imported into oral implant surgery planning software for image fitting. Then, virtual implants of the same specification were placed in the planting area, and the implant position was adjusted to overlap with the implant shadow in the CBCT image. Supracrestal tissue height (STH) was measured at the implant view interface (digital group). During the operation, implant holes were prepared step by step in accordance with the standard preparation method, and implants were implanted. The upper edge of the implant was flushed with the crest of the alveolar ridge. STH was measured by perio-dontal probing (periodontal probe group). Paired t-test was used to compare the STH differences between the digital and periodontal probe groups. Bland-Altman test was used to analyze the consistency of the two methods. Intra-group correlation coefficient (ICC) was used to verify the reliability of the results measured by different surveyors using di-gital methods.@*RESULTS@#No statistical significance was observed in the STH difference between the two methods (P>0.05). Bland-Altman test showed good consistency between the two methods, but the measurement of mandibular posterior teeth showed that the results of periodontal probe were greater than those of digital method. The ICC and 95%CI of the STH results measured digitally by different surveyors are 0.992 (0.986-0.996).@*CONCLUSIONS@#The digital me-thod is in good agreement with the periodontal probe method in measuring the soft tissue height of the bone cristae around the implant.


Subject(s)
Humans , Alveolar Process/diagnostic imaging , Cone-Beam Computed Tomography/methods , Dental Implants , Feasibility Studies , Reproducibility of Results , Tooth/diagnostic imaging
7.
Journal of Peking University(Health Sciences) ; (6): 114-119, 2023.
Article in Chinese | WPRIM | ID: wpr-971282

ABSTRACT

OBJECTIVE@#To investigate the clinical application of cone-beam computed tomography (CBCT) among endodontic practitioners, and to analyze the indications and reasonability of CBCT in the diagnosis and treatment of pulpal and periapical diseases.@*METHODS@#The clinical data were collected from patients who visited the Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology and underwent CBCT examination from January to December, 2021. The data with their complete clinical information (including clinical records, radiology request forms/reports, two-dimensional and three-dimensional imaging data) were included. Those who underwent CBCT examination for orthodontic or prosthodontics were excluded. The experience and training background of the endodontic specialists, the number of patients treated in the whole year, the objective and region of interest (ROI) of CBCT examination, technical parameters, such as machine type, field of view (FoV) and radiographic reports were collected and analyzed to evaluate the impact on diagnosis. Wilcoxon and Mann-Whitney tests were used to compare the distribution of CBCT ROI. Chi-squared test and pairwise comparison were used to compare the application of CBCT by endodontic specialists with different clinical experience (senior, middle and junior).@*RESULTS@#In 2021, a total of 3 308 CBCT scans were prescribed by 61 endodontic specialists who treated 34 952 patients throughout the year. 3 218 patients (male ∶female about 1 ∶2) amounting for 10% of the patients treated in the whole year who received CBCT scans with an median age of 35 years (28, 49). Around 98% CBCT examinations were performed after clinical examination and two-dimensional periapical radiographs were taken. The FoV of CBCT scanning less than 10 cm×10 cm accounted for 96% of the total number of the images. Among the 3 308 CBCT scans, 83% of the ROI were in posterior teeth, with a higher number of anterior teeth (Z=-2.278, P < 0.05). Maxillary and mandibular first molars accounted for 35% of the examined teeth. The objectives of CBCT scanning included three aspects: clarifying clinical diagnosis, guiding surgical and non-surgical endodontic treatment (including management of endodontic complications), and outcome assessment, accounting for 1 111 (34%), 1 745 (54%), 311 (10%), respectively. and the others 2%. In the diagnosis process, CBCT was mainly used for the diagnosis of chronic periapical periodontitis, root fracture, root resorption and dental trauma. In the study, 353 CBCT were used in the diagnosis of root fracture, with a positive diagnosis rate of 35% (125/353). 846 CBCT used to reveal the anatomy of the root canal system, of which 297 cases were used to find missed/extra canals after treatment failure, and 58% (171/297) were used to confirm the missed/extra canals. In the management of complications or errors, CBCT was mainly used to assist the diagnosis of perforation and to locate the separated instruments. In the study, 311 CBCT scans were used for outcome assessment, including 240 cases related to non-surgical treatment and 71 cases related to surgical endodontic treatment for follow-up or presence of clinical symptoms, and persistent lesions on 2D films. Among the 61 endodontic specialists who used CBCT, 23 (45%) were with senior experience, 15 (30%) with middle experience, and 23 (25%) with junior experience. The proportion of senior or junior experience prescribing CBCT examination was 10%, higher than that of middle experience (8%, χ12=39.4, χ22=29.1, P < 0.001). The application rate of chief endodontists was 18%, which was higher than that of associate chief endodontists (9%, χ12=139.4, P < 0.001). 31% (1 109/3 308) cases of diagnosis or treatment plans were changed after CBCT was taken.@*CONCLUSION@#Use of CBCT in endodontic practice could provide more clinical information, which is helpful for diagnosis, accurate treatment and prognosis evaluation.


