Retratamientos endodónticos: una realidad que preocupa / Endodontic retreatment: a worrying reality

Las evaluaciones radiográficas de tratamientos endodón- ticos realizadas por graduados muestran un alto porcentaje de procedimientos incorrectos. Esta circunstancia lleva a la rea- lización de un elevado número de retratamientos ortógrados y retrógrados, con los inconvenientes y desventajas que conlle- va recurrir a una reintervención endodóntica. Es responsabili- dad de los profesionales, docentes y autoridades universitarias y gubernamentales revertir esta situación que afecta a la salud bucal de la sociedad. En el presente editorial se proponen di- ferentes alternativas para intentar modificar este preocupante panorama (AU)

Radiographic evaluations of endodontic treatments per- formed by graduates show a high percentage of incorrect procedures. This circumstance leads to the performance of a high number of orthograde and retrograde retreatments, with the inconveniences and disadvantages that entails resorting to an endodontic reintervention. It is the responsibility of pro- fessionals, teachers, university and government authorities to reverse this situation that affects the oral health of society. In this editorial, different alternatives are proposed to try to modify this worrying outlook (AU)

Evaluación radiográfica de 5000 tratamientos endodónticos realizados en premolares y molares mandibulares y maxilares en una población en Argentina / Radiographic evaluation of 5000 endodontic treatments performed on mandibular and maxillary premolars and molars in a population in Argentina

Objetivo: Evaluar radiográficamente tratamientos en- dodónticos del sector posterior de la cavidad bucal y com- parar la frecuencia de aceptabilidad en cada pieza dentaria involucrada. Materiales y métodos: Se evaluaron 5000 radiogra- fías de archivo de tratamientos endodónticos realizados apro- ximadamente entre 2005 y 2019 en premolares y molares mandibulares y maxilares en Argentina. Se consideraron tratamientos correctos e incorrectos de acuerdo con: 1) con- formación de la preparación quirúrgica; 2) límite apical de la obturación; 3) homogeneidad de la obturación. Se obtuvo la fre- cuencia absoluta y relativa de correctos e incorrectos. El aná- lisis entre frecuencias y pieza dentaria se realizó con la prueba de chi cuadrado y el cálculo del coeficiente V de Cramer. Para la comparación entre grupos de piezas dentarias se utilizó la partición del valor de chi cuadrado obtenido en los corres- pondientes grados de libertad. Nivel de significación P <0.05. Resultados: La partición del valor de chi cuadrado no mostró diferencias significativas entre primeros y segundos premolares mandibulares. Las otras comparaciones exhibie- ron diferencias significativas. Conclusiones: Un alto porcentaje de los tratamientos endodónticos de la población estudiada tiene por lo menos una condición que permite categorizarlos como incorrectos según el criterio establecido en este trabajo. Este porcentaje es más preponderante en anatomías complejas (AU)

Aim: To evaluate radiographically endodontic treat- ments performed in the posterior area of the oral cavity and compare the frequency of acceptability in each tooth involved. Materials and methods: 5,000 archival radiographs of endodontic treatments performed between 2005 and 2019 on mandibular and maxillary premolars and molars in Argentina were evaluated. The percentages of correct and incorrect treatments were considered according to 1) shaping of the preparation; 2) apical limit of the obturation; 3) homogeneity of the obturation. The absolute and relative frequencies of correct and incorrect treatments were calcu- lated. The association between these frequencies and tooth type was analyzed using the chi-square test and Cramer's V coefficient. For the comparison between groups of teeth, the partition of the chi-square value obtained in the corre- sponding degrees of freedom was used. Level of significance was P <0.05. Results: The partition of the chi-square value did not show a significant difference between the first and second lower premolars. The differences were significant in the other comparisons. Conclusions: A high percentage of the endodontic treat- ments in the study population have at least one condition war- ranting their classification as incorrect according to the crite- ria established in this study. This percentage is more prevalent in complex anatomies (AU)

A clinical and radiographic comparative evaluation of custom-made zirconia crowns using CAD-CAM and stainless steel crowns in primary molars

