RESUMO
O objetivo do presente estudo foi avaliar em tomografias computadorizadas as dimensões dos tecidos periodontais supracrestais (TPSC). Cem pacientes, 600 dentes anteriores da maxila (200 incisivos centrais, 200 incisivos laterais e 200 caninos), foram avaliados. A distância média da margem gengival até a crista óssea alveolar (COA) foi de 3.25mm (95% IC: 3.20-3.30), enquanto que da junção cemento-esmalte até a COA foi de 1.77mm (95% IC: 1.72-182mm). As medidas foram significativamente diferentes entre os grupos de dentes (ANOVA, p < 0.001). A tomografia, pode representar uma importante ferramenta para a avaliação das dimensões dos TPSC.
The aim of this study was to evaluate the dimensions of the supracrestal periodontal tissues (SPT) on tomographic scans. One hundred patients, 600 maxillary anterior teeth (200 central incisors, 200 lateral incisors and 200 canines), were evaluated. The average distance from the gingival margin to the alveolar bone crest (ABC) was 3.25mm (95% CI: 3.20-3.30), while the distance from the cemento-enamel junction to ABC was 1.77mm (95% CI: 1.72-182mm). The measurements were significantly different between the tooth groups (ANOVA, p < 0.001). When properly indicated, tomography can be an important tool for assessing the dimensions of TPSCs on a case-by-case basis.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Tecidos , Periodonto , Tomografia Computadorizada de Feixe Cônico , MaxilaRESUMO
Este estudo teve como objetivo avaliar o dimorfismo sexual em uma coleção de mandíbulas portuguesas através de uma metodologia métrica digital, utilizando análise estatística descritiva, inferencial e multivariada para identificar quais parâmetros são mais dimórficos e quais são os melhores preditores de sexo. Trinta e três mandíbulas (14 mulheres e 19 homens) e pertences pessoais foram fotograficamente registrados com código e sexo. Os dados foram coletados por tomografia e as medidas foram feitas pelo software Simplant Pro. Foram registrados a largura máxima e mínima do ramo mandibular, altura condilar, altura do processo coronoide, altura da sínfise mandibular, ângulo mandibular, distâncias bimentual, biantegonial, bigonial e bicondilar e comprimento máximo mandibular. A análise estatística foi realizada utilizando IBM® SPSS. Os resultados mostraram diferenças estatisticamente significativas para os seguintes parâmetros: altura do processo coronoide, altura do côndilo, comprimento máximo da mandíbula e largura mínima do ramo mandibular. Na análise estatística multivariada foi possível identificar a altura do processo coronoide como melhor preditor de sexo com precisão em 72,2% dos casos. Isto permite uma diferenciação mais fácil entre mandíbulas femininas e masculinas com uma precisão de 64,3% e 78,9%, respectivamente. Foi possível concluir que a altura do processo coronoide é o parâmetro mais dimórfico e o melhor preditor de sexo na amostra.
This study aimed to assess sex dimorphism in a collection of Portuguese mandibles through a digital metric methodology by using descriptive, inferential, and multivariate statistical analysis to identify which parameters are the most dimorphic and which are the best sex predictors. Thirty-three mandibles (14 females and 19 males) and personal belongings were photographically registered with code and sex. Data was collected using tomography, and measurements were made using the Simplant Pro software. The maximum and minimum width of the mandibular ramus, condylar height, coronoid process height, mandibular symphysis height, mandibular angle, bi-mental, bi-antegonial, bi-gonial and bi-condylar distances, and maximal mandibular length were registered. Statistical analysis was performed using IBM® SPSS. The results showed statistically significant differences for the following parameters: coronoid process height, condyle height, the maximum length of the mandible, and the minimum width of the mandibular ramus. In the multivariate statistical analysis, it was possible to identify the coronoid process height as the best sex predictor accurately in 72.2% of cases. This allows for easier differentiation between female and male mandibles with an accuracy of 64.3% and 78.9%, respectively. It was possible to conclude that the coronoid process height is the most dimorphic parameter and the best sex predictor in the sample.