Subject(s)
Humans , Male , Adult , Prevalence , Root Canal Therapy/methods , Cone-Beam Computed Tomography/methods , Tooth , Imaging, Three-Dimensional
8.
Journal of Peking University(Health Sciences) ; (6): 52-61, 2023.
Article in Chinese | WPRIM | ID: wpr-971273

ABSTRACT

OBJECTIVE@#To evaluate the changes of periodontal phenotype (width of keratinized gingiva, thickness and height of alveolar bone) of lower anterior teeth in patients with skeletal class Ⅲ malocclusion before and after the periodontal-orthodontic-orthognathic combined treatment.@*METHODS@#In the study, 20 patients with skeletal class Ⅲ malocclusion (6 males and 14 females) completed the periodontal-orthodontic-orthognathic combined treatment were included from March 2017 to June 2022, with 39 central incisors, 40 lateral incisors and 40 canines. The mean age was (25.40±4.27) years (20-34 years). The mean follow-up time was (3.70±1.05) years from the beginning of periodontal corticotomy regenerative surgery (PCRS) to the end of the combined treatment. Cone-beam computed tomography (CBCT) was used to measure the thickness, area and height of alveolar bone by the same researcher, taken before the PCRS (T0), 6 months after the PCRS (T1), 12 months after the PCRS (T2), before the orthognathic surgery (T3), and after the periodontal-orthodontic-orthognathic combined treatment (T4). The periodontal clinical parameters were used to evaluate changes in the soft tissue by another researcher, measured before the PCRS (T0) and after the combined treatment (T4). Changes of soft and hard tissue were evaluated by the periodontal phenotype.@*RESULTS@#The width of keratinized gingiva increased significantly (all P < 0.001) in lower anterior teeth, the central incisors, lateral incisors and canines increased by (1.82±1.57) mm, (2.03±1.48) mm and (2.05±1.27) mm, respectively. The proportion of thick periodontal biotype in the central and lateral incisors increased significantly (all P < 0.001), while the changes of periodontal biotypes in the lower canines were not obvious. The thickness of labial alveolar bone of lower anterior teeth all increased significantly after periodontal corticotomy regenerative surgery and the combined treatment (all P < 0.001). The area of labial alveolar bone of lower anterior teeth also increased significantly after the combined treatment (all P < 0.001). The whole area of labial and lingual alveolar bone of central and lateral incisors increased (P < 0.001), while the whole area of canines remained the same. All The height of the alveolar bone increased (all P < 0.001) on the labial side after the treatment.@*CONCLUSION@#The periodontal phenotypes of lower anterior teeth were significantly improved after the periodontal-orthodontic-orthognathic combined treatment in patients with skeletal Angle class Ⅲ malocclusion. The improvement was long-termly stable, and the periodontal risk was reduced.


Subject(s)
Male , Female , Humans , Malocclusion, Angle Class III/surgery , Oral Surgical Procedures , Incisor , Cone-Beam Computed Tomography/methods
9.
Journal of Peking University(Health Sciences) ; (6): 333-338, 2023.
Article in Chinese | WPRIM | ID: wpr-986857

ABSTRACT

OBJECTIVE@#To study the effect of various intracanal materials on the accuracy of oral maxillofacial cone-beam computed tomography (CBCT) for the diagnosis of vertical root fracture (VRF).@*METHODS@#A total of twenty-four structurally intact single root canal dried and isolated teeth extracted for orthodontic treatment or periodontal disease were collected. The teeth were decrowned along the cemento-enamel junction (CEJ) and then used as samples for the study after conventional root canal preparation and post preparation. The 24 samples were divided into two groups with 12 samples in each group. Group A was the control group (no VRF group). According to intracanal materials, they were divided into five subgroups: blank group, fiber post group, gutta-percha point group, titanium post group and gold-palladium post group. Group B was the experimental group (VRF group), and subgroups were grouped as above. The VRF model was prepared by a unified method in the VRF group: the root was completely fractured in the buccolingual direction with a custom root canal nail and then cemented and reset. The control group was not subjected to the simulation of VRF. Titanium post and gold-palladium post were made according to the individuality of the root canal preparation, and the tightness of the post to the root canal wall was confirmed by X-ray radiograph. Then all the samples were scanned by CBCT in the isolate swine mandibular alveolar sockets. The diagnostic accuracy was statistically analyzed via blind interpretation by experienced endodontic specialists and oral and maxillofacial medical imaging specialists.@*RESULTS@#The accuracy of the diagnosis of VRF in the blank group, fiber post group, gutta-percha point group, titanium post group, and gold-palladium post group in CBCT was 95.83%, 91.67%, 87.50%, 79.17%, and 45.83%, respectively. Compared with the blank group, the differences were not statistically significant in the fiber post group (P>0.999), the gutta-percha point group (P=0.500) and the titanium post group (P=0.125). The lowest diagnostic accuracy of VRF was found in the gold-palladium post group, and the difference was statistically significant compared with all other groups (P < 0.001).@*CONCLUSION@#Various intracanal materials have different degrees of influence on the diagnostic accuracy of VRF diagnosis in CBCT. The influence of fiber post, gutta-percha point and titanium post was small, while the influence of gold-palladium post was significant.


Subject(s)
Animals , Cone-Beam Computed Tomography/methods , Gold , Gutta-Percha , Palladium , Swine , Titanium , Tooth Fractures/diagnostic imaging , Tooth Root/injuries , Reproducibility of Results
10.
Chinese Journal of Medical Instrumentation ; (6): 608-611, 2023.
Article in Chinese | WPRIM | ID: wpr-1010248

ABSTRACT

This article briefly describes the imaging performance standards of the kilovolt X-ray image guidance system used in radiotherapy, analyzes the main aspects that should be considered in the image quality of X-IGRT system, and focuses on parameters that should be considered in the imaging performance evaluation criteria of the CBCT X-IGRT. The purpose is to sort out the imaging performance evaluation standards of kilovolt X-IGRT system, clarify the image quality requirements of X-IGRT equipment, and reach a consensus when evaluating the imaging performance of X-IGRT system.


