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BACKGROUND: Changes in bone age and tooth development are late side effects of cancer therapy and can be identified by imaging examination. AIM: To evaluate the late effects of antineoplastic treatment on bone age and dental development in childhood cancer survivors. DESIGN: This is a retrospective case-control study on paediatric cancer survivors of both sexes who underwent antineoplastic treatment with 5-15 years of survival. Carpal radiographs were assessed for bone age and growth curve, and panoramic radiographs were used to evaluate dental development and alterations. Carpal radiographs were analyzed using the Greulich and Pyle inspection method, and the Martins and Sakima method was used to analyze the growth curve. All tests were applied with a confidence level of 95%. RESULTS: The study and control groups comprised 28 and 56 patients, respectively. There was no significant difference in bone age and growth curve between the study and control groups. Nonetheless, when sex was compared to chronological and bone ages, there was a significant difference in bone age (p = 0.019) and an underestimation in both groups and sexes in the Greulich and Pyle method. As to late dental effects, dental agenesia, microdontia, gyroversion, and unerupted teeth were found. Dental shape alterations mainly involve the root region. CONCLUSION: Close multidisciplinary collaboration is necessary during the follow-up period of young patients who have survived cancer.

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BACKGROUND: Arnold Chiari malformation (ACM) is characterized by an anatomical defect at the base of the skull where the cerebellum and the spinal cord herniate through the foramen magnum into the cervical spinal canal. Among the subtypes of the condition, ACM type I (ACM-I) is particularly outstanding because of the severity of symptoms. This study aimed to analyze the orofacial clinical manifestations of patients with ACM-I, and discuss their demographic distribution and clinical features in light of the literature. MATERIAL AND METHODS: A case series with patients with ACM-I treated between 2012 and 2015 was described. The sample consisted of patients who were referred by the Department of Neurosurgery to the Oral and Maxillofacial Surgery Service of Hospital da Restauração in Brazil for the assessment of facial symptomatology. A questionnaire was applied to evaluate the presence of painful orofacial findings. Data are reported using descriptive statistical methods. RESULTS: Mean patient age was 39.3 years and the sample consisted mostly of male patients. A high prevalence of headache (50%) and pain in the neck (66.7%) and masticatory muscles (50%) was found. Only one patient reported difficulty in performing mandibular movements and two reported jaw clicking sounds. Mean mouth opening was 40.83 mm. CONCLUSIONS: ACM-I patients may exhibit orofacial symptoms which may mimic temporomandibular joint disorders. This study brings interesting information that could help clinicians and oral and maxillofacial surgeons to understand this uncommon condition and also help with the diagnosis of patients with similar physical characteristics by referring them to a neurosurgeon. Key words:Arnold-Chiari malformation, facial pain, diagnosis, orofacial.

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Pycnodysostosis is a rare disorder that was first described in 1962; however, it was only in 1996 that the defective gene was discovered, which led to a better understanding of this disease. This study reports and discuss a case of pycnodysostosis. In addition, a search of articles published in PubMed-Medline was performed. The case was a 13-year-old girl who was referred to a private clinic for dental treatment. Clinical examination showed midface hypoplasia, prominent cheeks, a high nasal bridge, beaked nose, spoon-shaped fingers, frontal bossing, open fontanelles and dental alterations, findings compatible with pycnodysostosis. Patients with this disease also suffer from fractures because of bone hardness with almost no elasticity, a fact that requires special care particularly in the case of children and adolescents. The diagnosis of pycnodysostosis is made based on clinical and radiographic findings. Clinicians should be aware of this disorder to provide adequate dental treatment. Key words:Pycnodysostosis, developmental bone disease, imaging diagnosis.

