RESUMO
The purpose of this study was to compare the average distances from the root apices of the first molars, second molars, and second premolars to the mandibular canal according to sex in the Peruvian population using cone-beam computed tomography (CBCT). Eighty CBCT scans of Peruvian patients aged from 15-80 years were examined. After locating the mandibular canal, measurements of the vertical distances from the mandibular canal to the apices of the second premolars, as well as the first molars and second molars, were made. For the statistical analysis, Student's t test was used for both paired and unpaired samples, with a significance level of p0.05) between the distances from the apices of the second premolars and the first and second molars to the mandibular canal. However, for the second premolars and second molars on the left side, the values were higher, with averages of 5.52mm and 3.75mm, respectively. The mesial roots of the second molars were closer to the mandibular canal. In addition, women showed shorter distances than men.
El propósito de este estudio fue comparar las distancias promedio desde los ápices radiculares de primeros molares, segundos molares y segundos premolares al canal mandibular según sexo en la población peruana mediante tomografía computarizada de haz cónico (TCHC). Se examinaron 80 tomografías CBCT de pacientes peruanos con edades comprendidas entre los 15 y 80 años. Luego de ubicar el canal mandibular, se realizaron mediciones de las distancias verticales desde el canal mandibular hasta el ápice de los segundos premolares mandibulares, así como de los primeros molares y segundos molares. Para el análisis estadístico se utilizó la prueba t de Student para muestras pareadas y no pareadas con un nivel de significación de p0.05) entre las distancias desde los ápices de los segundos premolares mandibulares y los primeros y segundos molares al canal mandibular. Sin embargo, para los segundos premolares y segundos molares en el lado izquierdo, los valores fueron más altos con un promedio de 5,52mm y 3,75mm, respectivamente. Las raíces mesiales de los segundos molares estaban más cerca del canal mandibular. Además, las mujeres mostraron distancias más cortas que los hombres.
RESUMO
Objetivo: Realizar uma revisão integrativa da literatura acerca da eficácia da terapia de fotobiomodulação na amenização dos distúrbios neurossensoriais e da dor em pacientes com lesões no nervo alveolar inferior. Materiais e métodos: Para a pesquisa dos artigos foram utilizadas as bases de dados MEDLINE, LILACS, BBO, IBECS e SciELO com descritores em inglês combinados com os operadores booleanos. A busca limitou-se a artigos nos idiomas inglês, português ou espanhol, publicados nos últimos 10 anos, do tipo ensaios clínicos. Revisão de literatura: Nove artigos preencheram os critérios de inclusão, sendo oito ensaios clínicos randomizados e um ensaio clínico não randomiza-do. Os melhores resultados foram observados em testes de sensibilidade geral utilizando a Escala Visual Analógica. Os estudos atestaram melhora da condição independentemen-te do tempo pós-operatório, contudo, o início antecipado da terapia trouxe maiores benefícios. Ademais, embora a maioria dos artigos tenha apontado eficácia do tratamento, notou-se grande variabilidade nos protocolos de terapia a laser. Conclusão: O emprego da terapia de fotobiomodulação é eficaz no tratamento de injúrias iatrogênicas no nervo alveolar inferior. Entretanto, mais estudos são necessários a fim de estabelecer um protocolo para o uso do laser.
Objective: Conduct an integrative review of literature on the efficacy of photobiomodulation therapy in the aestheization of sensorineural disorders and pain in patients with lesions in the inferior alveolar nerve. Materials and methods: Medline, LILACS, BBO, IBECS and SciELO databases were used to search the articles with English descriptors combined with the boolean operators. The search was limited to articles in English, Portuguese or Spanish, published in the last 10 years, of the type clinical trials. Literature review: Nine articles met the inclusion criteria, eight randomized clinical trials and one non-randomized clinical trial. The best results were observed in general sensitivity tests using the Visual Analog Scale. Studies attested to an impro-vement in the condition regardless of postoperative time, however, early initiation of therapy brought greater benefits. Furthermore, although most articles have pointed out treatment efficacy, there was great variability in laser therapy protocols. Conclusion: The use of photobiomodulation therapy is effective in the treatment of iatrogenic injuries to the inferior alveolar nerve. However, more studies are needed in order to establish a protocol for the use of laser.
Assuntos
Ferimentos e Lesões , Terapia com Luz de Baixa Intensidade , Nervo MandibularRESUMO
RESUMEN: En la práctica clínica odontológica, reconocer estructuras anatómicas es determinante en la planificación de distintos tratamientos que involucren algún riesgo. Uno de los exámenes complementarios recomendados para la planificación de diferentes tratamientos en odontología es la Tomografía Computarizada de Haz Cónico (CBCT). Con este examen, se pueden pesquisar variantes anatómicas como el Foramen Mental Accesorio (FMA), el cual es importante identificar para prevenir complicaciones. El objetivo de este trabajo fue determinar la frecuencia y caracterización de FMA en una población chilena adulta, de la ciudad de Valdivia, Chile. Este estudio es de tipo observacional descriptivo. Se revisaron 247 exploraciones de diferentes centros radiológicos de la ciudad de Valdivia, cumpliendo 143 con los criterios de selección. Este estudio fue aprobado por el Comité ético científico del Servicio de Salud de Valdivia. Se encontró presencia de FMA en el 17,48 % que corresponde a 25 pacientes de un total de 143, correspondiendo un 80 % al sexo femenino. El rango etario en que se encontró con mayor frecuencia correspondió a 18-39 años. La distancia promedio entre FMA y FM (Foramen Mental) fue de 5,76 mm, correspondiendo a 2 mm la distancia mínima y 11,5 mm la distancia máxima. La distancia promedio entre FMA y ápice dentario más cercano fue de 5,36 mm. La distancia mínima y máxima fueron de 0,8 mm y 10,2 mm respectivamente. El ápice radicular mayormente asociado al FMA correspondió al segundo premolar con una frecuencia de 60 % (n=15). Este estudio confirma la importancia de la correcta evaluación de la región mental ante procedimientos en la zona, la cual es vital para prevenir lesiones en relación a esta variante anatómica.
SUMMARY: The recognition of key anatomical structures is decisive to avoid complications in the dental clinical practice. Cone Beam Computed Tomography (CBCT) is a complementary exam recommended for the planning of different procedures in dentistry. With this exam, anatomical variants can be identified, such as the Accessory Mental Foramen (AMF). The objective of this work was to determine the frequency and characteristics of AMF in an adult Chilean population from the city of Valdivia, Chile. This is an observational study that included 247 CBCT exams from different radiological centers in Valdivia. According to the selection criteria, 143 CBCT exams were included. This study was approved by the Scientific Ethics Committee of the Valdivia Health Services. AMF was identified in 25 patients representing 17.48 %. From this result, 80 % were found in females. AMF was most frequently identified in patients from 18 to 39 years old. The average distance between AMF and Mental Foramen (MF) was 5.76 mm, which corresponds to 2 mm the minimum distance and 11.5 mm the maximum distance. The average distance between AMF and the nearest dental apex was 5.36 mm, and the minimum and maximum distance were 0.8 mm and 10.2 mm, respectively. The root apex of the second premolar was most frequently associated with the AMF, representing 60 % (n=15). This study confirms the importance of the correct evaluation of the mental region before initiating procedures in the area, which is vital to prevent injuries associated with this anatomical variant.