Subject(s)
Radiotherapy Planning, Computer-Assisted/methods , Cone-Beam Computed Tomography/methods , Spiral Cone-Beam Computed Tomography , Radiotherapy, Intensity-Modulated/methods , Radiotherapy, Image-Guided/methods
11.
Journal of Biomedical Engineering ; (6): 894-902, 2023.
Article in Chinese | WPRIM | ID: wpr-1008914

ABSTRACT

For patients with partial jaw defects, cysts and dental implants, doctors need to take panoramic X-ray films or manually draw dental arch lines to generate Panorama images in order to observe their complete dentition information during oral diagnosis. In order to solve the problems of additional burden for patients to take panoramic X-ray films and time-consuming issue for doctors to manually segment dental arch lines, this paper proposes an automatic panorama reconstruction method based on cone beam computerized tomography (CBCT). The V-network (VNet) is used to pre-segment the teeth and the background to generate the corresponding binary image, and then the Bezier curve is used to define the best dental arch curve to generate the oral panorama. In addition, this research also addressed the issues of mistakenly recognizing the teeth and jaws as dental arches, incomplete coverage of the dental arch area by the generated dental arch lines, and low robustness, providing intelligent methods for dental diagnosis and improve the work efficiency of doctors.


Subject(s)
Humans , Radiography, Panoramic/methods , Cone-Beam Computed Tomography/methods , Head , Image Processing, Computer-Assisted/methods
12.
Rev. Fac. Odontol. (B.Aires) ; 38(90): 45-50, 2023. ilus
Article in Spanish | LILACS | ID: biblio-1554019

ABSTRACT

Objetivo: se presenta el caso clínico de sinusitis de origen endodóntico, conocida como síndrome en-doantral, haciendo énfasis en la dificultad de diag-nóstico con radiografía periapical y la importancia de la tomografía computarizada. Caso clínico: una mujer de 32 años, con antecedentes de apretamiento dental nocturno y sinusitis recurrente, fue remitida para evaluación endodóntica. El examen clínico reve-ló sensibilidad a la percusión y palpación en la unidad dental. La radiografía periapical no indicó lesión en el diente 16 y la prueba de sensibilidad pulpar fue ne-gativa, además, la tomografía computarizada reveló una extensa lesión periapical y comunicación entre la raíz del diente 16 y el seno maxilar, confirmada por la pérdida de la continuidad de la imagen hiperdensa en el suelo del seno, lo que llevó al tratamiento endo-dóntico. El control de la infección dental resolvió la sinusitis, resaltando la importancia del diagnóstico preciso y el tratamiento en casos de sinusitis odon-togénica. Conclusión: este caso destaca el valor de la tomografía computarizada como herramienta diag-nóstica crucial en contextos clínicos complejos (AU)


Objective: the clinical case of sinusitis of endodontic origin, known as endoantral syndrome, is presented, emphasizing the difficulty of diagnosis with periapical radiography and the importance of computed tomography. Clinical case: a 32-year-old woman, with a history of tooth clenching and recurrent sinusitis, was referred for endodontic evaluation. The clinical examination revealed sensitivity to percussion and palpation in the dental unit. The periapical radiograph did not indicate a lesion in tooth 16 and the pulp sensitivity test was negative, in addition, the computed tomography revealed an extensive periapical lesion and communication between the root of tooth 16 and the maxillary sinus, confirmed by the loss of continuity of the hyperdense image in the sine floor, which led to endodontic treatment. Dental infection control resolved sinusitis, highlighting the importance of accurate diagnosis and treatment in cases of odontogenic sinusitis. Conclusion: this case highlights the value of computerized tomography as a crucial diagnostic tool in complex clinical contexts (AU)


Subject(s)
Humans , Female , Adult , Maxillary Sinusitis/etiology , Maxillary Sinusitis/diagnostic imaging , Dental Pulp Necrosis/complications , Cone-Beam Computed Tomography/methods , Focal Infection, Dental/complications , Periapical Periodontitis/complications , Root Canal Therapy/methods
13.
Rev. ADM ; 79(6): 312-317, nov.-dic. 2022. ilus, tab
Article in Spanish | LILACS | ID: biblio-1434301