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The canalis sinuosus is a neurovascular canal, a branch of nerve of infraorbital canal, through which the anterior superior alveolar nerve passes and then leans medially in course between the nasal cavity and the maxillary sinus, reaching the premaxilla in the canine and incisor region. The purpose of this article is to report a case with the presence of canalis sinuosus, in order to alert and guide professionals and discuss the morphology of this anatomical variation avoiding trans- and postsurgical disorders in dental implants. A 51-year-old female was attended to in a radiology clinic, reporting paresthesia in the right upper lip region and painful symptomatology after the installation of an implant in the corresponding region. The case revealed the presence of canalis sinuosus in imaging exams. The knowledge of this anatomical variation is essential for professionals, because attention to this region prevents irreversible damage. Therefore, the use of imaging examinations is recommended during the planning stages and treatment and after surgery in patients undergoing surgery in this area.

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Malignant peripheral nerve sheath tumor is a malignant neoplasm that is rarely found in the oral cavity. About 50% of this tumor occurs in patients with neurofibromatosis type I and comprises approximately 10% of all soft tissue sarcomas of head and neck region. Intraosseous malignant peripheral nerve sheath tumor of the maxilla is rare. This article is the first to address malignant peripheral nerve sheath tumor of the maxilla presenting as a periapical radiolucency on nonvital endodontically treated teeth in the English medical literature. Surgical approaches to malignant soft tissue tumor vary based on the extent of the disease, age of the patient, and pathological findings. A rare case of intraosseous malignant peripheral nerve sheath tumor is reported in a 16-year-old woman. The patient presented clinically with a pain involving the upper left incisors region and with defined unilocular periapical radiolucency lesion involved between the upper left incisors. An incisional biopsy was made. Histological and immunohistochemical examination were positive for S-100 protein and glial fibrillary acidic protein showed that the lesion was an intraosseous malignant peripheral nerve sheath tumor of the maxilla. Nine years after the surgery, no regional recurrence was observed.

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This case study reports the successful outcome of horizontal root fractures of two different patients, which took place in permanent incisors. Report 1 describes a case of a 29-year-old patient who suffered a mandibular trauma affecting mainly the lower central incisors, caused by a car accident. A panoramic radiograph was taken right after the accident and showed a horizontal root fracture in the middle third of tooth 42, which went untreated. Report 2 illustrates a case of a 17-year-old male patient who searched for orthodontic therapy and the periapical radiograph showed horizontal root fracture in tooth 11 caused by a previous trauma, which went untreated as well. There was healing through the reestablishment of pulp activity and dental coloration without professional intervention.

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O objetivo da pesquisa foi avaliar a influência da variação da angulagem horizontal no diagnóstico de FRVs em dentes tratados endodonticamente. Vinte e dois pré-molares permanentes com raízes retas e ápices formados foram divididos em grupos: Grupo 01(controle): dois dentes, um deles com núcleo intrarradicular; Grupo 2: dez dentes com fratura; Grupo 3: dez dentes com fratura e núcleo intrarradicular. As amostras foram submetidas a testes de compressão com uma carga de 200 kg a uma velocidade de 0,5 mm / min. Radiografias periapicais foram obtidas (70 kVp, 10 mA, e tempo de exposição de 0,3 seg.) pelo Sistema Digora® em ângulos horizontais, na direção orto radial e com uma mudança de ângulo de 25º para a direita e para a esquerda. As imagens foram avaliadas por cinco endodontistas. O diagnóstico de dentes fraturados e não fraturados foi maior para o 1.º pré-molar (51,66%) que para o 2.º (43,1%). A presença de fratura vertical foi registrada em 60,9% e 66,7% para o 1.º e 2.º prémolares, respectivamente. A presença de fratura mostra associação estatisticamente significante com a presença de núcleo intrarradicular e a variação de angulagem no 2.º pré-molar (p-valor = 0,011). Esses resultados sugerem que variações na angulagem horizontal podem otimizar o diagnóstico de FRVs... (AU)