Assuntos
Humanos , Masculino , Feminino , Caracteres Sexuais , Diagnóstico , Tomografia Computadorizada de Feixe Cônico , MandíbulaRESUMO
INTRODUCTION: Cases involving invasive cervical root resorption (ICRR) in oncological patients are rare, in addition, follow-up of these patients has not yet been reported in the literature. OBJECTIVE: This study aims to present a literature review and report a case of denosumab as a possible cause of ICRR in a patient with breast cancer with 2 years of follow-up. CASE REPORT: A 39-year-old female with a history of luminal breast cancer was treated with denosumab semiannually for osteopenia with discontinuation 1 year ago. Oral examination revealed areas of ICRR lesions on two mandibular teeth. The patient presented irreversible pulpitis on the lower left first molar (#19). The lower right first premolar (#28) was asymptomatic, and the resorption cavity was restricted to the tooth crown. Cone-beam computed tomography (CBCT) established the ICRR 2Bp and 2Ad diagnosis in teeth #19 and #28, respectively. Periodontal surgery and a nonsurgical root canal were performed in the molar and restorative treatment was performed in the premolar. Two years after treatment, both teeth were functional and asymptomatic, and probing was within normal limits (< 3 mm) without bleeding. Periapical radiographic examination revealed no progression of resorption nor new lesions. CONCLUSIONS: This article highlights a rare adverse effect of an antiresorptive therapy, unfamiliar to most clinicians and specialists. In addition, it emphasizes that the early diagnosis and follow-up of ICRR are relevant and can provide successful treatment, avoiding infections and extractions.
Assuntos
Neoplasias da Mama , Tomografia Computadorizada de Feixe Cônico , Denosumab , Reabsorção da Raiz , Humanos , Feminino , Reabsorção da Raiz/diagnóstico por imagem , Adulto , Denosumab/uso terapêutico , Denosumab/efeitos adversos , Neoplasias da Mama/complicações , Conservadores da Densidade Óssea/uso terapêutico , Conservadores da Densidade Óssea/efeitos adversos , SeguimentosRESUMO
INTRODUCTION: The early diagnosis of mandibular asymmetry (MA) in patients with unilateral cleft lip and palate (UCLP) can contribute to its treatment. OBJECTIVE: The aim of this study was to evaluate the occurrence and the extent of MA in UCLP patients at different growth stages. METHODS: Cone-beam computed tomography (CBCT) of 47 UCLP patients were included, and divided into two groups (prepubertal stage and pubertal stage). The mandibular ramus height (Co-Go), mandibular body length (Go-Me), total mandibular length (Co-Me), gonial angle (CoGoMe), the volume of the mandibular condyles, and lateral chin deviation were evaluated. The cleft side (CS) and noncleft side (NCS) were compared using the paired t-test for dependent samples. Chin deviation and its possible association with specific sides were evaluated using the Mann-Whitney and Fisher's Exact tests, respectively. The significance level was set at 5%. RESULTS: Comparison of CS and NCS revealed that in prepubertal stage, Co-Me was shorter (105.5 ± 5.7 mm; p = 0.036) in the CS, and that in pubertal stage, Co-Go was lower (46 ± 6 mm; p= 0.004) and Go-Me was greater (78.5 ± 5.8 mm; p = 0.026) in the CS. In both growth stages, a significant association (p< 0.05) was observed between the side to which the chin has deviated and the CS. CONCLUSIONS: Although patients with UCLP in the prepubertal and pubertal stages presented significant measurements revealing MA, only Co-Go in the pubertal stage showed a clinically relevant difference. This specific result indicates that MA must be monitored during patients' growth.
Assuntos
Fenda Labial , Fissura Palatina , Tomografia Computadorizada de Feixe Cônico , Assimetria Facial , Imageamento Tridimensional , Mandíbula , Humanos , Fenda Labial/diagnóstico por imagem , Fenda Labial/fisiopatologia , Fissura Palatina/diagnóstico por imagem , Fissura Palatina/fisiopatologia , Estudos Transversais , Criança , Feminino , Masculino , Mandíbula/crescimento & desenvolvimento , Mandíbula/diagnóstico por imagem , Adolescente , Assimetria Facial/diagnóstico por imagem , Imageamento Tridimensional/métodos , Puberdade/fisiologia , Queixo/diagnóstico por imagem , Queixo/crescimento & desenvolvimento , CefalometriaRESUMO