Background and Aim of Study: Early childhood caries is a multifactorial disease process affecting children below 71 months of age and continues to be a global health problem. Stainless steel crowns (SSCs) are widely used and are very popular in pediatric dentistry due to its superiority and durability when compared with multisurface amalgam restorations. However, one of the major disadvantages with these crowns is the poor esthetics. Parents often request for a more esthetic alternative to the SSC. Zirconia crowns are one of the tooth-colored full crown restorations currently available for use in primary teeth. These are available as both preformed and custom-made crowns and show excellent esthetics. However, these require extensive tooth preparation with a subgingival finish lines, which would cause gingival trauma and bleeding during the preparation. The present study uses intraoral scanners for making the custom-made zirconia crowns, which will avoid the conventional impressions. Currently, there are no studies available in pediatric dentistry regarding CAD-CAM crowns. Hence, there is a need for the study. Aim: The aim of this study is to clinically evaluate the performance of preformed SSCs and custom-made zirconia crowns in primary molars. To elicit parental and patient satisfaction with respect to preformed SSCs and custom made zirconia crowns and to radiographically compare the interproximal bone height for 1 year. Methods: The patients were selected with purposive sampling. The tooth of interest was prepared according to the crown it would receive. The upper and the lower arch of the tooth receiving custom-made zirconia crown was scanned using an intraoral scanner. The crowns were cemented using Type 1 glass ionomer cement (GIC) (SSC) and resin modified GIC (custom-made zirconia crown). After the crown placement, the patient and the parent's satisfaction was scaled regarding the time taken, comfort, cost of crown, appearance of crown, etc., using a 5-point Likert scale. A baseline radiograph was taken after crown placement. The patient was recalled every 3 months till 1 year for evaluation (loss of retention, loss of proximal contact, gingival inflammation, opposing tooth wear, and marginal integrity). At the end of 1 year, radiographs were taken to check the interproximal bone. Results: After 1 year evaluation of custom-made zirconia crowns and preformed SSCs in primary molars, it was shown that both SSC and zirconia crowns showed good gingival scores but zirconia crown was better than SSC in improving the gingival health. SSCs showed better results with respect to the opposing tooth wear and marginal adaptability. Parents as well as patients preferred a tooth-colored crown as a treatment option. Conclusion: Custom-made zirconia crowns are comparable to the preformed SSCs and they show better gingival scores and excellent color match.

A scoping study of pulmonary paracoccidioidomycosis: severity classification based on radiographic and tomographic evaluation

The lungs have great importance in patients with paracoccidioidomycosis since they are the portal of entry for the infecting fungi, the site of quiescent foci, and one of the most frequently affected organs. Although they have been the subject of many studies with different approaches, the severity classification of the pulmonary involvement, using imaging procedures, has not been carried out yet. This study aimed to classify the active and the residual pulmonary damage using radiographic and tomographic evaluations, according to the area involved and types of lesions.

Obturation Quality Evaluation and Number of Visits Required to Complete Root Canal Treatment Performed by Undergraduate Students

@#Introduction: Assessment of root canal treatment (RCT) quality performed by undergraduate students is important in evaluating the teaching of endodontic. Hence, this study aims to evaluate the obturation quality of root canal treated teeth and the number of visits required by patients to complete RCT rendered by undergraduate students in School of Dental Sciences, Universiti Sains Malaysia (USM). Methods: All RCT cases performed by fourth year and final year undergraduate dental students in 2017/2018 were included in this study with a total of 258 teeth. Both digital and conventional periapical radiographs of all treated teeth were assessed. Evaluation of the obturation quality was classified as acceptable and unacceptable based on the length in relation to the radiographic apex and density of the obturation in relation to the presence of voids. The number of visits required to complete each RCT case by the students were also assessed. Results: Out of the total 258 teeth, 63.6% were maxillary and 36.4% were mandibular comprising 53.5% anteriors, 14.7% premolars and 31.8% molars. Overall acceptable obturation quality was 71.3%. There was significant association between obturation quality and type of teeth as well as location of teeth. Conclusion: Students in this institution performed significantly better obturation quality on anterior teeth than on premolars and molars as well as on maxillary teeth as compared to the mandibular teeth. Patients seemed to require more visits for RCT of molars than anteriors and premolars.

Evaluación radiográfica de la capacitación preclínica de alumnos de grado en el uso del sistema ProTaper Next en endodoncia / Radiographic evaluation of the preclinical training of undergraduate students in the use of ProTaper Next system in endodontics

Objetivo: Evaluar radiográficamente 162 tratamientos endodónticos realizados ex vivo en premolares inferiores y superiores humanos mediante el empleo del sistema ProTaper Next por parte de alumnos de grado de una cátedra de endodoncia de una universidad argentina. Materiales y métodos: Se evaluaron 162 tratamientos endodónticos realizados ex vivo durante los años 2017, 2018 y 2019 (54 por cohorte) en premolares inferiores y superiores humanos por alumnos de grado de la cátedra de Endodoncia I de la Escuela de Odontología de la Universidad del Salvador / Asociación Odontológica Argentina. Para la instrumentación fue empleado el sistema ProTaper Next. La muestra se tomó de forma aleatoria. En un programa de presentación de computadora se incluyeron las radiografías periapicales pre- y posoperatoria para su evaluación. Un evaluador externo analizó las imágenes radiográficas de los tratamientos y los categorizó como correctos o incorrectos teniendo en cuenta tres requisitos excluyentes: la conformación de la preparación quirúrgica, el límite apical y la homogeneidad de la obturación. Para el análisis estadístico, se utilizó la frecuencia relativa (intervalo de confianza 95%) y la prueba de chi-cuadrado. Resultados: La evaluación radiográfica de los tratamientos endodónticos realizados mostró un número considerable de tratamientos correctos. Los resultados para cada cohorte (años 2017, 2018 y 2019) fueron del 96,3% (87,2- 99,5%), el 94,4% (84,6-98,8%) y el 98,2% (90,1-99,9%) respectivamente. El porcentaje global de tratamientos correctos fue del 96,3% (92,1-98,6%). La diferencia entre las cohortes no fue estadísticamente significativa (P>0,05). Conclusión: El empleo del sistema ProTaper Next por parte de estudiantes de grado evaluados mostró resultados radiográficamente satisfactorios en la instrumentación ex vivo de conductos radiculares de premolares inferiores y superiores humanos (AU)