This study aimed to evaluate the influence of changing horizontal angle during periapical radiography on the diagnosis of VRFs in endodontically treated teeth. Twenty-two single-rooted premolars with straight root canals and apex formation were divided into groups: Group 1 (control) - two non-fractured teeth, one of them with intraradicular post; Group 2 - ten fractured teeth; and Group 3 - ten fractured teeth with intraradicular post. Specimens were subjected to compression testing with a load of 200 kg at a speed of 0.5 mm/min. Periapical radiographs were obtained (70 kVp, 10mA, and 0.3 sec exposure time) in a Digora™ system at horizontal angles in the orthoradial direction and with a 25º angle shift to the right and to the left. Images were evaluated by five endodontists. The diagnosis of fractured and non-fractured roots was higher for the first premolar (51.6%) than for the second premolar (43.1%). The presence of VRFs was recorded in 60.9% of cases for the first premolar, and in 66.7% for the second premolar. Presence of VRFs showed a statistically significant association with presence of intraradicular post and angle variation in the second premolar (p=0.011). These results suggest that changes in horizontal angulation, may optimize the diagnosis of VRFs... (AU)

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OBJECTIVE: To evaluate the detection of mucous retention cyst of maxillary sinus (MRCMS) using panoramic radiography and cone beam computed tomography (CBCT). STUDY DESIGN: A digital database with 6,000 panoramic radiographs was reviewed for MRCMS. Suggestive images of MRCMS were detected on 185 radiographs, and patients were located and invited to return for follow-up. Thirty patients returned, and control panoramic radiographs were obtained 6 to 46 months after the initial radiograph. When MRCMS was found on control radiographs, CBCT scans were obtained. Cysts were measured and compared on radiographs and scans. The Wilcoxon, Spearman and Kolmorogov-Smirnov tests were used for statistical analysis. The level of significance was set at 5%. RESULTS: There were statistically significant differences between the two methods (p<0.05): 23 MRCMS detected on panoramic radiographs were confirmed by CBCT, but 5 MRCMS detected on CBCT images had not been identified by panoramic radiography. Eight MRCMS detected on control radiographs were not confirmed by CBCT. MRCMS size differences from initial to control panoramic radiographs and CBCT scans were not statistically significant (p= 0.617 and p= 0.626). The correlation between time and MRCMS size differences was not significant (r = -0.16, p = 0.381). CONCLUSION: CBCT scanning detect MRCMS more accurately than panoramic radiography.

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Objetivo: Esta pesquisa refere-se ao estudo da anatomia interna da raiz mésio-vestibular dos primeiros e segundos molares superiores permanentes. Material e método: Duzentos e vinte cinco molares tiveram a sua raiz mésio-vestibular seccionada ao nível amelo-cementário e, visualmente, com auxílio de sonda exploradora, foram selecionadas aquelas que apresentaram na região cervical, dois orifícos correspondentes às entradas dos condutos mésio-vestibular e mésio-palatino, perfazendo um total de cem raízes (44,44 %). Todas elas foram submetidas ao processo de diafanização, associada à injeção de hematoxilina, que confere transparência às raízes e coloração aos condutos, permitindo, assim, a avaliação tridimensional da anatomia dental interna. Resultados: A presença de dois condutos percorrendo toda a raiz e terminando separados em dois forames foi observada em 46% da amostra, sendo que 68% em altura apical distinta e, a percentagem de condutos que se fusionaram nos terços cervical, médio ou apical e terminaram em um forame foi de 53%. Encontrou-se, também, uma raiz com três condutos e oito dentes com uma raiz extra, correspondente ao canal mésio-palatino. Conclusão: Os resultados mostraram que a incidência expressiva de mais de um conduto na raiz mésio-vestibular e o complexo sistema de canais que ela apresenta, pode ter grande influência no sucesso dos tratamentos endodônticos dos molares superiores, exigindo, por isso, atenção especial do endodontista.