ABSTRACT

Objetivo: analizar, mediante tomografía computarizada de haz cónico (TC o CBCT [Cone Beam Computed Tomograph]) la frecuencia del tipo de morfología interna de los conductos radi- culares según la clasificación de Vertucci y el número de raíces de los primeros premolares superiores. Material y métodos: en una población argentina de 50 pacientes, 30 de sexo femenino y 20 masculino, que concurrieron a la Cátedra de Diagnóstico por Imá- genes de la Facultad de Odontología de la Universidad de Buenos Aires, se evaluaron 100 primeros premolares superiores con CBCT. Se estudiaron las variables: número de raíces, tipo de morfología interna, edad, sexo y lado. Fueron seleccionadas las tomografías de maxilar superior que incluyeron ambos primeros premolares en salud dental, periodontal y con ápice cerrado. Se realizó una adquisición volumétrica 100 × 90 mm y tamaño de vóxel de 150 µm. Se realizó la exploración de las imágenes en el plano axial de los tercios apical, medio y cervical de las piezas 1.4 y 2.4. Se utilizó un corte axial, observando en él, el tercio apical, medio y cervical de las piezas 1.4 y 2.4. Cada premolar fue analizado con 30 cortes transversales. Se utilizó la clasificación de Vertucci para agrupar las distintas variables anatómicas de los conductos radiculares de los primeros premolares superiores, la cual consta de VIII tipolo- gías. Resultados: el tipo más representativo entre los 100 primeros premolares superiores, dentro de la clasificación de Vertucci, fue el tipo IV (dos conductos separados desde la cámara al ápice). La coincidencia de tipos entre los lados derecho (78%; IC 95%: 65 a 87%) e izquierdo (70%; IC 95%: 56 a 81%) fue significativa. La distribución según el número de raíces en el lado derecho (χ 2 = 2.88) e izquierdo (χ2 = 0.72) no presentó una heterogeneidad significativa. La coincidencia del número de raíces entre los lados derecho e izquierdo fue significativa. Conclusión: se comprobó el tipo de morfología interna más frecuente, el número de raíces y su variabilidad de acuerdo al lado, sexo, y edad; lo cual es de una relevante importancia para realizar una correcta instrumentación y obturación del sistema de conductos radiculares (AU)


Objective: to analyze, using cone beam computed tomography (CBCT), the frequency of the type of internal morphology of the root canals according to the Vertucci classification and the number of roots of the first upper premolars. Material and methods: 100 first upper premolars were evaluated with CBCT, which corresponded to 30 female and 20 male patients in the Chair of Diagnostic Imaging of the Faculty of Dentistry, University of Buenos Aires. Variables were studied: number of roots, type of internal morphology, age, sex and side. The tomography of the upper jaw with both first premolars in dental, periodontal and closed apex health, a 100 × 90 mm volumetric acquisition and a voxel size of 150 µm were selected. An axial cut was used, observing the apical, middle and cervical third of pieces 1.4 and 2.4. Each premolar was analyzed with 30 paraxial cuts. The Vertucci classification was used to group the different anatomical variables of the root canals of the first upper premolars which consists of VIII typologies. Results: the most representative type among the top 100 upper premolars within the Vertucci classification was type IV (two separate ducts from the chamber to the apex). The type coincidence between the right (78%; 95% CI: 65 to 87%) and left (70%; 95% CI: 56 to 81%) los primeros premolares superiores, la cual consta de VIII tipolo gías. Resultados: el tipo más representativo entre los 100 primeros premolares superiores, dentro de la clasificación de Vertucci, fue el tipo IV (dos conductos separados desde la cámara al ápice). La coincidencia de tipos entre los lados derecho (78%; IC 95%: 65 a 87%) e izquierdo (70%; IC 95%: 56 a 81%) fue significativa. La distribución según el número de raíces en el lado derecho (χ 2 = 2.88) e izquierdo (χ2 = 0.72) no presentó una heterogeneidad significativa. La coincidencia del número de raíces entre los lados derecho e izquierdo fue significativa. Conclusión: se comprobó el tipo de morfología interna más frecuente, el número de raíces y su variabilidad de acuerdo al lado, sexo, y edad; lo cual es de una relevante importancia para realizar una correcta instrumentación y obturación del sistema de conductos radiculares (AU))


Subject(s)
Humans , Male , Female , Bicuspid/anatomy & histology , Dental Pulp Cavity/anatomy & histology , Dental Pulp Cavity/diagnostic imaging , Cone-Beam Computed Tomography/methods , Argentina , Schools, Dental , Tooth Root/anatomy & histology , Data Interpretation, Statistical , Age and Sex Distribution
14.
Rev. Asoc. Odontol. Argent ; 110(3): 1101211, sept.-dic. 2022. ilus, tab
Article in Spanish | LILACS | ID: biblio-1424821

ABSTRACT

Objetivos: Estudiar con tomografías computadas de haz cónico (CBCT) las lesiones perirradiculares de primeros molares superiores tratados endodónticamente; evaluar la lo- calización y, en los que tenían lesión en la raíz mesiovestibu- lar (MV), evaluar la frecuencia del conducto MV2. Materiales y métodos: A partir de una muestra de 179 tomografías, que incluían primeros molares superiores, se seleccionaron y analizaron aquellas en las cuales estos ha- bían recibido un tratamiento endodóntico previo, presentaban lesiones perirradiculares y conservaban una restauración co- ronaria. Las variables analizadas fueron: la localización de áreas radiolúcidas compatibles con lesiones perirradiculares de origen endodóntico y la correlación entre diferentes loca- lizaciones y la calidad del tratamiento realizado (adecuado, defectuoso o sin tratamiento). Los datos fueron analizados mediante la prueba de chi-cuadrado y la prueba de Spearman. Resultados: De las 179 CBCT que incluían primeros molares superiores, 90 reunían las condiciones requeridas. La frecuencia de las lesiones perirradiculares fue significativa- mente mayor en la raíz MV al compararla con las raíces disto- vestibular y palatina (p<0,05). El conducto MV1 presentó un tratamiento adecuado en todos los casos. El conducto MV2 recibió un tratamiento adecuado en 4 casos (4,44%), defec- tuoso en 4 casos (4,44%) y no tratado en 82 casos (91,1%); con una diferencia estadísticamente significativa (p<0,05). Conclusiones: En la muestra analizada, la localización de lesiones perirradiculares postratamiento endodóntico en primeros molares superiores se encontró con mayor frecuencia asociada a la raíz mesiovestibular, donde en la mayoría de los casos el con- ducto MB2 no fue tratado o presentó un tratamiento defectuoso (AU)