INTRODUCTION: With the introduction of Cone Beam Computed Tomography (CBCT) in dentistry, precise measurements are now attainable. OBJECTIVE: This study seeks to explore the correlation between incisors inclination and various lip parameters utilizing CBCT technology. Moreover, it aims to assess whether specific incisors inclinations significantly influence lip thickness, length, and position. MATERIAL AND METHODS: This was a retrospective observational study of available records of orthodontic patients (n=84) aged between 11 and 17.5 years old with pre- and post-treatment CBCT imaging. The 3D Slicer software was used to assess lip parameters and incisors inclinations while adhering to standard CBCT imaging methods. Statistical analysis was conducted to find associations between incisors inclination and lip parameters. RESULTS: Within certain limits of incisor inclination, lip parameters showed minimal impact. Changes in upper incisor inclination within an average of 5° did not significantly correlate with upper lip parameters. Similarly, changes in lower incisor inclination within an average of 5.6° had no significant effect on lower lip parameters. However, inclination changes of tooth #21 within 5.4° significantly affected upper lip length within 0.35mm. CONCLUSIONS: Lip parameters remained unaffected with specific ranges of incisor inclinations, except for a slight effect on upper lip length with changes in inclination of tooth #21. Clinicians can consider the specific ranges of incisors inclination during treatment planning, especially for patients concerned about lip appearance.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Incisivo , Lábio , Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Incisivo/diagnóstico por imagem , Incisivo/anatomia & histologia , Lábio/diagnóstico por imagem , Lábio/anatomia & histologia , Adolescente , Estudos Retrospectivos , Criança , Feminino , Masculino , Imageamento Tridimensional/métodosRESUMO
OBJECTIVE: This retrospective study aimed to compare the three-dimensional (3D) outcomes of the novel miniscrew-anchored maxillary protraction (MAMP) therapy and the bone-anchored maxillary protraction (BAMP) therapy. METHODS: The sample comprised growing patients with skeletal Class III malocclusion treated with two skeletal anchored maxillary protraction protocols. The MAMP group comprised 22 patients (9 female, 13 male; 10.9â ±â 0.9 years of age at baseline) treated with Class III elastics anchored on a hybrid hyrax expander in the maxilla and two mandibular miniscrews distally to the permanent canines. The BAMP group comprised 24 patients (14 female, 10 male; 11.6â ±â 1.1 years of age at baseline) treated with Class III elastic anchored in two titanium miniplates in the infra-zygomatic crest and two miniplates in the mesial of the mandibular permanent canines. Three-dimensional displacements were measured in the pre- and post-treatment cone-beam computed tomography scans superimposed on the cranial base using the Slicer Automated Dental Tools module of 3D Slicer software (www.slicer.org). Mean differences (MD) between groups and 95% confidence interval (CI) were obtained for all variables. Intergroup comparison was performed using the Analysis of Covariance (Pâ <â .05). RESULTS: Both groups showed improvements after treatment. The MAMP group showed a smaller anterior (MD: -1.09 mm; 95% CI, -2.07 to -0.56) and 3D (MD: -1.27 mm; 95% CI, -2.16 to -0.74) displacements of the maxilla after treatment when compared with BAMP. Both groups showed negligible and similar anteroposterior changes in the mandible (MD: 0.33 mm; 95% CI, -2.15 to 1.34). A greater increase in the nasal cavity width (MD of 2.36; 95% CI, 1.97-3.05) was observed in the MAMP group when compared with BAMP. LIMITATIONS: The absence of an untreated control group to assess the possible growth impact in these findings is a limitation of this study. CONCLUSION: Both BAMP and MAMP therapies showed adequate 3D outcomes after treatment. However, BAMP therapy produced a greater maxillary advancement with treatment, while MAMP therapy showed greater transversal increases in the nasal cavity.
Assuntos
Placas Ósseas , Parafusos Ósseos , Tomografia Computadorizada de Feixe Cônico , Imageamento Tridimensional , Má Oclusão Classe III de Angle , Maxila , Procedimentos de Ancoragem Ortodôntica , Técnica de Expansão Palatina , Humanos , Feminino , Masculino , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Estudos Retrospectivos , Má Oclusão Classe III de Angle/terapia , Má Oclusão Classe III de Angle/diagnóstico por imagem , Técnica de Expansão Palatina/instrumentação , Tomografia Computadorizada de Feixe Cônico/métodos , Criança , Imageamento Tridimensional/métodos , Maxila/diagnóstico por imagem , Cefalometria/métodos , Desenho de Aparelho Ortodôntico , Resultado do Tratamento , Dente Canino/diagnóstico por imagem , Mandíbula/diagnóstico por imagemRESUMO