Aim: To evaluate radiographically, 162 endodontic treatments performed ex vivo by three cohorts of students from a school of dentistry in Argentina, using ProTaper Next rotatory system in mandibular and maxillary human premolars. Materials and methods: 162 mandibular and maxillary human premolars received endodontic treatment by undergraduate students from the Department of Endodontics I of the School of Dentistry USAL/AOA. The treatments were performed ex vivo during the academic years 2017, 2018 and 2019 (54 teeth were chosen for each cohort) using the rotatory system ProTaper Next. The samples were taken randomly. Pre and postoperative radiographs were included in a computer presentation program for its evaluation. An external examiner analysed the radiographic images by the shape of the preparation, the apical limit, and the homogeneity of the obturation, considering the treatments well obturated (correct) or ill obturated (incorrect). To be considered correct the case had to meet all the requirements. The statistic calculations used in this study were: relative frequency (confidence interval 95%) and the chi-square test. Results: The radiographic evaluation showed a considerable number of endodontic treatments correctly done using ProTaper Next system. The percentages for each cohort were 96.3% (87.2-99.5%), 94.4% (84.6-98.8%) y 98.2% (90.1-99.9%) for years 2017, 2018 y 2019 respectively. Global percentage of correctly endodontic treatments was 96.3% (92.1-98.6%). The difference between the cohorts was not statistically significant (P>0.05). Conclusion: The use of ProTaper Next by the dental students evaluated showed satisfactory results in the ex vivo instrumentation of mandibular and maxillary human premolar root canals (AU)

Clinical observation and radiographic evaluation of Biqi Capsule in treating knee osteoarthritis / 中草药

Objective: To evaluate the clinical efficacy of Biqi Capsule in treating knee osteoarthritis through randomized controlled trial, and investigate its effect on radiography. Methods: One hundred eligible patients were randomly assigned at a 1:1 ratio to receive Biqi Capsule (intervention group) and Calcitriol Capsule (control group). The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and VAS for pain were assessed at week 12 and 24. MRI Osteoarthritis Knee Score (MOAKS) was assessed at week 24. The safety index and adverse event were also tested before and after the trial. Results: A total of 100 participants were enrolled in this trial, of which 16 patients were lost to follow-up, and 84 patients were included into analysis for per-protocol set. The intervention group could better improve the WOMAC than the control group after 24-week treatment (P 0.05). However, in the sub-group analysis, the intervention group had an improvement on the MOAKS score in the patients who did not take the non-steroid anti-inflammatory drugs (NSAIDs) (P 0.05). Conclusion: Biqi Capsule had a better treatment effects on the improvement of joint stiffness and function of patients with knee osteoarthritis. It also had a better effect in the patients who did not take NSAIDs on the radiographic evaluation.

Anátomo-radiografia dos ossos longos do membro torácico do Tamandua tetradactyla / Anatomo-radiography of long-bones in thoracic limb ofTamandua tetradactyla

Objetivou-se descrever os acidentes anatômicos dos ossos longos do membro torácico de Tamandua tetradactyla por meio de análises macroscópicas e radiográficas. Foram utilizados 34 espécimes, que foram a óbito por atropelamento. A avaliação do úmero demonstrou as mesmas estruturas presentes nos animais domésticos, além de outras sem prévia descrição. Já no antebraço, rádio e ulna se apresentaram completamente separados, e apesar de, como o úmero, serem identificados alguns dos mesmos acidentes anatômicos descritos em outras espécies, também notamos particularidades. Todas as estruturas descritas na análise macroscópica foram identificadas à radiografia, quando realizada em pelo menos duas projeções ortogonais. As estruturas anátomo-radiográficas dos ossos longos do T. tetradactyla demonstraram grande variação anatômica em comparação a outros mamíferos, o que torna a referida espécie muito singular. Assim o conhecimento de suas particularidades é fundamental para abordagens clínico-cirúrgicas mais seguras.

The objective was to describe the anatomical accidents of the long bones of the thoracic limb of Tamandua tetradactyla by means of macroscopic and radiographic analyzes. We used 34 specimens, which were deaths by running over. Evaluation of the humerus demonstrated the same structures present in domestic animals, besides others without previous description. In the forearm, radius and ulna were completely separated, and although, like the humerus, some of the same anatomical accidents described in other species were identified, we also noticed particularities. All the structures described in the macroscopic analysis were identified on radiography, when performed in at least two orthogonal projections. The anatomic-radiographic structures of the long bones of T. tetradactyla showed great anatomical variation compared to other mammals, which makes the species very unique. Thus knowledge of their particularities is fundamental for safer clinical-surgical approaches.

