Análise da relação entre o assoalho do seio maxilar e as raízes dos dentes posteriores superiores por meio de tomografias Cone Beam e radiografias panorâmicas / Analysis of the relationship between the maxillary sinus floor and the posterior maxillary dental roots using cone beam tomographies and panoramic radiographies

A relação das raízes dentárias superiores com o assoalho do seio maxilar é de suma importância para o planejamento de intervenções endodônticas. Este estudo objetivou avaliar a porcentagem de raízes de pré-molares e molares superiores em íntimo contato com o seio maxilar por meio de tomografias computadorizadas e comparar a visualização da mesma região em radiografias panorâmicas, por diferentes avaliadores. Foi realizada a análise de 82 tomografias por uma radiologista (radiologista 1). Após, 41 radiografias panorâmicas correspondentes às tomografias foram analisadas tanto por um estudante de especialização em Endodontia quanto por outra radiologista (radiologista 2), buscando também analisar a relação entre as raízes e o seio maxilar. Foram utilizados os testes Qui-quadrado e Exato de Fisher, e para a concordância entre os examinadores, o teste Kappa. A análise das tomografias (p<0,001) mostrou o primeiro pré-molar significativamente mais fora do seio maxilar e a raiz palatina do primeiro molar mostrou-se mais dentro. O índice Kappa da avaliação das radiografias panorâmicas comparado à tomografia pelo estudante foi de 0,784 e da radiologista 2 foi de 0,838, obtendo, esta última, melhores resultados que o estudante de Endodontia. Quando analisado por grupo dental, a concordância entre a radiografia panorâmica e a tomografia decresceu quanto mais posterior se localiza o elemento dental. A experiência influencia no julgamento da relação da raiz com o seio maxilar. A tomografia computadorizada é o exame mais indicado para analisar a relação entre as raízes dos dentes superiores e o assoalho do seio maxilar (AU).

The relationship of the superior dental roots with the maxillary sinus floor is utterly important for endodontic interventions planning. This study aimed to evaluate the percentage of premolars and maxillary molars roots in close contact with the maxillary sinus using computed tomographies and to compare the visualization of the same region in panoramic radiographs by different examiners. The analysis of 82 tomographies was performed by a radiologist (radiologist 1). Afterwards, 41 panoramic radiographies corresponding to the tomographies were analyzed by both an Endodontics specialization student and another radiologist (radiologist 2), also aiming to analyze the relationship between the roots and the maxillary sinus. Chi-square and Fisher's exact tests were used, and for agreement between the examiners the Kappa test was used. Analysis of the tomographies (p <0.001) showed that the first premolar was significantly more outside the maxillary sinus and the first molar palatine root showed to be more inside. The Kappa index of panoramic radiographies assessment compared to the tomography by the student was 0.784 and to the radiologist 2 was 0.838, obtaining this last one better results than that of the Endodontics student. When analyzed by dental group, the concordance between panoramic radiography and tomography decreased as more posterior is located the dental element. Experience influences in the judgment of the root and maxillary sinus relationship. Computed tomography is the most appropriate test to analyze the relationship between the upper teeth roots and the maxillary sinus floor (AU).

Evaluation of three root canal filling techniques through digital radiograph

Introduction: Endodontic obturation consists of root canal filling by antiseptic or inert materials that promote a three-dimensional sealing and stimulate the repair process without interfering with it. Different obturation techniques and materials have been proposed to meet this requirement. Objective: To compare the root canal filling promoted by lateral condensation technique, Tagger's hybrid technique and McSpadden technique by assessing the filling quality through digital radiograph. Material and methods: A total of 45 extracted single-rooted human teeth were used and randomly divided into three experimental groups. After instrumentation, the teeth were filled by lateral condensation (n=15), Hybrid Tagger (n=15), and McSpadden techniques (n=15). Then, digital radiographs were taken with projected increased 10 times, at mesial-distal and buccolingual directions. Results: Visually, few empty spaces were detected at the three root thirds of teeth filled by different techniques. However, statistical analysis (Kruskal-Wallis) found no differences among the different groups, neither among the different thirds nor between both incidences evaluated. Conclusion: It was concluded that the three obturation techniques exhibited similar behavior in relation to the sealing of the root canal through digital radiograph.