PURPOSE: This study utilized cone-beam computed tomography images to assess the potential of maxillary sinus (MS) and piriform aperture (PA) measurements in sex prediction and to identify possible correlations between these structures and the MS ostium. METHODS: A total of 204 images were selected and divided into two groups: 102 for constructing and testing the formula, and 102 for validation. In each subgroup, the images were equally divided for 11 measurements by two examiners in the MS (height, width, length, and total width), PA (height and width), and maxillary ostium diameter. RESULTS: Significant correlations were found in males and in the total analysis for all measurements of the right MS, while the length of the left MS showed a positive correlation with PA height. In the total analysis, the height of the left MS and the total width along the MS also positively correlated with PA height. When tested, the constructed formula resulted in an accuracy of 82.4%. CONCLUSION: Tomographic images proved to be excellent tools for sex prediction, as the measurements described in this study could be reproduced and analyzed in different populations, considering that craniometric characteristics may vary across populations.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Seio Maxilar , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/anatomia & histologia , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Idoso , Adolescente , Cefalometria/métodosRESUMO
OBJECTIVE: Cleft lip and palate are the most common congenital malformations in the craniofacial region, occurring at a rate of 1:700 births in Brazil. These conditions lead to functional impacts on patients, such as changes in breathing, teeth, speech, chewing, swallowing and sucking. Treatment begins with primary surgeries, including lip and palate repair, which aim to reconstruct the soft tissues. Secondary alveolar bone grafting (SABG) reconstructs the bone defect in the cleft region, with the main goal of supplying bone tissue to the cleft region and restore the continuity of the alveolar process. To measure the changes in cross-sectional areas (CSAs) and nasal volume in patients and their impact on the nasal cavity (NC) in the two-month postoperative period (PO2M). METHODOLOGY: This study included 15 patients with complete unilateral cleft lip and palate (U/CLP) indicated for alveolar bone grafting (ABG). Cone beam computed tomography scans obtained prior to SABG and at PO2M were compared. Nasal volumes and CSAs were measured by marking the masks delimiting the nasal cavity on CT scans using Mimics™ software. RESULTS: NC volumes (total, right and left sides) were statistically lower at PO2M in patients with left-sided UCLP. In right-sided UCLP, these volumes were only significant for the total NC and left NC. The CSAs of the internal nasal valve in both groups showed significantly lower values compared to the preoperative period (p≤0.05). CONCLUSION: In the short term, alveolar bone graft surgery reduces the volume of nasal cavities and the cross-sectional areas of the right and left internal nasal valve as a whole, not only the cleft area where the graft material was placed.
Assuntos
Enxerto de Osso Alveolar , Fenda Labial , Fissura Palatina , Tomografia Computadorizada de Feixe Cônico , Cavidade Nasal , Humanos , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Enxerto de Osso Alveolar/métodos , Feminino , Masculino , Resultado do Tratamento , Cavidade Nasal/cirurgia , Criança , Estatísticas não Paramétricas , Fatores de Tempo , Valores de Referência , Adolescente , Período Pós-Operatório , Reprodutibilidade dos TestesRESUMO
OBJECTIVES: To investigate the influence of combining levels of metal artifact reduction (MAR) tool with different filters and slice-thickness in the detection of mandibular canals perforated by implants on CBCT scans and to objectively assess the impact of the aforementioned combinations. MATERIALS AND METHODS: Implants were placed above (8 implants) and inside (10 implants) mandibular canals of dried-mandibles. CBCT scans were obtained with the Eagle 3D unit (85 kVp, 8 mA, 5 × 5 cm FOV, 130 µm voxel size, and off/medium/high MAR levels). Examiners evaluated the scans under each MAR level and across different conditions: no filter, Sharpen 1×, Sharpen 2×; 0 mm, 1 mm, and 2 mm slice-thickness. The gray values on axial reconstructions were assessed. Area under the receiver operating characteristic curve (AUC), sensitivity, specificity, mean and standard deviation (SD) for gray values were calculated and compared by multi-way Analysis of Variance. RESULTS: Overall, the AUC and sensitivity decreased with high-level MAR (p < 0.0001), regardless other variables tested. Enabling MAR tool decreased mean gray values (p < 0.01) and increasing MAR levels reduced the SD values on scans with Sharpen 2× (p < 0.012). CONCLUSIONS: High-level MAR impairs the visualization of mandibular canals perforated by implants. Moreover, enabling MAR tool decreases the mean gray values. CLINICAL RELEVANCE: MAR tool, filters, and slice thickness influence the image quality of CBCT scans. Therefore, it is important to evaluate the impact of these parameters on the diagnosis of mandibular canals perforated by implants.