Anátomo-radiografia dos ossos longos do membro torácico do Tamandua tetradactyla / Anatomo-radiography of long-bones in thoracic limb of Tamandua tetradactyla

Objetivou-se descrever os acidentes anatômicos dos ossos longos do membro torácico de Tamandua tetradactyla por meio de análises macroscópicas e radiográficas. Foram utilizados 34 espécimes, que foram a óbito por atropelamento. A avaliação do úmero demonstrou as mesmas estruturas presentes nos animais domésticos, além de outras sem prévia descrição. Já no antebraço, rádio e ulna se apresentaram completamente separados, e apesar de, como o úmero, serem identificados alguns dos mesmos acidentes anatômicos descritos em outras espécies, também notamos particularidades. Todas as estruturas descritas na análise macroscópica foram identificadas à radiografia, quando realizada em pelo menos duas projeções ortogonais. As estruturas anátomo-radiográficas dos ossos longos do T. tetradactyla demonstraram grande variaçãoanatômica em comparação a outros mamíferos, o que torna a referida espécie muito singular. Assim o conhecimento de suas particularidades é fundamental para abordagens clínico-cirúrgicas mais seguras.

The objective was to describe the anatomical accidents of the long bones of the thoracic limb of Tamandua tetradactyla by means of macroscopic and radiographic analyzes. We used 34 specimens, which were death by running over. Evaluation of the humerus demonstrated the same structures present in domestic animals, besides others without previous description. In the forearm, radius and ulna were completely separated, and although, like the humerus, some of the same anatomical accidents described in other species were identified, we also noticed particularities. All the structures described in the macroscopic analysis were identified on radiography, when performed in at least two orthogonal projections. The anatomic-radiographic structures of the long bones of T. tetradactyla showed great anatomical variation compared to other mammals, which makes the species very unique. Thus knowledge of their particularities is fundamental for safer clinical-surgical approaches.

Proximal humerus fracture with locking plate: functional and radiographic results / Fraturas do úmero proximal com placa bloqueada: resultados funcionais e radiográficos

ABSTRACT Objective: To correlate the functional outcome and radiographic indices of proximal humerus fractures treated with locking plate. Methods: Seventy patients with proximal humerus fractures treated with locking plate, with mean follow-up of 30 months. These patients were analyzed for the score of the University of California, Los Angeles (UCLA) for the operated shoulder, range of motion measurements and radiography of both shoulders. After that, a graphical correlation was established between the radiographic measurements and the functional outcomes. Results: 78% good and excellent results according to the UCLA score, with mean130° elevation; 45° lateral rotation; and thumb-T10 medial rotation. The type of fracture according to the Neer classification and age had a significant correlation with the range of motion. An association was found between the lowest mean elevation and the UCLA score when the neck-shaft angle variation in the antero-posterior plane was greater than 15° varus (p <0.001). Conclusion: The variation of the neck-shaft angle measurement in the anteroposterior plane showed significant correlation with the range of motion and can be one of the predictors of functional results in proximal humerus fractures treated with locking plate. Level of evidence III, Retrospective Study.

RESUMO Objetivo: Correlacionar os resultados funcionais e os índices radiográficos das fraturas do úmero proximal tratadas com placa bloqueada. Métodos: Examinou-se 70 pacientes com fraturas do úmero proximal tratados com placa bloqueada, com seguimento médio de 30 meses. Esses pacientes foram submetidos à análise do escore da Universidade da Califórnia de Los Angeles (UCLA) no ombro operado, avaliação do arco de movimento e a exames radiográficos de ambos os ombros. Estabeleceu-se, então, a correlação gráfica entre as medidas radiográficas e os resultados funcionais. Resultados: Obtivemos 78% de bons e excelentes resultados conforme o escore da UCLA, com médias de: 130° de elevação; 45° de rotação lateral; e polegar-T10 de rotação medial. O tipo de fratura segundo a classificação de Neer e a idade teve significativa correlação com o arco de movimento. Encontrou-se associação entre menor média de elevação e escore UCLA quando a variação do ângulo cervicodiafisário na incidência anteroposterior foi maior que 15° em varo (p<0,001). Conclusão: A variação da medida do ângulo cervicodiafisário na incidência anteroposterior mostrou significativa correlação com o arco de movimento, podendo ser um dos preditores dos resultados funcionais nas fraturas do úmero proximal tratadas com placa bloqueada. Nível de Evidência III, Estudo Retrospectivo.

Evaluation of 1211 third molars positions according to the Classification of Winter, Pell & Gregory / Evaluación de posiciones de 1211 terceros molares acorde a la Clasificación de Winter, Pell & Gregory

Panoramic radiographs are important for the evaluation and classification of the third molars position, allowing the diagnosis and planning of extraction. The objective of this study is to evaluate upper and lower third molars positions in panoramic radiographs with the classification methods proposed by Pell and Gregory (1933) and Winter (1926) and the subsequent comparison of results with other authors. Panoramic radiographs of 310 patients were analyzed, 197 female and 113 male, totaling 1,211 third molars. In relation to the upper third molars, the most prevalent positions were: angle compared to the long axis of the second molar of Distoangular form (53.23 %) and the depth of impaction as Class C (48.25 %). In the lower third molars, the most prevalent positions were: angle to the long axis of the second molar in Mesioangular classification (52.96 %), the depth of impaction was B (46.54 %) and the tooth relationship with the mandibular ramus was identified as class I (55.26 %). These results provide information that can be utilized in predicting third molar development in terms of impaction or eruption, assisting dental surgeons in making decisions regarding surgical planning and treatment.