Aim: To study with cone-beam computed tomography (CBCT) the periradicular lesions of maxillary first molars with endodontical treatment; to evaluate its localization and, in those with a mesiobuccal root (MB) injury, assess the fre- quency of the MB2 root canal. Materials and methods: From a sample of 179 tomog- raphies (CBCT) that included maxillary first molars, those in which they had received previous endodontic treatment, pre- sented periradicular lesions and had a coronary restoration were selected and analyzed. The analyzed variables were: localization of radiolucent areas compatible with periradic- ular lesions of endodontic origin and the correlation between different localizations and quality of the performed treatment (adequate, defective, or untreated). Data were analyzed by the chi-square test and the Spearman test. Results: Of the 179 CBCT that included maxillary first molars, 90 met the required conditions. The frequency of periradicular lesions was significantly higher in the MB root when compared with distobuccal and palatal roots (P<0,05). The MB1 canal presented an adequate treatment in all cas- es. The MB2 canal received adequate treatment in 4 cases (4.44%), a defective one in 4 cases (4.44%) and was untreated in 82 cases (91.1%). The differences among these frequencies were statistically significant (P<0.05). Conclusions: In the analyzed sample, the localization of periradicular lesions after endodontic treatment in maxillary first molars was associated more frequently with the mesio- buccal root in which in the majority of cases the MB2 canal was untreated or presented a defective treatment


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Periapical Periodontitis/epidemiology , Root Canal Therapy/adverse effects , Tooth, Nonvital/diagnostic imaging , Cone-Beam Computed Tomography/methods , Argentina/epidemiology , Root Canal Therapy/statistics & numerical data , Schools, Dental , Tooth Root/injuries , Chi-Square Distribution , Dental Restoration Failure/statistics & numerical data , Molar/injuries
15.
Rev. Asoc. Odontol. Argent ; 110(3): 1101233, sept.-dic. 2022. ilus
Article in Spanish | LILACS | ID: biblio-1425918

ABSTRACT

Objetivo: La reabsorción dentinaria interna es un pro- ceso causado por la actividad odontoclástica asociada princi- palmente a la inflamación pulpar crónica y/o traumatismos, y se caracteriza por la pérdida progresiva de tejido dentinario y la posible invasión al cemento. El presente informe describe el diagnóstico y tratamiento de un molar inferior que presentó un cuadro sintomático de reabsorción dentinaria interna. Caso clínico: Un paciente de 38 años fue derivado a la consulta por presentar una zona de reabsorción interna en un segundo molar inferior. Durante el examen clínico y ra- diográfico se tomó una radiografía preoperatoria periapical con radiovisiógrafo en la que se observó la presencia de un área compatible con el diagnóstico de reabsorción dentinaria interna, el que fue posteriormente confirmado por medio de una tomografía computada de haz cónico. La imagen de la lesión se presentó como una zona radiolúcida deformante de bordes nítidos, localizada a nivel de la cámara pulpar. El tra- tamiento consistió en la extirpación de la pulpa coronaria y de la instrumentación, desinfección y obturación de los conduc- tos radiculares y la cavidad de acceso. En el control clínico y radiográfico realizado luego de 3 años se observó que el paciente estaba asintomático y las estructuras perirradiculares se encontraban dentro de los límites normales. La observación histológica del material removido de la cámara pulpar reveló la presencia de un tejido granulomatoso con numerosos vasos sanguíneos y escasos focos micro hemorrágicos. Hasta el momento, el tratamiento endodóntico es el pro- cedimiento indicado para el tratamiento de la reabsorción dentinaria interna. Se destaca la importancia de la tomografía computada de haz cónico para el diagnóstico y tratamiento temprano de las reabsorciones dentinarias internas a efectos de contar con un pronóstico favorable (AU)


Aim: Internal dentine resorption is aprocess caused by odontoclastic activity, mainly associated with chronic pulpal inflammation and/or trauma, and it'scharacterized by a pro- gressive loss of dentine tissue and the possible invasion of the cementum. This report describes the diagnosis and treatment of a lower molar that presented a symptomatic case of inter- nal dentine resorption. Clinical case: A 38-years old patient was referred to the office because of presenting an area of internal resorption in a lower second molar. During clinical and radiographic exam- ination, a periapical preoperative radiograph with radiovisio- graph was taken, in which the presence of an area compatible with the diagnosis of internal dentine resorption was observed, which was later confirmed by a cone-beam computed tomog- raphy.The image of the lesion was presented as a deforming radiolucent area with sharp edges, located at pulp chamber level. Treatment consisted of the removal of the coronary pulp and the instrumentation, disinfection and filling of the root ca- nals and the access cavity. In the clinical and radiographic control carried out 3 years after procedure, it was observed that the patient was asymptomatic and the periradicular struc- tures were within normal limits. The histological observation of the removed material from the pulp chamber revealed the presence of a granulomatous tissue with numerous blood ves- sels and scarce micro hemorrhagic focus. Until now, the endodontic treatment is the indicated pro- cedure to treat internal dentine resorption. It is necessary to highlight the importance of the cone-beam computerized to- mography for the early diagnosis and treatment of internal dentine resorptions in order to have a favorable outlook (AU)


