Three-dimensional evaluation of mandibular condyle and coronoid process according to sex, age, and skeletal deformities.

OBJECTIVE: To correlate the volume of the mandibular condyle (MC) and the coronoid process (CP) with sex, age, and skeletal deformities. METHODS: The structures were visualized through semi-automatic segmentation of the 3D model and complemented with manual segmentation, using the ITK-SNAP 3.0 software. Mann-Whitney, Kruskal-Wallis, and the Dunn test were performed (p < 0.05). RESULTS: The MC volume showed statistical differences between sex and skeletal deformities. Men and Class III patients showed higher values. CP volume was not influenced by age or skeletal deformities. However, statistical differences were found between sex, with higher values for men. CONCLUSION: MC volume was influenced by sex and skeletal deformities, while CP was influenced only by sex. Women have smaller volumes for these structures. Age is not correlated with the volume of MC and CP. The highest and lowest values of condylar volume were found for Class III and II individuals, respectively.

Comparison of limited- and large-volume cone-beam computed tomography using a small voxel size for detecting isthmuses in mandibular molars.

PURPOSE: This study was performed to compare the ability of limited- and large-volume cone-beam computed tomography (CBCT) to display isthmuses in the apical root canals of mandibular molars. MATERIALS AND METHODS: Forty human mandibular first molars with isthmuses in the apical 3 mm of mesial roots were scanned by micro-computed tomography (micro-CT), and their thickness, area, and length were recorded. The samples were examined using 2 CBCT systems, using the smallest voxels and field of view available for each device. The Mann-Whitney, Friedman, and Dunn multiple comparison tests were performed (α=0.05). RESULTS: The 3D Accuitomo 170 and i-Cat devices detected 77.5% and 75.0% of isthmuses, respectively (P>0.05). For length measurements, there were significant differences between micro-CT and both 3D Accuitomo 170 and i-Cat (P<0.05). CONCLUSION: Both CBCT systems performed similarly and did not detect isthmuses in the apical third in some cases. CBCT still does not equal the performance of micro-CT in isthmus detection, but it is nonetheless a valuable tool in endodontic practice.

Accuracy of cone-beam CT in detecting vertical root fractures in teeth with post-endodontic restorations: an in vitro study

The aim of this study was to evaluate the accuracy of cone-beam CT (CBCT) for the detection of artificially created vertical root fractures (VRF) in extracted teeth restored with metallic (MP) and fiberglass (FGP) posts. After root canal obturation, 60 extracted human premolars were scanned by using the highest-resolution settings of a CBCT unit. Theprepared roots were randomly divided into three groups: group C (control group): non-restored and non-endodontically treated teeth (n = 20); group MP (n = 20); group FGP (n = 20). In all groups, 10 teeth were artificially fractured. Two external and independent observers blindly recorded the presence or absence of VRF. Sensitivity, specificity, accuracy, intra-and interobserver agreement were calculated. Kappa value for inter-and intraobserver agreement was 0.82 and 0.84 respectively, demonstrating goodagreement. The highest values for sensitivity (0.80 -0.90), specificity (1.00) and accuracy (0.90 -0.95) were found in the control group. The teeth with FGP restoration presented the lowest sensitivity (0.30 -0.50) and accuracy (0.60 -0.65) values. Both examiners had a good performance in the diagnosis of fractures in teeth with MP, with accuracy ranging between 0.85 -0.90. The presence of MP did not influence accuracy; however, the presence of FGP reduced the diagnostic capacity of CBCT.

Observational study of adverse reactions related to articaine and lidocaine.

PURPOSE: This study determined the frequency of adverse reactions related to the administration of local dental anesthesia with 4% articaine compared with 2% lidocaine, both associated with epinephrine 1:100,000. The null hypothesis was that there is no difference between the administrations of both dental local anesthesia. METHODS: From a total of 727 patients in an emergency service, 338 and 389 patients were subjected to local anesthesia with lidocaine and articaine, respectively. A questionnaire was completed for each patient that contained patient data, the local anesthesia applied, and any reactions. RESULTS: The overall frequency of adverse reactions was 3.71%, with sweating and pallor being the most frequently observed. There was an association between adverse reactions and the use of daily medication by patients anesthetized with articaine (p = 0.0266). In contrast, in patients anesthetized with lidocaine, there was an association among the duration of the procedure (p = 0.0423), the type of procedure (p = 0.0146), and first anesthesia exposure (p = 0.0448). CONCLUSIONS: The low frequency of adverse reactions with use of articaine and lidocaine led to the conclusion that both solutions are safe for use in dentistry.

Cone beam computed tomography study of osteoarthritic alterations in the osseous components of temporomandibular joints in asymptomatic patients according to skeletal pattern, gender, and age.