Aim: This research concerns the study of the internal anatomy of the mesiobuccal root of the first and second permanent maxillary molars. Material and methods: Two hundred and twenty five molars had their mesiobuccal root sectioned at the amelo-cemental. With the aid of the exploratory probe it was conducted a visual selection of the roots that presented at the cervical region two orifices corresponding to the entries of the mesiobuccal and mesiopalatal conduits. The total amount was of one hundred roots (44,44%). All of them underwent the process of diafanization associated with the injection of hematoxylin, what brings transparency to the roots and coloration to the ducts, thus enabling three-dimensional evaluation of the internal dental anatomy. Results: The presence of two conduits running through the entire root and ending in two separate foramina was observed in 46% of the sample, 68% in distinct apical height. The percentage of the conduits that merged at cervical, middle or apical thirds and ended in a foramen was of 53%. It was also found a root with three conduits and eight teeth with an extra root, corresponding to the mesio-palatal canal. Conclusions: The results showed that the expressive incidence of more than one conduit at the mesiobuccal root and the complex system of canals that it presents can have a great influence on the success of treatments of the upper molars, therefore requiring special attention from the endodontist.

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Objetivos: Este estudo avaliou a qualidade de imagens radiográficas expostas em consultórios odontológicos e processadas nos próprios consultórios por cirurgiões-dentistas e/ou auxiliares ou em laboratório, por pesquisadores. Métodos: Dezoito consultórios odontológicos participaram da pesquisa. Cada um recebeu um par de caixas de filmes periapicais Kodak Ektaspeed, os quais foram expostos conjuntamente, com um molar inferior extraído. O tempo de exposição variou em função do consultório odontológico. A auxiliar e/ou o cirurgião-dentista realizaram o processamento de um dos filmes, com as mesmas técnicas e recursos utilizados habitualmente (Grupo 1). O outro filme foi processado por pesquisadores em no Laboratório de Metrologia da Universidade de Pernambuco (Grupo 2). Por meio de questionário, dois radiologistas avaliaram a nitidez, densidade, contraste, definição do esmalte, dentina e junção amelodentinária, erros presentes nas imagens e se cada imagem podia ser suficiente para um bom diagnóstico. A análise estatística foi analisada utilizando o teste do Qui-quadrado e o teste exato de Fisher. Resultados: O Grupo 2 demonstrou maior número de radiografias com baixa densidade e radiografias escuras (p<0,05). O Grupo 1 apresentou maior número de radiografias claras, com pontos escuros, pontos marrons e radiografias arranhadas (p<0,05). Não houve diferença estatística significante em relação à nitidez, contraste, definição do esmalte, dentina e junção amelodentinária, presença de pontos claros e capacidade de levar a um bom diagnóstico (p>0,05). Conclusões: Este estudo sugeriu que imagens radiográficas produzidas em consultórios odontológicos apresentam imperfeições na técnica de execução e no processamento. Entretanto, apesar da importância do correto processamento radiográfico, a sobre-exposição de filmes foi a maior causa de falhas na qualidade da imagem.

This work aims evaluate subjectively the quality of radiographic images exposed in dental offices and processed in proper dental offices by surgeon-dentists and/or assistants or in laboratory, by researchers. Methods: Eighteen dental offices integrated the research. Each one received a pair of Kodak Ektaspeed periapical films which was exposed together with an extracted inferior molar. The exposition time varied in function of each dental office. The assistant and/or surgeon dentist carried through the processing of one of the films, with the same technique and resources used habitually (Group 1). The other film was processed by researchers in the Laboratory of Metrology of Federal University of Pernambuco (Group 2). Through a questionnaire, two radiologists evaluated the sharpness, density, contrast, definition of enamel, dentine and amelodentinary junction, errors present in the images and if each image would be enough for a good diagnosis. Results: Through Chi-Square or Fisher´s Exact test, it was observed that Group 2 got a bigger number of radiographs with low density and dark radiographs (p-value<0,05). Group 1 presented a bigger number of clear radiographs, with dark spots, brown spots and scratch radiographs (p-value<0,05). There wasn?t statistical significant difference in relation to sharpness, contrast, definition of enamel, dentine, and amelodentinary junction, presence of clear spots and the capacity of carrying through a good diagnosis (p-value> 0.05). Conclusions: This study suggested that radiographic images produced in dental office present imperfections in technique execution and in the processing. However, despite the importance of a correct radiographic processing, the overexposure of the films was the major cause of flaws in image quality.