Assuntos
Artefatos , Tomografia Computadorizada de Feixe Cônico , Implantes Dentários , Mandíbula , Metais , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Sensibilidade e Especificidade , Técnicas In Vitro , Imageamento Tridimensional/métodosRESUMO
While the literature has noted variations in hydrogen peroxide (HP) permeability, and consequently, tooth sensitivity among different types of anterior teeth, there is a scarcity of research on this specific topic. This study evaluated HP permeability and color change (CC) in different groups of human maxillary anterior teeth (canines, lateral incisors, and central incisors) after in-office bleaching with HP at 35%. Thirty teeth maxillary anterior (n=10) were bleached with HP at 35% gel in one session of three 15-minutes applications. Buccal thickness (mm) was measured from images obtained using cone beam computed tomography. The concentration of HP (µg/mL) that reached the pulp chamber was assessed using UV-Vis spectrophotometry. CC (WID, ∆Eab, and ∆E00) was evaluated before and after bleaching with a digital spectrophotometer. One-way ANOVA and Tukey's test were applied to statistically evaluate the data for buccal thickness, HP permeability, and CC (α=0.05). Comparison between thickness and HP permeability was performed using Pearson's correlation. Thicker teeth, such as canines, had lower HP amounts inside the pulp chamber compared to central and lateral incisors. Despite the significant effect of buccal thickness on HP permeability (p<0.05), no correlation was found between the two factors. CC was similar across tooth types (p>0.05). The difference in buccal thickness among the superior anterior teeth does not interfere with CC. However, a thinner buccal wall thickness is associated with greater HP permeability detected in the pulp after in-office bleaching.
Assuntos
Peróxido de Hidrogênio , Incisivo , Maxila , Clareamento Dental , Humanos , Clareamento Dental/métodos , Incisivo/diagnóstico por imagem , Cavidade Pulpar/diagnóstico por imagem , Cor , Clareadores Dentários , Espectrofotometria/métodos , Tomografia Computadorizada de Feixe CônicoRESUMO
OBJECTIVES: To assess the effective and organ/tissue equivalent radiation doses of different scout projection protocols in four CBCT units. METHODS: Optically stimulated luminescence dosimeters (OSLD) were placed in reference anatomical locations in the head and neck segments of an anthropomorphic phantom representing an average adult male. Ten repeated exposures were obtained from each of the twelve scout projections studied, acquired from four maxillofacial cone beam computed tomography (CBCT) units (Midmark EIOS, 3D Accuitomo F170, Veraviewepocs 3D R100, and Veraview X800). The effective and organ/tissue equivalent doses were calculated for each protocol. RESULTS: Effective doses ranged from 0.7 µSv (Accuitomo F170 60 × 60 mm-anterior maxilla) to 6.9 µSv (Midmark 50 × 50 mm-anterior maxilla). The highest organ/tissue equivalent doses were recorded for the oral mucosa and salivary glands; however, the thyroid was the highest contributor to the effective dose, followed by the salivary glands. CONCLUSIONS: Despite some variability among CBCT machines and protocols, the acquisition of scout projections is a low-dose procedure. The use of scout projections to ensure an adequate position of the region of interest within the field of view is highly desirable as they contribute minimally to overall CBCT patient dose.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Imagens de Fantasmas , Doses de Radiação , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Masculino , Adulto , Dosimetria por Luminescência Estimulada Opticamente/métodosRESUMO
INTRODUCTION: Alveolar bone coverage can be diagnosed through cone beam computed tomography (CBCT) and this information can prevent orthodontic tooth movement beyond the biological limit. OBJECTIVE: This study evaluated the impact of the bone coverage (BC) diagnosis by CBCT in the orthodontists' planning. METHODS: One hundred fifty-nine Brazilian orthodontists suggested treatment plans for six patients at two different times, using two sequential questionnaires. The first questionnaire consisted of extra and intra-oral photographs, one panoramic radiograph; one lateral cephalometric radiograph with Steiner and Tweed analysis, and the patient chief complaint. The second questionnaire included the same presentations of cases with tomographic images and the radiologist's report. The McNemar test assessed the difference between the first and the second treatment plans. RESULTS: In all six cases, most participants changed the treatment plan after evaluating the CBCT images and the radiologist's report (93.7% in case 5, 78.6% in case 4, 74.2% in case 3, 69.8% in case 6, 66% in case 2 and 61% in case 1; p≤0.01). CONCLUSION: The evaluation of bone coverage through CBCT images has a substantial impact on the orthodontic diagnosis and planning of the Brazilian orthodontists.