OBJECTIVE: The aim of this study was to evaluate the prevalence of osteoarthritic alterations in the osseous components of the temporomandibular joint (TMJ) in asymptomatic patients with different skeletal patterns, gender, and age groups with cone beam computed tomography (CBCT) images. STUDY DESIGN: CBCT images of 213 asymptomatic patients were assessed for the presence of any degenerative changes in the condyle and fossa/eminence complex. Each TMJ was evaluated separately and was classified as normal, indeterminate for osteoarthritis, or affected by osteoarthritis. Differences were tested by using the χ2 and Fisher's exact tests (P < .05). RESULTS: In total, 52.3% of the joints presented some visible alteration in the osseous components. Abnormalities were detected in 32.6% of the condyles and 31.5% of the articular fossae/eminences, and flattening was the most prevalent alteration in all classes. There was no statistically significant difference in the prevalence of alterations in either the condyle or the articular fossa/eminence among the skeletal groups for the entire sample or for the gender and age subsets. CONCLUSIONS: There are no differences in degenerative TMJ changes in patients with or without skeletal jaw discrepancies. No differences were found when gender and age were considered.

Retrospective study on sequelae in traumatized permanent teeth.

OBJECTIVE: This study aimed to identify possible associations of the presence or absence of posttrauma sequelae with the factors inherent to the traumatized tooth and treatment. MATERIALS AND METHODS: This retrospective study was performed through the evaluation of records and radiographs of a center of reference for dental trauma between January 2008 and December 2014. The factors were analyzed and associated with posttrauma sequelae, such as pulp necrosis and root resorption. STATISTICAL ANALYSIS USED: A binomial logistic regression model was fit (P < 0.05). RESULTS: In luxations, it was possible to observe 37% pulp necrosis, 16% inflammatory root resorption, and 8% replacement resorption. The binomial logistic regression revealed that male gender (P = 0.0392, odds ratio [OR] = 2.79), avulsion injury (P = 0.0009, OR = 12.27), and elapsed time >16 days between the time of trauma to the beginning of the endodontic treatment (P = 0.0450, OR = 7.53) showed a greater chance of presenting a posttrauma complication. CONCLUSIONS: Gender, type of injury, stage of root development, and time after trauma until the beginning of the endodontic intervention were related to the appearance of sequelae.

Reflexões sobre a conduta clínica e as sequelas após reimplante tardio / Considerations on the clinical approach and sequelae after late replantation

Introdução: a avulsão dentária é uma injúria severa e o manejo dos dentes e tecidos moles envolvidos durante e após o reimplante é de extrema importância para se obter um prognóstico favorável. Objetivo: o objetivo deste trabalho foi discutir sobre a conduta do reimplante tardio, baseado na exemplificação de um caso clínico, e sugerir quais as outras abordagens terapêuticas. Relato do caso: paciente do sexo feminino, 9 anos de idade, sofreu avulsão do elemento #11, o qual foi mantido a seco por duas horas. Foi realizado o reimplante do dente, seguido de contenção flexível durante quinze dias. O dente manteve-se com reposta positiva ao teste de sensibilidade pulpar por cinco meses e, posteriormente, foi iniciado o tratamento endodôntico com dez trocas de medicação intracanal à base de hidróxido de cálcio associado ao propilenoglicol. No controle clínico e radiográfico após seis meses, observou-se sinais de reabsorção radicular por substituição, que permaneceu em posição durante três anos. Conclusão: apesar do reimplante tardio ser uma opção de tratamento, outras abordagens clínicas devem ser estudadas e levadas em consideração a fim de minimizar sequelas futuras.

Prevalência de lesões cervicais não cariosas e da hiperestesia dentinária em alunos de Odontologia / Prevalence of non-carious cervical lesions and dentin hypersensitivity in Odontology students

O objetivo deste estudo foi determinar a prevalência de lesões cervicais não cariosas (LCNCs) e de hiperestesia dentinária em estudantes do curso de Odontologia da Universidade Estadual de Maringá (UEM) e registrar as variáveis bucais, comportamentais e sistêmicas comuns aos pacientes portadores, Foram examinados 80 alunos, utilizando um questionário como instrumento de coleta de dados. O exame clínico foi utilizado para verificar a presença de lesões na face vestibular de pré-molares e primeiros molares de todos os quadrantes, além da hiperestesia dentinária. A análise estatística foi analisada através do teste qui-quadrado com nível de significância de 5%. 77,5% apresentaram LCNCs, com média de 2,5 ± 2,8. O dente mais acometido foi o 1° pré-molar seguido do 2° pré-molar e do 1° molar. Quanto à hiperestesia dentinária houve diferença estatisticamente significante em um único elemento dentário (p=0,00540). Idade, hábitos parafuncionais, tipo de escova dental e dieta ácida não apresentaram relação com a presença das LCNCs. Assim, a ocorrência das LCNCs não pode ser atribuida a um único fator etiológico.

The aim of this study was to determine the prevalence of non-carious cervicallesions (NC-CLs) and dentin hypersensitivity in Odontology students of the State University of Maringá (UEM) and correlate them to variables oral, behavioral and systemic. Data of 80 students were collected via a questionnaire and clinical examination. The clinical examination was used to verify the dentin hypersensitivity and the presence of lesions on the buccal surface of premolars and first molars. Statistical analysis was performed by chi-square test at 5% significance level. 77,5% had NCCLs, with mean of 2.5 ± 2.8. The teeth with most NCCLs were the first premolar, foliowed by second premolar and then first molar. The dentin hypersensitivity was statistical in a single tooth (p = 000540). No significant diference for age, parafunctional habits, type of toothbrush and acidic diet, between the groups with or without NCCLs. Thus, the occurrence of NCCLs cannot be attributed only to a single etiological factor.