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INTRODUCTION: Lymphangiomas mimicking apical periodontitis, usually found in soft tissue of children and infants younger than 2 years, are extremely rare in aged patients, particularly in bone tissues. METHODS: An 81-year-old woman was seen in a radiological service to undergo imaging studies for the placement of dental implants. A panoramic radiograph showed a radiolucent multilocular structure in the left mandibular molar region, where teeth #17 and #18 had previously been treated endodontically. A fracture in tooth #17 was detected. Because of the patient's clinical history and the characteristics of the image, which showed changes in trabecular bone structure, the patient was referred for cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) for further evaluation. CBCT scans demonstrated a well-circumscribed lesion immediately below the roots of teeth #17 and #18. MRI showed no involvement of the surrounding soft tissues, and the lesion affected only the mandibular bone. Incision biopsy was performed, and the tissue sample (histopathology specimen) was sent to microscopic evaluation. RESULTS: Microscopically, there was a proliferation of vascular endothelium covered by long and mature endothelial cells. In the vessel lumens, there was eosinophilic material similar to lymph. The microscopic examination suggested the diagnosis of lymphangioma. CONCLUSIONS: Pathologies of non-endodontic origin such as lymphangioma, which might be in the area of the tooth apex, should be included in the differential diagnosis of apical periodontitis. Histopathologic examination is mandatory for their diagnosis and treatment.

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Introdução: a Portaria 453 do Ministério da Saúde recomenda processar filmes radiográficos intrabucais em câmara escura portátil opaca, sem visor e pelo método temperatura x tempo. Porém, ainda é frequente o processamento pelo método visual em câmaras com visor de polímero de acrílico.O objetivo deste estudo foi avaliar e comparar a capacidade de filtragem de quatro câmaras escuras portáteis (Unemol®,VH®, MPG® e câmara sem identificação) com a de uma câmara escura convencional (controle), e verificar sua influência na qualidade de imagem em diferentes filmes radiográficos (Kodak®: DF-58 Ultra-Speed, E-Speed, IP-21 Insight; e Agfa®Dentus M2). Métodos: os filmes foram expostos junto comum penetrômetro de alumínio e uma placa de chumbo e processados,em soluções Kodak® prontas para uso, em cada câmara portátil e na câmara escura convencional (controle).Os filmes permaneceram três minutos no revelador e a cada minuto eram aproximados do visor, simulando a condição clínica, seguido de banho intermediário e fixação por seis minutos. Foi feita a avaliação fotodensitométrica e os dados foram analisados estatisticamente pelos testes de Mann-Whitneye Kruskal-Wallis. Resultados: o primeiro teste mostrou que, em relação ao grupo controle, somente não houve diferença estatística significativa com a câmara Unemol® quando da utilização dos filmes IP-21 Insight e E-Speed, e com a câmara VH® ao usar o filme IP-21 Insight. O segundo teste mostrou diferença estatística significativa quando da comparação dos filmes entre si. Conclusão: conclui-se que o visor de acrílico aumenta a densidade base e velamento, prejudicando a qualidade da imagem radiográfica

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OBJETIVO: avaliar métodos de digitalização indireta de radiografias cefalométricas em comparação ao método digital direto. MÉTODOS: a amostra foi composta de dez radiografias cefalométricas adquiridas pelo Orthopantomograph OP100/Orthocef OC100 (GE - Instrumentarium), digital direto. As imagens foram inseridas no programa Adobe Photoshop® e cinco pontos cefalométricos foram marcados. Procedeu-se a impressão em transparência e foi feita a digitalização indireta das imagens impressas, por meio das câmeras fotográficas digitais Sony® DSC-W5 e Canon® Rebel XT/EOS 350D, fixas em estativa, nas distâncias de 25cm e 60cm e com o scanner Scan Jet 4C Hewlett Packard®. As imagens diretas e indiretas foram inseridas e calibradas no software Radiocef Studio (Radiomemory®, Brasil), marcando-se o centro dos pontos previamente assinalados. A análise cefalométrica computadorizada gerou três grandezas angulares e quatro lineares, as quais foram submetidas a tratamento estatístico. RESULTADOS: as imagens do scanner Scan Jet 4C HP® demonstraram pequenas alterações significativas, porém, sem relevância clínica. Quando da digitalização a 60cm da radiografia, as duas câmeras causaram distorções que foram significativas mas clinicamente aceitáveis; e, a 25cm, causaram as maiores distorções, com importância clínica, na Canon® Rebel XT. CONCLUSÃO: o scanner Scan Jet 4C HP® com leitor de transparências foi o melhor método e as câmeras operando a 60cm mostraram-se adequadas para digitalização de radiografias. As câmeras na distância de 25cm causaram distorções na imagem que alteraram as medidas lineares, podendo a Canon® Rebel XT comprometer o diagnóstico ortodôntico.