Las radiografías panorámicas son importantes para la evaluación y clasificación de la posición de los terceros molares, lo que permite el diagnóstico y la planificación de la extracción. El objetivo de este estudio fue evaluar terceros molares superiores e inferiores y posiciones en las radiografías panorámicas con los métodos de clasificación propuestas por Pell & Gregory, y Winter y la posterior comparación de los resultados con otros autores. Se analizaron las radiografías panorámicas de 310 pacientes, 197 mujeres y 113 hombres, con un total de 1.211 terceros molares. En relación con los terceros molares superiores, las posiciones más prevalentes fueron: ángulo con respecto al eje longitudinal del segundo molar de forma distoangular (53,23 %) y la profundidad de la impactación como Clase C (48,25 %). En los terceros molares inferiores, las posiciones más prevalentes fueron: ángulo con respecto al eje longitudinal del segundo molar en la clasificación mesioangular (52,96 %), la profundidad de impactación fue de B (46,54 %) y la relación de los dientes con la rama mandibular fue identificado como Clase I (55,26 %). Estos resultados proporcionan información que puede ser utilizada para predecir el desarrollo del tercer molar en términos de compactación o erupción, ayudando a los cirujanos dentistas en la toma de decisiones respecto a la planificación y el tratamiento quirúrgico.

Cross-sectional assessment of the periapical status as related to quality of root canal fillings and coronal restorations in a Yemeni population

Aim: the present study aimed to examine the influence of the quality of root canal fillings and coronal restorations on the prevalence of periapical lesions. Materials and Methods: Two hundred digital panoramic radiographs were obtained from the archive of Al‑HamziDental Center in Sana’a, Yemen. The final sample consisted of 120 radiographs, and 675 root filled teeth.The quality of root canal fillings was scored according to criteria of length, homogeneity and taper. Coronal status (type of restoration, signs of marginal leakage or decay) was also evaluated. The periapical status was categorized on the basis of presence or absence of radiographical signs of apical periodontitis. Chi-square test was used to determine statistical significance between different parameters. Results: We found that 93.6 percent of root filled teeth were associated with apical periodontitis. Only 9.2 percent of root filled teeth were found to have an acceptable standard of root canal fillings, of which 32.3 percent was also associated to signs of periapical disease. In roots with an unacceptable root canal filling, 95.4 percent had periapical disease. Teeth with good (14.4 percent) and poor (32.9 percent) intra-coronal restorations had apical periodontitis in 93.8 percent and 97.7 percent of cases, respectively. Crown restorations were present in 52.7 percent of root filled teeth, of which 91.0 percent were associated with periapical lesions. Conclusion: The poor technical quality of root canal fillings and coronal restorations is consistent with a high prevalence of apical periodontitis.

Estudio radiográfico de la calidad de 700 tratamientos endodónticos de piezas dentarias unirradiculares / Radiographic study of root canal treatments quality in 700 single rooted teeth

Objetivo: evaluar radiográficamente la calidad de 700 tratamientos endodónticos realizados a nivel nacional entre los años 2004 y 2014. Materiales y métodos: en un total de 700 tratamientos endodónticos de incisivos y caninos inferiores y superiores humanos, se analizó la calidad de la obturación endodóntica en relación con su límite apical, homogeneidad, material empleado y el respeto de la anatomía original. Asimismo, fueron consideradas la restauración coronaria y la existencia de anclajes intrarradiculares. En cuanto a la calidad global, se calculó la frecuencia porcentual de casos incorrectos y el correspondiente intervalo de confianza (95 por ciento). Resultados: se observó un 48,1 +- 3,7 por ciento de tratamientos deficientes. Del total de dientes evaluados clínicamente, el 26,7 por ciento presentaba restauraciones coronarias, el 65,9 por ciento coronas y el 7,4 por ciento obturaciones temporarias o ausencia de restauración. En el análisis radiográfico, el 63 por ciento tenía anclajes intrarradiculares. Conclusión: la frecuencia de tratamientos deficientes hallada es una información relevante al establecer políticas para la atención de la salud y la formación de recursos profesionales.

Aim: the radiographic evaluation the quality of 700 endodontic treatments performed during 2004-2014, in the national environment. Materials and methods: The endodontic obturationquality in relation to the apical limit, homogeneity, material usedand the original anatomic consideration were analyzed in 700 radiographic images from human maxillary and mandibular incisors and canines. The coronal restoration and the presence of intracanal anchorage were also considered. In the case of overal lquality, percent frequency of incorrect treatments as well as thecorresponding confidence interval (95%) was calculated. Results: 48.1 ± 3.7% of deficient treatments were observed. From the total of the clinical evaluated teeth 26.7% showed coronal restorations, 65.9% crowns and 7.4% temporaryor absent coronal fillings. In the radiographic analysis 63% showed intracanal anchorage. Conclusion: The frequency of deficient treatments thatwas found is relevant information that has to be taken intoaccount when establishing policies for health care servicesand professional training.