Subject(s)
Humans , Male , Adult , Root Resorption/therapy , Root Resorption/diagnostic imaging , Tooth Crown/physiopathology , Root Canal Therapy/methods , Follow-Up Studies , Dental Pulp Diseases/complications , Cone-Beam Computed Tomography/methods , Molar/physiopathology
16.
Rev. cuba. estomatol ; 59(3)sept. 2022.
Article in Spanish | LILACS, CUMED | ID: biblio-1441568

ABSTRACT

Introducción: La identificación, interpretación y manejo de hallazgos incidentales en imagenología dental es imprescindible. Algunos de ellos requieren técnicas de imagen adicionales y remisión a profesionales de experiencia, otros únicamente su descripción. Una de estas variantes anatómicas se halla en el clivus, la fossa navicularis magna, asociada en pocos casos a repercusiones sistémicas. Objetivo: Describir las características de la fossa navicularis magna para su identificación mediante tomografía computarizada de haz cónico. Presentación de los casos: Tres pacientes de sexo femenino, con un rango de edad entre 35-71 años que acuden al Centro Odontológico de la Universidad San Martín de Porres para tratamientos de ortodoncia y rehabilitación oral. En estas áreas, como parte del protocolo se solicita tomografía computarizada de haz cónico por pieza retenida y elaboración de guías quirúrgicas respectivamente. El escaneo permite la identificación de un defecto tipo muesca en el clivus, de límites bien definidos y bordes corticalizados, lo que sugiere fossa navicularis magna. La historia clínica de los pacientes no sugirió implicaciones clínicas. Principales comentarios: Se informa y discute esta variante anatómica cuya presencia no requiere tratamiento y generalmente no tiene repercusiones sistémicas. En contados casos ha estado asociado con cuadros clínicos que amenazan la vida del paciente, precisamente porque puede servir como un trayecto para infecciones intracraneales. De ahí la necesidad de conocer y describir esta variante anatómica(AU)


Introduction: The identification, interpretation and management of incidental findings in dental imaging is essential. Some of them require additional imaging techniques and referral to experienced professionals, others only their description. One of these anatomical variants is found in the clivus, fossa navicularis magna, associated in few cases with systemic repercussions. Objective: Describe the characteristics of fossa navicularismagna for its identification by cone-beam computed tomography. Presentation of cases: Three female patients, with an age range between 35-71 years who come to the Dental Center of San Martín de Porres University for orthodontic treatments and oral rehabilitation. In these areas, as part of the protocol, cone-beam computed tomography per retained piece and development of surgical guides are requested, respectively. The scan allows the identification of a notch-like defect in the clivus, of well-defined boundaries and corticalized edges, suggesting fossa navicularis magna. The patients' medical history did not suggest clinical implications. Main comments: This anatomical variant is reported and discussed and its presence does not require treatment and generally has no systemic repercussions. In rare cases it has been associated with clinical pictures that threaten the patient's life, precisely because it can serve as a path for intracranial infections. Hence the need to know and describe this anatomical variant(AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Cranial Fossa, Posterior/abnormalities , Cone-Beam Computed Tomography/methods
17.
Rev. cuba. estomatol ; 59(2): e3855, abr.-jun. 2022. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1408396

ABSTRACT

Introducción: La ruptura de una aguja dental es una complicación infrecuente y sucede generalmente por el movimiento repentino y/o cierre bucal inesperado del paciente, por doblar la aguja en forma inadecuada, por insertarla completamente o moverla dentro del tejido blando, por elegir agujas de calibre y longitud inadecuados y al realizar técnicas anestésicas inapropiadas. Cuando la aguja no puede ser recuperada al instante, debe establecerse su ubicación imagenológica tridimensional y decidir el manejo. Ante tal situación, su eliminación quirúrgica es la propuesta más recomendable por la posibilidad de que migre y lesione estructuras anatómicas importantes. Objetivo: Realizar una revisión de la literatura y presentar un caso clínico de ruptura de aguja dental localizada en el espacio pterigomaxilar, resuelto con un abordaje intrabucal laterofaríngeo. Presentación de caso: Paciente masculino de 8 años de edad, que acude a consulta por presentar ruptura de una aguja dental. Para obtener su ubicación se utilizó una tomografía computarizada de haz cónico con reconstrucción tridimensional a boca cerrada y abierta. Esta prueba ofreció mayor precisión y correspondencia anatómica, considerando que la eliminación quirúrgica podría realizarse mediante un abordaje intrabucal. Así fue hecho y durante la intervención quirúrgica se advirtió que la aguja había migrado a una ubicación superior y posterior, al espacio pterigomaxilar. Ante tal situación, resultó de mayor complejidad su recuperación, que ya presentaba riesgos por el procedimiento complejo al que se sometió. Conclusiones: La anestesia local intrabucal no está exenta de complicaciones propias como la ruptura de la aguja dental. Cuando este evento se presenta, el resultado puede ser de muy difícil manejo(AU)