OBJECTIVE: To evaluate the indirect digitization method of cephalometric radiographs in comparison with the direct digital method. METHODS: The sample was composed of ten cephalometric radiographs acquired by Orthopantomograph OP100/Orthocef OC100 (GE - Instrumentarium), digital direct. In the AdobeÕ Photoshop program, five cephalometric landmarks were set in the images and the impression in transparencies was made. The indirect digitization of the images was performed through the SonyÕ DSC-W5 and CanonÕ Rebel XT/EOS 350D digital photographic cameras-fixed in a copy stand, at the distances of 25 cm and 60 cm-and through the Hewlett PackardÕ Scan Jet 4C scanner. The direct digital images and the indirect ones were inserted and gauged in the Radiocef Studio (RadiomemoryÕ, Brazil) software and the center of the previously marked landmarks was set. The cephalometric computerized analysis generated three angular measurements and four linear ones which were submitted to statistical analysis. RESULTS: The images from the scanner demonstrated small statistically significant alterations, without clinical significance. When digitizing the radiographs at 60 cm, both cameras caused distortions which were statistically significant, but clinically acceptable. At 25 cm, the cameras caused the largest distortions, being more expressive and with clinical significance in the images of CanonÕ Rebel XT. CONCLUSIONS: The Hewlett PackardÕ Scan Jet 4C scanner with transparency reader and the SonyÕ DSC-W5 and CanonÕ Rebel XT/EOS cameras operating at 60 cm were shown appropriate for the digitization of cephalometric radiographs. In 25 cm, the digital cameras caused distortions in the image which altered the linear measurements with possibilities of jeopardizing the orthodontic diagnosis.

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The determination of the success of endodontic treatment has been often discussed based on outcome obtained by periapical radiography. The aim of this study was to verify the influence of intracanal post on apical periodontitis detected by cone-beam computed tomography (CBCT). A consecutive sample of 1020 images (periapical radiographs and CBCT scans) taken from 619 patients (245 men; mean age, 50.1 years) between February 2008 and September 2009 were used in this study. Presence and intracanal post length (short, medium and long) were associated with apical periodontitis (AP). Chi-square test was used for statistical analyses. Significance level was set at p<0.01. The kappa value was used to assess examiner variability. From a total of 591 intracanal posts, AP was observed in 15.06%, 18.78% and 7.95% using periapical radiographs, into the different lengths, short, medium and long, respectively (p=0.466). Considering the same posts length it was verified AP in 24.20%, 26.40% and 11.84% observed by CBCT scans, respectively (p=0.154). From a total of 1,020 teeth used in this study, AP was detected in 397 (38.92%) by periapical radiography and in 614 (60.19%) by CBCT scans (p<0.001). The distribution of intracanal posts in different dental groups showed higher prevalence in maxillary anterior teeth (54.79%). Intracanal posts lengths did not influenced AP. AP was detected more frequently when CBCT method was used.

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This article describes the case of a 34-year-old woman whose prosthodontist had referred her for root canal treatment of tooth No. 10, due to an initial diagnosis of apical periodontitis. Although periapical radiolucencies were present, teeth No. 10 and 11 responded positively to pulp vitality tests. A series of periapical radiographs revealed circumscribed periapical radiolucencies on teeth No. 21 and 28, while teeth No. 23, 24, and 27 were associated with mixed radiolucent/radiopaque periapical lesions. All teeth responded to cold stimulus. Based on the clinical and radiographic findings, a diagnosis of periapical cemento-osseous dysplasia was suggested. A re-evaluation 12 months later confirmed this diagnosis. Tooth No. 10 was restored and the patient was scheduled to return for clinical and radiographic follow-up after one year and three years.