Radiographic evaluation of root canal fillings in a selected Yemeni population: a retrospective study / Evaluación radiográfica de tratamientos de endodoncia realizados en una población Yemení: estudio retrospectivo

Abstract: aim: to assess the root canal filling quality performed by general dental practitioners in Yemen through radiographic evaluation. Materials and Methods: Four hundred fifty-five digital panoramic radiographs were selected from the archive of the Dental Health Center in Sana'a, Yemen. The final sample consisted of 221 patients, 685 teeth, and 977 root canals. The criteria for overall radiographic adequacy of root canal fillings were defined as the presence of adequate length, density and taper, and absence of iatrogenic errors (ledges, transportations and perforations). Chi-square test was used to determine statistical significance between different parameters. Results: This study considered only radiographic criteria for evaluation of the root canal fillings. The percentage of root canal fillings with adequate length, density and taper was 30.8 percent, 29.6 percent and 20.7 percent, respectively. Considering the incidence of iatrogenic errors, perforations were present in 12 root canals (1.2 percent), while the presence of transportations was observed in 20 root canals (2.0 percent). However, ledges were no detected in any root canals. Conclusion: The root canal filling quality performed by general dental practitioners in Yemen is poor.

Resumen: objetivo: evaluar a través de la evaluación radiográfica la calidad de los tratamientos de endodoncia realizados por odontólogos generales en Yemen. Materiales y Métodos: Cuatrocientos cincuenta y cinco radiografías panorámicas digitales fueron seleccionados desde el archivo del Centro de Salud Dental en Sana'a, Yemen. La muestra final fue de 221 pacientes, 685 dientes y 977 endodoncias. Los criterios de adecuación radiográfica general de los tratamientos de endodoncia se definieron como la presencia de longitud adecuada, la densidad y la forma cónica y la ausencia de errores iatrogénicos (proyecciones, transportaciones y perforaciones). Se utilizó la prueba de chi-cuadrado para determinar la significación estadística entre los diferentes parámetros. Resultados: En este estudio se consideró sólo criterios radiológicos para la evaluación de las obturaciones del conducto radicular. El porcentaje de obturaciones del conducto radicular con la longitud adecuada, la densidad y la forma cónica fue del 30,8 por ciento, 29,6 por ciento y 20,7 por ciento, respectivamente. Teniendo en cuenta la incidencia de errores iatrogénicos, las perforaciones estaban presentes en 12 tratamientos (1,2 por ciento), mientras que se observó la presencia de transportaciones en 20 tratamientos (2,0 por ciento). Sin embargo, las proyecciones no fueron detectadas en ningún tratamiento. Conclusión: La calidad de los tratamientos de endodoncia realizados por dentistas generales de Yemen es pobre.

The Improvement and Completion of Outcome index: A new assessment system for quality of orthodontic treatment / 대한치과교정학회지

OBJECTIVE: Given the considerable disagreement between the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation, we aimed to develop a novel assessment system-the Improvement and Completion of Outcome (ICO) index-to evaluate the outcome of orthodontic treatment. METHODS: Sixteen criteria from 4 major categories were established to represent the pretreatment malocclusion status, as well as the degree of improvement and level of completion of outcome during/after treatment: dental relationship (arch length discrepancy, irregularity, U1-SN, and IMPA); anteroposterior relationship (overjet, right and left molar position, ANB); vertical relationship (anterior overbite, anterior open-bite, lateral open-bite, SN-MP); and transverse relationship (dental midline discrepancy, chin point deviation, posterior cross-bite, occlusal plane cant). The score for each criterion was defined from 0 or −1 (worst) to 5 (ideal value or normal occlusion) in gradations of 1. The sum of the scores in each category indicates the area and extent of the problems. Improvement and completion percentages were estimated based on the pre- and post-treatment total scores and the maximum total score. If the completion percentage exceeded 80%, treatment outcome was considered successful. RESULTS: Two cases, Class I malocclusion and skeletal Class III malocclusion, are presented to represent the assessment procedure using the ICO index. The difference in the level of improvement and completion of treatment outcome can be clearly explained by using 2 percentage values. CONCLUSIONS: Thus, the ICO index enables the evaluation of the quality of orthodontic treatment objectively and consecutively throughout the entire treatment process.

An Unusual Single Quadrant Dental Anomaly: A Case Report.

Anomalies of the dentition present real challenges to the dental practitioner. The occurrence of multiple supernumerary teeth in the absence of an associated systemic condition or syndrome is considered as a rare phenomenon. Here, we discuss a case of four supernumerary teeth in one maxillary quadrant with a fusion of supernumerary tooth to maxillary permanent central incisor, which was evident on radiological and clinical examination. Various radiographic views including intraoral periapical radiograph, maxillary occlusal radiograph, orthopantomograph, and cone-beam computed tomographic (CBCT) imaging were done to identify and locate the presence of supernumerary and supplemental teeth. The present case emphasizes the importance of different radiographic views and modalities in correct identification of the dental anomalies and thereby providing a prompt diagnosis and treatment as the exact identification of supernumerary teeth and differentiating it from permanent tooth is of prime importance in treatment planning and management.

