Associação de parâmetros tomográficos com o desfecho clínico após tratamento de furca em pacientes com periodontite C / Association of tomographic parameters with the clinical outcome after furcation treatment in patients with periodontitis C

O objetivo deste estudo foi comparar as possíveis alterações em parâmetros geométricos dimensionais das lesões de furca em molares superiores - área máxima de abertura da lesão (AMA), as angulações formadas entre as raízes (ANG), o volume e densidade da lesão (VDL) e a presença e altura de defeitos infraósseos relacionados com a lesão (DIO) ­ obtidos em imagens por tomografia computadorizada de feixe cônico (TCFC), de pacientes acometidos por periodontite grau C, após a terapia regenerativa com a utilização de proteínas derivadas da matriz do esmalte (EMD). Para tal, foram estudados 02 grupos: controle (cirurgia) (n=17) e grupo teste (cirurgia+EMD) (n=17). Adicionalmente, foi estudada a correlação entre os parâmetros e o sucesso da terapia adotada, avaliando-se a redução da profundidade de sondagem (∆PS) e o ganho do nível de inserção clínica horizontal (∆NICH). Utilizou-se os softwares OnDemand3D (Cybermed, Seul, Coréia do Sul) e itk-SNAP 3.4.0 (University of North Carolina, Chapel Hill, NC, EUA) para avaliação das imagens de TCFC. Para análise das características demográficas foram realizados Teste T, Mann-Whitney Rank Sum Test e Qui-Quadrado, indicando não haver diferenças estatísticas entre idade, número de dentes analisados e sexo (p>0,05). Os testes ANOVA e Teste T foram aplicados no intuito de estudar os parâmetros clínicos (∆PS e ∆NICH) no baseline e após 06 meses de tratamento nos dois grupos, não sendo observadas diferenças estatisticamente significantes entre os grupos, para ambos os tempos (p>0.05). O coeficiente de correlação de Pearson foi aplicado, demostrando em relação ao ∆PS, que no grupo cirurgia apenas DIO mostrou-se estatisticamente significante (p=0,01), com correlação moderada positiva (R=0,59). Em relação à ∆NICH, no grupo cirurgia+EMD, apenas AMA apresentou estatisticamente significante (p=0,03), com correlação moderada negativa (R=-0,5). Podemos concluir, que o conhecimento sobre a anatomia da lesão e a presença de defeitos infraósseos e sua altura em questão, são fatores que devem ser levados em consideração no tratamento periodontal(AU)

The objective of this study is to compare the possible changes on geometric dimensional parameters of furcation lesions in maxillary molars - maximum area of lesion opening (AMO), angulations formed between roots (ANG), volume and density of the lesion (VDL) and the presence and height of lesion-related infra-osseous defects (DIO) - obtained on cone beam computed tomography (CBCT) images of patients with grade C periodontitis after regenerative therapy using enamel matrix derivative proteins (EMD). To this end, 02 groups were analyzed: control (surgery) (n = 17) and test group (surgery + EMD) (n = 17). Additionally, the correlation between the parameters and the success of the adopted therapy was studied, and the reduction of the depth pocket (ΔPD) and the relative horizontal clinical attachment level (ΔHCAL) were evaluated. Both software OnDemand3D (Cybermed, Seoul, South Korea) and the itk-SNAP 3.4.0 (University of North Carolina, Chapel Hill, NC, USA) were used to evaluate the CBCT images. In order to analyze the demographic characteristics, Mann-Whitney Rank Sum Test and Chi-Square were used, indicating that there were no statistical differences between age, number of teeth analyzed and gender (p> 0.05). The ANOVA and T-tests were applied in order to study the clinical parameters (ΔPD and ΔHCAL) at the baseline and after 06 months of treatment in both groups, no statistically significant differences were observed between the groups in both times (p > 0.05). The Pearson's correlation coefficient was applied, which demonstrated that, in the ΔPD, only DIO was statistically significant (p = 0.01), with a moderate positive correlation (R = 0.59). Regarding ΔHCAL, in the surgery + EMD group, only AMO presented a statistically significant (p= 0.03), with moderate negative correlation (R= -0.5). In conclusion, the anatomy of the lesion and the presence of infra-osseous defects and their height in question are factors that should be taken into consideration in periodontal treatment(AU)

Incidence and classification of bifid mandibular canals using cone beam computed tomography

Aim: To determine the prevalence and classification of bifid mandibular canals using cone beamcomputed tomography (CBCT). Methods: The sample comprised 300 CBCT scans obtainedfrom the Radiology and Imaging Department database at São Leopoldo Mandic Dental School,Campinas, SP, Brazil. All images were performed on Classic I-Cat® CBCT scanner, withstandardized voxel at 0.25 mm and 13 cm FOV (field of view). From an axial slice (0.25 mm) aguiding plane was drawn along the alveolar ridge in order to obtain a cross-section. Results:Among 300 patients, 188 (62.7%) were female and 112 (37.3%) were male, aged between 13to 87 years. Changes in the mandibular canal were observed in 90 patients, 30.0% of thesample, 51 women (56.7%) and 39 men (43.3%). Regarding affected sides, 32.2% were on theright and 24.5% on the left, with 43.3% bilateral cases. Conclusions: According to the resultsobtained in this study, a prevalence of 30% of bifid mandibular canals was found, with the mostprevalent types classified as B (mesial direction) and bilateral.