Introduction: The rupture of a dental needle is an uncommon complication and usually happens due to the sudden movement and / or unexpected oral closure of the patient, by bending the needle improperly, by inserting it completely or moving it into the soft tissue, by choosing needles of inadequate caliber and length and by performing inappropriate anesthetic techniques. When the needle cannot be recovered instantly, its three-dimensional imaging location must be established and handling decided. In such a situation, its surgical elimination is the most recommended proposal due to the possibility of migrating and injuring important anatomical structures. Objective: Conduct a literature review and present a clinical case of dental needle rupture located in the pterygomaxillary space, resolved with a lateropharyngeal intraoral approach. Case presentation: An 8-year-old male patient, who comes to the consultation for a ruptured dental needle. To obtain its location, a cone-beam computed tomography with three-dimensional reconstruction was used at closed and open mouth. This test offered greater precision and anatomical correspondence, considering that surgical removal could be performed by an intraoral approach. This was done and during the surgical intervention it was noticed that the needle had migrated to an upper and posterior location, to the pterygomaxillary space. Faced with this situation, his recovery was more complex, in addition to the one that this procedure represents by itself. Conclusions: Intraoral local anesthesia is not exempt from its own complications such as the rupture of the dental needle. When this event occurs, the result can be very difficult to manage(AU)


Subject(s)
Humans , Male , Child , Surgical Procedures, Operative/methods , Cone-Beam Computed Tomography/methods , Needles , Review Literature as Topic , Correspondence as Topic , Imaging, Three-Dimensional/adverse effects
18.
Article in English | LILACS, BBO | ID: biblio-1516449

ABSTRACT

Objetivo: Este estudo avaliou a influência do método de visualização e análise do exame de tomografia computa-dorizada de feixe cônico (TCFC) no diagnóstico de afecções endodônticas. Materiais e métodos: Vinte casos clínicos contendo doze diferentes afecções endodônticas foram ana-lisados por dois especialistas em radiologia odontológica e um especialista em endodontia. Inicialmente, os avaliadores visualizaram os casos em Portable Document Format (PDF) contendo uma seleção de imagens digitais e, por consenso, descreveram suas hipóteses diagnósticas para cada caso. Após uma semana, os avaliadores reavaliaram os casos, desta vez utilizando reconstrução multiplanar em um visualizador de imagens no formato Digital Imaging and Communications in Medicine (DICOM). Novamente, por consenso, eles indicaram suas hipóteses diagnósticas. Resultados: Em 10% dos casos, houve discrepância entre os diagnósticos realizados utili-zando as seleções de imagens digitais em PDF e utilizando a reconstrução multiplanar. A visualização das imagens em PDF obteve sensibilidade de 0.714, especificidade de 0.966, e acurácia de 90%. Discussão: Na maioria destes casos, as afecções endodônticas identificadas utilizando o visuali-zador de imagens DICOM (reconstrução multiplanar) não foram detectadas quando visualizados os PDF de imagens pré-selecionadas. Conclusão: Embora mais estudos sejam necessários, os autores reiteram que a utilização de recons-truções multiplanares sempre são preferíveis comparadas à outras formas de análise da TCFC, para que se atinja o máximo potencial diagnóstico do exame de imagem.


Aim: This study evaluated the influence of the method used for visualization and analysis of cone-beam com-puted tomography (CBCT) on the diagnosis of endodontic conditions. Materials and methods: Twenty clinical cases containing twelve different endodontic conditions were analyzed by two specialists in dental radiology and one specialist in endodontics. Initially, the evaluators viewed the cases in Portable Document Format (PDF) containing a selection of digital images and, by consensus, described their diagnostic hypotheses for each case. One week la-ter, the evaluators reassessed the cases, this time using multiplanar reconstructions with a Digital Imaging and Communications in Medicine (DICOM) format image viewer. Once more, by consensus, they recorded their diagnostic hypotheses. Results: In 10% of the cases there was a discrepancy between the diagnoses made using preselected digital images in PDFs and by viewing multiplanar reconstructions. The visualization of the PDF images obtained a sensitivity of 0.714, specificity of 0.966, and 90% accuracy. Discussion: In the majority of these cases, endodontic conditions identified using the DICOM image viewer (multiplanar reconstruction) were not detected using the PDFs of preselected images. Conclusion: Although more studies are needed, the au-thors reiterate that using multiplanar reconstructions should always be preferred to other forms of analysis for CBCT, so that the maximum diagnostic potential of the imaging exam can be achieved.


Subject(s)
Diagnosis , Endodontics/methods , Cone-Beam Computed Tomography/methods
19.
Rev. cuba. estomatol ; 59(2): e4293, abr.-jun. 2022. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1408392

ABSTRACT

Introducción: En el ámbito odontológico es muy común el uso de radiografías intraorales, extraorales e incluso de tomografías computarizadas volumétricas. Las radiografías intraorales presentan una baja dosis de radiación en comparación con las tomografías computarizadas volumétricas que pueden emitir una mayor dosis de radiación con cierto grado de riesgo para los pacientes. A pesar de que se conoce sobre la importancia del uso del consentimiento informado y los riesgos durante estos procedimientos, muy poco se ha reportado sobre la utilización del consentimiento informado en radiología oral y maxilofacial. Objetivo: Analizar los beneficios y los retos de usar el consentimiento informado en radiología odontológica. Comentarios principales: Actualmente, no existe un consenso claro en la comunidad odontológica sobre si se debe obtener el consentimiento informado del paciente antes de que se someta a un examen de imagen con radiación ionizante. Su aplicación de manera repetitiva o prolongada podría afectar al paciente a largo plazo. Consideraciones globales: Existe un consenso universal en resaltar la importancia del consentimiento informado en todo el ámbito de la salud. Sin embargo, en la práctica, su realización puede conllevar ciertas dificultades, tales como la identificación del responsable de su realización, el tiempo que lleva ejecutarla y la preocupación por causar un miedo innecesario en el paciente. Si estas dificultades logran ser superadas, podremos ver los beneficios de tener un consenso claro para la utilización de un consentimiento informado en el área odontológica(AU)