Evaluación clínica y radiográfica de 30 implantes dentales colocados en un servicio odontológico de posgrado / Clinical and Radiographic Evaluation of 30 Dental Implants placed in a Postgraduate Dental Service

Resumen Introducción y objetivo: Existen reportes de complicaciones que hacen que el implante fracase, esto justifica la evaluación permanente de los mismos. Se buscó evaluar clínica y radiográficamente los implantes colocados en un servicio odontológico de posgrado para proponer un protocolo de evaluación y monitoreo. Materiales y métodos: Este estudio descriptivo evaluó 30 implantes de 16 pacientes. Los antecedentes quirúrgicos se tomaron de la historia clínica. Se valoraron criterios primarios como dolor, exudado, supuración, movilidad y profundidad del surco y criterios secundarios como los índices de placa y de sangrado. Se analizaron radiografías peri apicales milimetradas para identificar la presencia de anormalidades y la pérdida ósea marginal. Resultados: Diecinueve implantes cumplieron con los criterios de éxito Ahlqvist. Clínicamente, 22 implantes presentaron alguna alteración en los criterios de normalidad evaluados. En los criterios primarios se encontró presencia de signos inflamatorios en 11 implantes. El índice de higiene oral registró un porcentaje de 33% de placa en 2 implantes de un mismo paciente. El índice de sangrado registró un valor de 1 en 22 implantes. No se observó movilidad en toda la muestra, ni imágenes radio-lúcidas alrededor de los implantes. Conclusión: Diecinueve de los implantes analizados registraron "éxito clínico" según los criterios de Ahlqvist. Radiográficamente 28 implantes registraron condiciones dentro de parámetros normales. Los protocolos para evaluar los implantes deben considerar la historia médica y quirúrgica, criterios primarios y secundarios, la pérdida ósea marginal y la calidad del hueso alrededor del implante.

Introduction and objective: There are reports of complications that can cause implants to fail. This justifies long term evaluation of implants. The purpose of this study was to evaluate clinically and radiographically implants placed in a postgraduate dental service in order propose a protocol for evaluating and monitoring. Materials and methods: This descriptive study evaluated 30 implants on 16 patients. The surgical records were obtained from the patient's medical history. Primary criteria such as pain, exudate, suppuration, mobility and probing depth were assessed. Secondary criteria such as plaque and probing depth index were also assessed. Radiological analysis was performed to identify the presence of abnormalities and the average marginal bone loss. Results: 19 of the implants evaluated met the success criteria by Ahlqvist et al. Clinically, 22 implants showed some changes in the criteria of abnormality assessed in this study. Regarding the primary criteria, presence of inflammatory signs were found in 11 implants. Oral hygiene index showed a rate of 8% in 4 implants in the same patient, and 33% of plaque in 2 implants in the same patient. The bleeding index showed a value of 1 in 22 implants. Mobility was not observed in the sample and no radiolucent images around the implants. Conclusions: Nineteen of the examined implants were considered clinically successful according to the criteria by Ahlqvist et al. Radiographically, 28 implants showed conditions within normal parameters. Protocols for evaluating dental implants should consider the medical and surgical history, primary and secondary criteria , marginal bone loss and bone quality around the implants.

A Radiographic Evaluation of Graft Height Changes after Maxillary Sinus Augmentation according to Single-unit Implants and Multi-unit Implants / 이화의대지

OBJECTIVES: This study was performed to evaluate whether there is the difference of graft height changes in radiographic evaluation in single implants and multiple implants after maxillary sinus floor augmentation with an auto-xenograft mixture. METHODS: The study group comprised 29 patients (16 men, 13 women; mean age, 56.5+/-12.4 years; range, 27 to 87 years) treated at the implant clinic of the Ewha Womans University Mokdong Hospital. They were treated with the sinus floor augmentation of lateral window technique and simultaneous placement of dental implants. Their implants have been evaluated for 42.4+/-10.5 months. To evaluate the height of grafted material, the real implant length was compared with that of panoramic radiography evaluated by a digital caliper (PACS program), and then the real height of grafted material was assumed. SPSS 19.0 was used in statistical analysis. Wilcoxon singed rank test was utilized for P value and Mann-Whitney for statistical significance in the changes of grafted height between single implants and multiple implants. The level of statistical significance was defined as P0.001). CONCLUSION: There was no statistical significance of radiographic graft height after maxillary sinus floor augmentation between single implants and multiple implants.