Assuntos
Processo Alveolar , Tomografia Computadorizada de Feixe Cônico , Planejamento de Assistência ao Paciente , Radiografia Panorâmica , Humanos , Estudos Transversais , Processo Alveolar/diagnóstico por imagem , Brasil , Cefalometria , Inquéritos e Questionários , Feminino , Masculino , Ortodontistas , Técnicas de Movimentação Dentária , Ortodontia CorretivaRESUMO
INTRODUCTION: The long pathway that the canines take as they emerge into the maxillary arch makes them vulnerable to disruption during their natural emergence time. The process of planning treatment for impacted maxillary canine (IMC) presents significant challenges, underscoring the need for careful consideration and expertise. OBJECTIVE: The aim of this article was to shed light on these complexities by discussing clinical case studies involving IMC, providing insights into the intricacies of their management. CONCLUSIONS: The management of IMC within orthodontics presents a multifaceted challenge that include the necessity for precise diagnostic processes, prudent use of cone beam computed tomography (CBCT), the strategic selection between open and closed exposure techniques, a in-depth understanding of the specific orthodontic biomechanics involved, and a keen awareness of potential adverse outcomes such as ankylosis, prolonged treatment times, root resorption, and additional complications.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Dente Canino , Maxila , Dente Impactado , Dente Impactado/terapia , Dente Impactado/diagnóstico por imagem , Humanos , Dente Canino/diagnóstico por imagem , Maxila/diagnóstico por imagem , Planejamento de Assistência ao Paciente , Extrusão Ortodôntica/métodos , Reabsorção da Raiz/diagnóstico por imagem , Reabsorção da Raiz/terapia , Feminino , Adolescente , Fenômenos Biomecânicos , Masculino , Anquilose Dental/terapia , Anquilose Dental/diagnóstico por imagem , Criança , Técnicas de Movimentação Dentária/métodosRESUMO
OBJECTIVE: This study aimed to assess root volumes of maxillary canines and adjacent lateral incisors in patients with unilateral maxillary canine impaction. METHODS: This cross-sectional study was performed on cone-beam computed tomography (CBCT) scans of 100 patients (49 females and 51 males) with unilateral maxillary canine impaction. The images were loaded in Planmeca Romexis Viewer, and root layers between the cementoenamel junction and apex were reconstructed at 600-µm intervals. At each layer, the root boundary was marked, and finally, the root volume was calculated by multiplying the layers' area by the thickness of 600 µm. The root size of canines and lateral incisors was compared between the impaction and normal eruption sides. RESULTS: Sixty-two patients showed buccal canine impaction, and 38 presented palatal impaction. The mean root volume of canines on the impaction side was significantly greater than that on the normal eruption side; either the tooth was buccally or palatally impacted (p<0.001). The lateral incisors on the side of buccally-impacted canines showed a significantly smaller root volume than that of the contralateral side (p<0.001). However, there was no significant difference in the root size of lateral incisors between the two sides in cases presenting palatal canine impaction (p=0.177). CONCLUSION: The difference in root volume of canines between the two sides can serve as an indicator of canine impaction. The reduction in the root size of the lateral incisor on the side of the buccally impacted canine may be due to root resorption created by pressure from the canine's crown.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Dente Canino , Incisivo , Maxila , Raiz Dentária , Dente Impactado , Humanos , Dente Impactado/diagnóstico por imagem , Masculino , Dente Canino/diagnóstico por imagem , Feminino , Incisivo/diagnóstico por imagem , Estudos Transversais , Maxila/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem , Adolescente , Adulto Jovem , Adulto , CriançaRESUMO
Managing teeth with open apices can be a challenging scenario for clinicians. This case report describes the 24-year follow-up of a maxillary central incisor that failed to develop after a traumatic injury resulting in a wide-open apex. A 10-year-old girl presented complaining of discomfort in her upper teeth. Tooth #9 had received a traumatic blow several years before and was discoloured with a resin composite restoration on the mesio-incisal edge. The tooth was painful to percussion and palpation. An inadequate root canal filling and incomplete root formation were observed on the initial periapical radiograph. Root canal retreatment was initiated, and the canal filled entirely with mineral trioxide aggregate (MTA) because of the extremely wide canal and open apex. The patient was asymptomatic at the 24-year follow-up with the cone beam computed tomography and periapical radiographs demonstrating the stability of the MTA.
