Diagnostic accuracy of cone-beam CT compared with panoramic images in predicting retromolar canal during extraction of impacted mandibular third molars

OBJECTIVES: The clinical significance of the existence of a retromolar canal and of its neurovascular content is not yet clear. The aim of the present study was to assess the visibility, diameter and course of the mandibular retromolarcanal(MRC) using cone beam computed tomography (CBCT) scan -had been taken for pre-operative radiographic evaluation of impacted mandibular third molars- compared to panoramic radiographs. Study DESIGN: Subjects eligible for study enrollment were those who underwent preoperative CBCT scan for the extraction of impacted mandibular third molars were determined to be extremely close to the mandibular canal on panoramic radiographs. Radiographs were screened for the presence and course of retromolar canals, and linearmeasurements. RESULTS: 947hemimandibles in 632 patients were examined. A total of 253 MRCs (144 left, 109 right) were detected with CBCT images (26.7%). Only 29 of these canals were also seen on the corresponding panoramic radiographs. Most MRCs had a vertical course (type VI, 28.46%), followed by slightly curved (type I, 26.09%). The visibility of the MRC on the OPGs, according to the increase in the diameter, was not statistically significant for both sides(p >.05).Statistically difference were found for the width at the point of origin from the mandibular canal (p: .037),the mean distance from the MRC to the second molar (p: .042) and height of MRC when compared the gender. CONCLUSIONS: The findings suggest that the MRC isn't a rare anatomical structure. This study therefore clearly establishes the incidence and importance of the MRC. The detection of the presence of the MRC using CBCT maybe crucial for extraction of mandibular third molars

Efectos de la técnica de arcos botantes para la abertura de la sutura occipitomastoidea en la cervicalgia mecánica / Effects of flying buttresses for the opening of the occipitomastoid suture in mechanical neck pain

Introducción: La cervicalgia mecánica (CM) podría considerarse un problema de salud pública, ya que afecta a casi la mitad de la población en algún momento de su vida. En el 14% de la población, tiene una duración de 6 meses o más, provocando limitaciones laborales, en las actividades de la vida diaria así y de ocio. Objetivo: Analizar los efectos inmediatos de la técnica con arcos botantes (TAB) para la abertura de la sutura occipitomastoidea (OM), realizada bilateralmente, sobre la amplitud articular cervical, el umbral de dolor a la presión (UDP) y la intensidad del dolor. Material y Métodos: Estudio experimental, controlado, aleatorizado, doble ciego. Treinta (n=30) sujetos con CM, distribuidos aleatoriamente en dos grupos, Grupo Experimental (GE)(n=15) que recibió la TAB bilateralmente, y Grupo Control (GC) (n=15) que no recibió ninguna intervención. En ambos grupos se evaluaron (antes y después), la amplitud articular cervical, el UDP, los Puntos gatillo de Trapecios superiores y Escalenos anteriores (algómetría), y la intensidad del dolor en reposo y con cada movimiento cervical mediante una escala numérica del dolor (END). Resultados: El GE presenta mejoras estadísticamente significativas para las variables algométricas del trapecio superior derecho(p=0,033),trapecio superior izquierdo(p=0,03), la OM izquierda(p=0,003), el escaleno izquierdo(p=0,043), la amplitud de movimiento en rotación izquierda(p=0,04) y la intensidad del dolor a la rotación izquierda (p=0,013). Observamos tendencia a la significación estadística de la amplitud del movimiento de lateroflexión izquierda (p=0,056). Conclusiones: La técnica con arcos botantes para la abertura de la OM, aplicada en pacientes con CMC, aumenta el UDP en los músculol s trapecios, escaleno izquierdo y la sutura OM izquierda, la amplitud de movilidad y disminuye el dolor, durante la rotación cervical izquierda (AU)

Introduction: Mechanical neck pain (CM) could be considered a public health problem, affecting almost half of the population at some point in their lives. In 14% of the population, it has a duration of 6 months or more, causing labor limitations in activities of daily life and leisure. Objective: To analyze the immediate effects of the technique with flying buttresses (TFB) for the opening of the occipitomastoid (OM) suture, conducted bilaterally on the cervical joint extent, the pain pressure threshold (UDP) and the pain intensity. Material and methods: Experimental study, controlled, randomized, double-blind. Thirty (n = 30) subjects with CM, randomized into two groups: Experimental Group (GE) (n = 15) bilaterally received the TAB and Control Group (CG) (n = 15) that did not receive any intervention. In both groups, the cervical joint amplitude were evaluated (before and after), as well as the UDP, the trigger points of the higher trapezoids and anterior scalenes (algometry) and pain intensity at rest and with each cervical movement using a numerical pain scale (END). Results: The GE introduces significant improvements for algometrical variables of the right upper trapezius (p = 0.033), left upper trapezius (p = 0.03), the left OM (p = 0.003), the left scalene (p = 0.043), the range of motion in left rotation (p = 0.04) and pain intensity in left rotation (p = 0.013). We observed a trend towards statistical significance of the range of left sidebending (p = 0.056). Conclusions: The flying buttress technique for the opening of OM, applied in patients with CMC, increases the UDP in the trapezius muscles, left scalene and left OM suture, range of motion and decreases pain during left cervical rotation (AU)