Avaliação física e radiográfica de biomateriais usados para regeneração óssea / Physical and radiographic evaluation of biomaterials used for bone regeneration

A busca por novos materiais para regeneração óssea incentiva o estudo dos biomateriais; sabe-se que suas características físicas, como forma, aspecto superficial e área, bem como as radiográficas, principalmente a densidade, podem influenciar nos resultados obtidos quando de sua utilização clínica. O objetivo deste estudo foi avaliar o tamanho, a forma, o aspecto superficial e a densidade radiográfica de grânulos de alguns dos principais biomateriais utilizados para regeneração óssea. Os dados obtidos foram analisados estatisticamente, permitindo a detecção das diferenças entre os biomateriais testados. Os resultados radiográficos mostraram que todos os biomateriais avaliados apresentaram densidades radiográficas estatisticamente iguais, porém maiores do que a densidade radiográfica do tecido ósseo da calvária de ratos, região normalmente usada para seu teste. Nas análises físicas, o βTCP e a HAP apresentaram maior rugosidade superficial, enquanto que para os parâmetros diâmetro e área dos grânulos, os resultados foram heterogêneos, com o osso bovino liofilizado apresentando as maiores medidas. Baseado nos resultados obtidos, pode-se concluir que os biomateriais testados apresentaram densidade radiográfica maior do que a região óssea onde são normalmente implantados e diferenças significativas na forma, no tamanho e na rugosidade dos grânulos, características estas que podem estar diretamente relacionadas com o seu desempenho clínico.

The search for new alternatives used in bone regeneration pushes the biomaterials? development, and characteristics such as form, superficial roughness and size, allied to the radiographic bone density of those biomaterials can influence their clinical use. The objective of this study was to evaluate the shape, the size, the superficial aspects and the radiographic density of some of the most used bone-regenerating biomaterials grains. Radiographic results showed that all evaluated biomaterials had statistically equal radiographic densities, but all of them were higher than the radiographic bone density of rats calvaria, which is the region normally used for its test. On the physical analysis, βTCP and HAP showed the higher superficial roughness, while the grains? diameter and area showed heterogeneous results, with the lyophilized bovine bone showing the higher measures. Based on the results, it is concluded that the tested biomaterials presented higher radiographic density than the region where they are normally applied, and that significant differences in the shape, size and surface roughness could be seen, characteristics which can interfere in their clinical performance.

Radiographic quality of root canal fillings performed in a postgraduate program in endodontics

The aim of this study was to evaluate the standard quality of 1,347 root fillings performed by postgraduate students in Endodontics according to 3 radiographic quality parameters. The analyzed quality parameters included apical extension (AE), taper (TA) and homogeneity (HO), which received scores S2 (ideal standard), S1 (slight deviation) or S0 (accentuated deviation). A perfect filling (PF) received S2 for all parameters. In the absence of one or two S2 score, the fillings were deemed as satisfactory (SF) or deficient (DF), respectively. The results showed 51.7 percent, 41.5 percent and 6.8 percent of PF, SF, and DF, respectively. AE, TA, and HO presented equivalent quality parameters in root-filled canals of mandibular incisors and mandibular premolars (p>0.05). Conversely, in maxillary incisors, canines and distal root of mandibular molars, significant differences (p<0.05) were found between 2 parameters. Besides, there were significant differences (p<0.05) among the measured parameters in root-filled canals of maxillary premolars, all root canals of the maxillary molars and mesial root of the mandibular molars. AE showed the lowest frequency of S2 score for all groups. In conclusion the prevalence of perfect, satisfactory and deficient fillings varied significantly according to the root canal group. The quality parameters categorized fillings in 3 complexity degrees. AE was the most critical parameter of quality in root canal fillings.

O objetivo deste estudo foi avaliar o padrão de qualidade de 1.347 obturações de canais radiculares realizadas por estudantes de pós-graduação em endodontia, conforme 3 parâmetros radiográficos. Os parâmetros de qualidade analisados incluíram limite apical (LA), conicidade (CO) e homogeneidade (HO), os quais receberam escores E2 (padrão ideal), E1 (suave desvio) ou E0 (desvio acentuado). Obturação perfeita (OP) recebeu E2 em todos os parâmetros. Na ausência de um ou dois E2, as obturações foram consideradas satisfatórias (OS) ou deficientes (OD), respectivamente. Os resultados mostraram 51,7 por cento, 41,5 por cento e 6,8 por cento de OP, OS e OD, respectivamente. LA, CO e HO apresentaram semelhantes parâmetros de qualidade nos canais radiculares de incisivos e pré-molares inferiores (p>0,05). Em contrapartida, nas obturações de incisivos superiores, caninos e canais distais de molares inferiores, foram encontradas diferenças significativas entre 2 parâmetros (p<0,05). Além disso, houve diferença significativa (p<0,05) entre os parâmetros medidos em obturações de canais radiculares de pré-molares superiores, todos os canais radiculares de molares superiores e canais mesiais de molares inferiores. LA mostrou a menor frequência de E2 para todos os grupos. Em conclusão, a prevalência de obturações perfeitas, satisfatórias e deficientes variou significativamente em função dos grupos de canais radiculares. Os parâmetros de qualidade categorizaram as obturações em 3 graus de complexidade. LA foi o parâmetro crítico da qualidade das obturações dos canais radiculares.