Introduction: In the dental field, the use of intraoral, extraoral and even volumetric computed tomography is very common. Intraoral X-rays have a low dose of radiation compared to volumetric CT scans that can emit a higher dose of radiation with some degree of risk to patients. Although the importance of the use of informed consent and the risks during these procedures are known, very little has been reported about the use of informed consent in oral and maxillofacial radiology. Objective: Analyze the benefits and challenges of using informed consent in dental radiology. Main Comments: Currently, there is no clear consensus in the dental community on whether the patient's informed consent should be obtained before they undergo an imaging examination with ionizing radiation. Its application repetitively or prolongedly could affect the patient in the long term. Global considerations: There is a universal consensus to highlight the importance of informed consent in the entire field of health. However, in practice, its realization can lead to certain difficulties, such as the identification of the person responsible for its implementation, the time it takes to execute it and the concern to cause unnecessary fear in the patient. If these difficulties can be overcome, we can see the benefits of having a clear consensus for the use of informed consent in the dental area(AU)


Subject(s)
Humans , Radiation, Ionizing , Informed Consent , Cone-Beam Computed Tomography/methods
20.
J. oral res. (Impresa) ; 11(1): 1-13, may. 11, 2022. ilus, tab
Article in English | LILACS | ID: biblio-1399621

ABSTRACT

Objective: To determine the impact of CBCT on diagnostic evaluation and treatment plan for the maxillary sinus in dental implant planning. Material and Methods: Diagnostic evaluation and treatment plan for the maxillary sinus were evaluated by eight specialists experienced in dental implant placement. Eight panoramic radiographs (PAN) and CBCT examinations were obtained from five adult patients with a specific clinical need for dental implants. Evaluation was performed first on PAN then, at least 2 weeks later, on CBCT. Residual alveolar ridge height, mucosal thickening, radiographic findings and treatment plan were recorded. The confidence level was evaluated for both diagnostic evaluation and treatment plan. The kappa statistic for intra-observer reproducibility and McNemar test were performed. Results: In the diagnostic evaluation, CBCT showed significant impact on the diagnosis of radiographic findings. Availability of CBCT significantly changed the treatment plan, for less invasive treatment, or no treatment need. Observers had significantly greater confidence when using CBCT than PAN, when indicating presence of mucosal thickening and radiographic findings in the maxillary sinus. In addition, CBCT increased confidence in the treatment plan. Conclusion: The present study suggests that CBCT has an impact on the diagnostic evaluation of radiographic findings in the maxillary sinus and on the decision to place implants, owing to misdiagnosis of pathology and planning of more invasive treatments when using PAN. Availability of CBCT also improves clinician confidence. Further studies at higher levels of diagnostic efficacy should be performed, to justify the use of CBCT, by evaluating the actual treatment performed and its outcome.


Objetivo: Determinar el impacto de la tomografía computarizada de haz cónico (CBCT) en la evaluación diagnóstica y el plan de tratamiento del seno maxilar en la planificación de implantes dentales. Material y Métodos: La evaluación diagnóstica y el plan de tratamiento del seno maxilar fueron evaluados por ocho especialistas con experiencia en la colocación de implantes dentales. Se obtuvieron ocho radiografías panorámicas (PAN) y exámenes CBCT de cinco pacientes adultos con una necesidad clínica específica de implantes dentales. La evaluación se realizó primero en PAN y luego, al menos dos semanas después, en CBCT. Se registraron la altura del reborde alveolar residual, el engrosamiento de la mucosa, los hallazgos radiográficos y el plan de tratamiento. Se evaluó el nivel de confianza tanto para la evaluación diagnóstica como para el plan de tratamiento. Se realizó el estadístico kappa para la reproducibilidad intraobservador y la prueba de McNemar. Resultados: En la evaluación diagnóstica, CBCT mostró un impacto significativo en el diagnóstico de los hallazgos radiográficos. La disponibilidad de CBCT cambió significativamente el plan de tratamiento, para un tratamiento menos invasivo o sin necesidad de tratamiento. Los observadores tuvieron una confianza significativamente mayor al usar CBCT que PAN, al indicar la presencia de engrosamiento de la mucosa y hallazgos radiográficos en el seno maxilar. Además, CBCT aumentó la confianza en el plan de tratamiento. Conclusión: El presente estudio sugiere que la CBCT tiene un impacto en la evaluación diagnóstica de los hallazgos radiográficos en el seno maxilar y en la decisión de colocar implantes, debido al diagnóstico erróneo de la patología y la planificación de tratamientos más invasivos al usar PAN. La disponibilidad de CBCT también mejora la confianza del clínico. Se deben realizar más estudios a niveles más altos de eficacia diagnóstica para justificar el uso de CBCT, evaluando el tratamiento real realizado y su resultado.


Subject(s)
Humans , Dental Implants , Cone-Beam Computed Tomography/methods , Maxillary Sinus/diagnostic imaging , Peru/epidemiology , Diagnostic Imaging/instrumentation , Planning , Alveolar Process
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