Assuntos
Compostos de Alumínio , Compostos de Cálcio , Combinação de Medicamentos , Incisivo , Maxila , Óxidos , Retratamento , Materiais Restauradores do Canal Radicular , Silicatos , Ápice Dentário , Humanos , Feminino , Compostos de Cálcio/uso terapêutico , Compostos de Alumínio/uso terapêutico , Incisivo/lesões , Silicatos/uso terapêutico , Criança , Óxidos/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Retratamento/métodos , Seguimentos , Ápice Dentário/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodos , Obturação do Canal Radicular/métodosRESUMO
OBJECTIVES: This study aimed to investigate nasal septum deviation (NSD), nasal bone length (NBL), and the morphology of the middle nasal conchae (MNC) and inferior nasal conchae (INC), as well as their correlations. MATERIALS AND METHODS: The sample included 56 cone-beam computed tomography scans divided into two groups: a study group (SG; individuals with NF1; n = 28) and a control group (CG; individuals without NF1; n = 28). NSD, NBL, MNC, and INC classifications were assessed. MNC images were classified as normal, bullous, paradoxical, secondary, and accessory. INC images were classified as normal, lamellar, compact, combined, and bullous. Intra- and interobserver reliability were evaluated. RESULTS: SG had a mean NSD of 11.6° (±4.5°) compared with 9.6° (±3.2°) for the CG, showing moderate deviations with no significant difference between groups. SG had a mean NBL of 22.4 mm (±3.4 mm) compared with 22.1 mm (±3.2 mm) for the CG, with a statistically significant difference. Both groups exhibited normal, bullosa, and accessory MNC classifications. SG INC were normal, lamellar, and combined, whereas CG INC were normal and lamellar. There was a weak correlation between NSD and NBL across groups. CONCLUSION: Individuals with NF1 showed longer NBL. The weak correlation between NSD and NBL suggested multifactorial influences on these variations. These findings advance our understanding of craniofacial development in NF1 and highlight the need for further research into nasal cavity involvement in this complex genetic disorder.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Cavidade Nasal , Septo Nasal , Neurofibromatose 1 , Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Nasal/diagnóstico por imagem , Masculino , Feminino , Neurofibromatose 1/diagnóstico por imagem , Adulto , Septo Nasal/diagnóstico por imagem , Septo Nasal/anormalidades , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Osso Nasal/diagnóstico por imagem , Estudos de Casos e ControlesRESUMO
INTRODUCTION: Bidirectional vertical ridge augmentation in the posterior maxilla is very challenging. PURPOSE: To evaluate the regenerative potential of micrografts, derived from periosteum or bone tissue, added to an anorganic xenograft in vertical reconstruction of the posterior maxilla, by a prospective, controlled study. MATERIALS AND METHODS: After clinical selection and the analysis of CBCT scans, 24 posterior maxillary sites, in 19 patients, were treated by using Barbell Technique®. Sites requiring both inlay and onlay reconstruction were enrolled in the study. In the Control Group (CG, n = 8), a xenograft was used in the inlay site and for the onlay site, a 1:1 mix of xenograft and an autograft was used. In Test Group 1 (TG1, n = 8), both inlay and onlay sites were grafted with the xenograft associated with the micrografts derived from periosteum. In Test Group 2 (TG2, n = 8), both inlay and onlay sites were grafted with the xenograft associated with the micrografts derived from bone. Six months after the procedures, CBCT scans were obtained, and bone biopsy samples were harvested during implant placement surgery. The bone specimens were analyzed histomorphometrically, by measuring the percentages of vital mineralized tissue (VMT), non vital mineralized tissue (NVMT) and non mineralized tissue (NMT). Immunohistochemically, the levels of VEGF were categorized by a score approach. RESULTS: Histomorphometric analysis revealed, for the inlay grafts, no significant difference among the groups for VMT, NVMT and NMT. However, for onlay grafts, CG achieved a higher amount of VMT in comparison with TG2, and the opposite occurred for NMT values. In this regard, no statistical difference was observed between CG and TG1. Concerning immunohistochemistry, the VEGF values for CG and TG1 were slightly higher than those obtained by TG2 for both inlay and onlay grafts, but without statistical significance. CBCT analysis showed a similar level of gain for all groups, for both inlay and onlay bone augmentation sites. Clinically, one implant (in CG) within a total of 50 implants installed, had early failure and was replaced after 3 months. All patients received implant supported prosthesis. CONCLUSION: This study indicated that the clinical use of micrograft derived from periosteum may have some potential to increase bone formation in onlay reconstructions, unlike the micrograft derived from bone tissue.