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The determination of the success of endodontic treatment has been often discussed based on outcome obtained by periapical radiography. The aim of this study was to verify the influence of intracanal post on apical periodontitis detected by cone-beam computed tomography (CBCT). A consecutive sample of 1020 images (periapical radiographs and CBCT scans) taken from 619 patients (245 men; mean age, 50.1 years) between February 2008 and September 2009 were used in this study. Presence and intracanal post length (short, medium and long) were associated with apical periodontitis (AP). Chi-square test was used for statistical analyses. Significance level was set at p<0.01. The kappa value was used to assess examiner variability. From a total of 591 intracanal posts, AP was observed in 15.06 percent, 18.78 percent and 7.95 percent using periapical radiographs, into the different lengths, short, medium and long, respectively (p=0.466). Considering the same posts length it was verified AP in 24.20 percent, 26.40 percent and 11.84 percent observed by CBCT scans, respectively (p=0.154). From a total of 1,020 teeth used in this study, AP was detected in 397 (38.92 percent) by periapical radiography and in 614 (60.19 percent) by CBCT scans (p<0.001). The distribution of intracanal posts in different dental groups showed higher prevalence in maxillary anterior teeth (54.79 percent). Intracanal posts lengths did not influenced AP. AP was detected more frequently when CBCT method was used.

O objetivo deste estudo foi determinar a influência de retentores intraradiculares na periodontite apical (PA), detectados por radiografia periapical (RP) e tomografia computadorizada de feixe cônico (TCFC). Um total de 1.020 imagens, tomadas de 619 pacientes (245 homens, idade média de 50,1 anos), entre Fevereiro de 2008 e Setembro de 2009, foram avaliadas. A presença e o comprimento de retentores intraradiculares (curto, médio e longo) foram associados com a PA. Os dados foram estatisticamente avaliados empregando-se os testes Qui-quadrado e o Kappa. Três observadores avaliaram todas as imagens, considerando-se a presença de retentor intraradicular, seu comprimento e a PA. De um total de 1.020 dentes analisados no estudo, a PA foi detectada em 397 (38,92 por cento) usando RP e em 614 (60,19 por cento) usando TCFC (p<0,001). Em 591 retentores intraradiculares, nos diferentes comprimentos (curto, médio, longo) foram observadas PA usando RP em 15,06 por cento; 18,78 por cento e 7,95 por cento, respectivamente (p=0,466). Considerando os mesmos comprimentos de retentores foram observados PA em 24,20 por cento; 26,40 por cento e 11,84 por cento por meio de TCFC, respectivamente (p=0,154). A distribuição de retentores nos diferentes grupos dentários mostrou elevada prevalência em dentes anteriores superiores (54,79 por cento). Os retentores intraradiculares não influenciaram a PA e as TCFC detectaram mais freqüentemente a periodontite apical.

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This case report shows the importance of establishing the correct diagnosis to provide the appropriate treatment options The traumatic bone cyst is a pseudocyst, usually asymptomatic and found by a routine radiographic examination. Unicystic radiolucency is almost always observed, which can involve the periradicular area of teeth, simulating an inflammatory lesion of endodontic origin. Differential diagnosis should include other pathologies, such as odontogenic keratocyst, central giant cell granuloma, and unicystic ameloblastoma. Its etiology and pathogenesis are not yet definitely established. In the present study, after review of the medical and dental histories and clinical and radiographic examination of teeth #24-27 (pulpal vitality test showed positive), the primary diagnosis was traumatic bone cyst. The planning was excisional biopsy. After surgical exploration, only one small blood clot was observed in the intraosseous socket, which was carefully curetted and filled with blood. A clinical and radiographic examination after 6 months showed apical formation and pulpal vitality preserved.

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