Assuntos
Aumento do Rebordo Alveolar , Transplante Ósseo , Humanos , Aumento do Rebordo Alveolar/métodos , Transplante Ósseo/métodos , Masculino , Feminino , Estudos Prospectivos , Pessoa de Meia-Idade , Adulto , Xenoenxertos , Periósteo/transplante , Periósteo/cirurgia , Maxila/cirurgia , Tomografia Computadorizada de Feixe Cônico , Transplante Autólogo , Autoenxertos/transplante , IdosoRESUMO
OBJECTIVE: To assess the effect of a blooming artifact reduction (BAR) filter on cone beam computed tomography (CBCT) images in the dimensional analysis of dental implants. STUDY DESIGN: Six types of implants (n = 5 for each type) composed of titanium (3 types), titanium-zirconia alloy, zirconium oxide, and titanium-aluminum-vanadium alloy, and made with 2 manufacturing processes (milled and printed) were individually installed in a bovine rib block according to the manufacturer's protocol. CBCT images were acquired with i-CAT and Carestream scanners, randomized, and analyzed without and with the e-Vol DX BAR filter (60 images for each scanner). Implant length, diameter, and thread-to-thread distance were measured by two radiologists, with a stereomicroscopic image of each implant as the reference standard for calculation of distortion in measurements. Repeated measures ANOVA with Bonferroni corrections and intraclass correlation coefficients (ICC) were applied (α = 0.05). RESULTS: The BAR filter significantly reduced distortion in various parameters for specific implants, aligning closely with stereomicroscopic measurements. Titanium and printed implants showed reduced dimensional distortion regardless of BAR filter use. Carestream measurements presented smaller dimensional differences than i-CAT for most implants and parameters, especially without BAR (P < .05). Interexaminer reliability was good to excellent, with ICC ranging from 0.80 to 0.95. CONCLUSIONS: The BAR filter can enhance implant dimensional analysis, although variations based on implant material and manufacturing process were observed.
Assuntos
Artefatos , Tomografia Computadorizada de Feixe Cônico , Implantes Dentários , Titânio , Animais , Bovinos , Zircônio , Interpretação de Imagem Radiográfica Assistida por Computador , Imageamento TridimensionalRESUMO
AIM: To evaluate the influence of different levels of metal artifact reduction (MAR) tool and milliamperage (mA) on the diagnosis of fracture extension in endodontically treated teeth using cone beam CT (CBCT). MATERIALS AND METHODS: Ten maxillary premolars were endodontically treated and positioned in the empty sockets of a human maxilla covered with wax. CBCT acquisitions were performed using the Eagle Edge device (Dabi Atlante, Brazil) adjusted to 120 kVp, FOV of 4 × 6 cm, exposure time of 24 s and voxel size of 0.2 mm in 8 different conditions with different MAR (1, 2 and 3) and mA (3.2 and 6.3) levels. Crown-root fractures were simulated in the universal testing machine, and CBCT images were acquired again. Five radiologists evaluated the presence and extension of fractures with a 5-point scale. Statistical analysis was performed by analysis of variance, Tukey and Kappa test (α = 0.05). RESULTS: Although different mA levels did not significantly (p > 0.05) affect the diagnosis values for fracture presence and extension, when evaluated the different levels of MAR, AUC and sensitivity showed significantly higher values (p < 0.05) for MAR 0 using 6.3 mA and kappa agreement showed significantly higher values (p < 0.05) for MAR 0 and 2 using 6.3 mA. CONCLUSIONS: Although mA levels do not have a diagnostic effect when isolating the MAR level; in 6.3 mA, MAR 0 and 2 can positively influence the diagnosis of fracture extension in endodontically treated teeth using CBCT. CLINICAL RELEVANCE: The isolate evaluation of dental fracture presence can overlook diagnostics error of its extension.
Assuntos
Artefatos , Dente Pré-Molar , Tomografia Computadorizada de Feixe Cônico , Fraturas dos Dentes , Dente não Vital , Humanos , Fraturas dos Dentes/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodos , Dente não Vital/diagnóstico por imagem , Dente Pré-Molar/diagnóstico por imagem , Dente Pré-Molar/lesões , Técnicas In Vitro , Metais , Maxila/diagnóstico por imagem , Sensibilidade e EspecificidadeRESUMO
This study employed e-Vol DXS cone beam computed tomography (CBCT) software to assess dentin remnants in the furcation area of mesial canals in mandibular molars during root canal retreatment (RCR). Four groups (Reciproc®, ProTaper Next®, Race Evo®, Protaper Gold®) were subjected to RCR, and CBCT images were captured before (T1) and after (T2) treatment. Measurements of remaining dentin thickness at 1 mm and 3 mm below the furcation were scrutinized. Results revealed no significant differences in mean thicknesses of mesiobuccal (MB) and mesiolingual (ML) canals at 1 mm and 3 mm from the furcation pre-treatment (T1). Post-treatment (T2) showed analogous findings, with no significant differences in mean thicknesses. However, disparities were found between MB and ML canals at both distances, both before and after retreatment. In essence, the evaluated instruments exhibited safety in RCR, implying that they are appropriate for use in critical areas of mandibular molars without inducing excessive wear. This study underscores the reliability of these instruments in navigating danger zones during RCR, and contributes valuable insights for dental practitioners who handle complex root canal scenarios in mandibular molars.