Performance of cone beam computed tomography and conventional intraoral radiographs in detecting interproximal alveolar bone lesions: a study in pig mandibles.

BACKGROUND: Cone beam computed tomography (CBCT) has been largely used in dentistry. Nevertheless, there is lack of evidence regarding CBCT accuracy in the diagnosis of early periodontal lesions as well as the correlation between accuracy and lesion size. The aim of this study was to evaluate accuracy of CBCT and conventional intraoral radiographs in detecting different-sized interproximal bone lesions created in pig mandibles. The hypothesis was that CBCT accuracy would be superior to radiographs in detecting incipient bone lesions. METHODS: Twenty swine dry mandibles were used, totalizing 80 experimental sites. Four groups were created according to exposure time to perchloric acid 70-72%: controls (no exposure), 2-hour exposure, 4-hour exposure, and 6-hour exposure. Standardized CBCT and conventional intraoral radiographs were taken and analyzed by two trained radiologists. The presence of lesions in the dry mandible was considered the gold standard. Sensitivity, specificity, and accuracy in detecting different-sized bone lesions were calculated for CBCT and intraoral radiographs. RESULTS: Accuracy of CBCT ranged from 0.762 to 0.825 and accuracy of periapical radiography ranged from 0.700 to 0.813, according to examiner and time of acid exposure. Inter-examiner agreement varied from slight to fair, whereas intra-examiner agreement varied from moderate to substantial. CONCLUSIONS: CBCT performance was not superior to that provided by conventional intraoral radiographs in the detection of interproximal bone loss.

Odontoplasty associated with clinical crown lengthening in management of extensive crown destruction.

AIM: The aim of this study was to evaluate the clinical outcome of teeth submitted to odontoplasty during clinical crown lengthening surgery (CCLS), when compared to their contralateral non-operated teeth. MATERIALS AND METHODS: Fourteen patients submitted to odontoplasty during CCLS were evaluated according to plaque index, bleeding on probing, probing depth and final restoration outcome (total success, relative success and failure). RESULTS: The mean follow-up period was 13.57 (± 8.00) months, and ranged from 6 to 24 months. Twelve cases presented total success of the final rehabilitation and 2 cases presented relative success. The cases of relative success were due to the necessity for a new periodontal intervention (scalling). No differences were observed with respect to periodontal parameters (P>0.05) and the patients that showed relative success presented generalized poor oral hygiene. CONCLUSIONS: The odontoplasty during clinical crown lengthening surgery is a feasible procedure in the management of extensive crown destruction.

Retalho deslocado lateralmente na correção de recessão gengival causada pela excisão cirúrgica de um fibroma ossificante periférico: relato de caso / Use of laterally positioned flap to correct gingival recession caused by excisional biopsy of peripheral ossifying fibroma: case report

o presente relato de caso refere-se a um paciente do sexo masculino (JP) de 45 anos que compareceu à clínica do Centro de Extensão, Treinamento e Aperfeiçoamento em Odontologia (CETAOl, com a seguinte queixa principal: "Sanqramento na gengiva" (sic). Na anamnese não foi relatada nenhuma alteração sistêmica. No exame extraoral nada digno de nota foi observado, No exame intraoral, notou-se um nódulo, levemente consistente, na região da gengiva marginal vestibular dos incisivos inferiores (entre os dentes 41 e 32), de coloração semelhante à mucosa, liso e com dimensões de 1,6 cm x 1,0 em, associado à retração gengival no dente 31. Após a realização de procedimentos básicos, e devido aos possíveis diagnósticos diferenciais, optou-se pela biopsia excisional da lesão e correção cirúrgica da retração no mesmo tempo operatório, através da técnica de retalho deslocado lateralmente. A lesão foi levada ao exame histopato- lógico, revelando como diagnóstico fibroma ossificante periférico. O paciente não apresentou nenhuma complicação pós-cirúrgica e após 10 meses de acompanhamento observou-se um recobrimento radicular significativo, sem a presença de recidiva da lesão.

This paper describes the treatment of a male patient, 45 years old, who showed up at the office complaining about gingival bleeding. No relevant information was detected in the inter- view and the extra-oral examination. The intra-oral examination revealed a firm nodule (t.scrn x 1,Ocm) at the marginal gingiva of the buccal aspect of the lower incisors (between 41 and 32). The color of the lesion was similar to the oral mucosa and a gingival recession was asso- ciated with the buccal aspect of tooth 31. After root scaling and dental hygiene orientation, the diagnostic hypotheses were evaluated and indicated a good prognosis with low chance of recurrence. Thus, the adopted surgical approach included the nodule removal and the root co- verage of tooth 31 recession, by the laterally positioned flap technique, at the same procedure. The histopathological diagnosis of the lesion was peripheral ossifying fibroma. Ten months after surgery, no complications were reported and significant root coverage oftooth 31 recession was obtained without recurrence of the lesion.

Periodontal surgery associated with odontoplasty in the esthetic functional rehabilitation of a fractured anterior tooth.

Anterior dental fractures often require a multidisciplinary approach. This article presents a case in which an extensive fracture with palatal biological width invasion was treated successfully through clinical crown lengthening with odontoplasty. This procedure was a simple direct technique that restored the tooth without damaging the dental esthetics, the gingival contour, or the papillae.

Clinical importance of the presence of lateral canals in endodontics.

This article presents a clinical case in which the diagnosis and treatment of a lateral canal was instrumental in the successful completion of endodontic therapy. Endodontic treatment was performed by crown-down shaping and copious irrigation (using 2.5% sodium hypochlorite associated with 17% ethylenediaminetetracetic acid (EDTA)). After 10 months, there were no clinical symptoms of inflammation and radiographs showed periradicular healing.

Impacto da ação do hipoclorito de sódio e EDTA na qualidade do selamento em restaurações com resina composta em dentina / Impact of sodium hipoclorite and EDTA on the quality sealing of composite resin restoration performed in human dentin

O objetivo do presente estudo foi analisar o impacto de substâncias químicas utilizadas em endodontia no processo de adesão à dentina em cavidades restauradoras com resina composta. Quarenta dentes humanos foram utilizados e, após preparo cervical, divididos aleatoriamente em quatro grupos experimentais de acordo com o irrigante utilizado no preparo químico-mecânico pela técnica coroa-ápice: G1 - água destilada, G2 - NaOCL 1%, G3 - NaOCL 5% e G4 - NaOCL 1% associado ao EDTA 17%. Cada solução permaneceu 45 minutos em contato com as paredes dentinárias. Em seguida, os canais foram secos e as paredes de esmalte isoladas com cera para fundição. Empregou-se um adesivo dentinário de dois passos após o condicionamento ácido e a restauração instituída com resina composta. Após a termociclagem, os dentes foram secos e o ápice selado com duas camadas de cianoacrilato gel seguido de aplicação de esmalte na superfície radicular. Os espécimes foram imersos em nanquim por 24 horas e posteriormente lavados em água corrente. Os procedimentos de diafanização foram instituídos e os dentes mantidos em salicilato de metila para avaliação por dois examinadores calibrados, utilizando lupa estereomicroscópica (8X) para quantificar o número de faces coronárias infiltradas. Escores correspondentes ao número de faces envolvidas foram analisados através de teste não paramétrico de Kruskal-Wallis e comparações múltiplas com Student-Newman-Keuls. O Grupo Controle (G1) apresentou os piores resultados de infiltração revelando diferenças estatisticamente significativas em comparação aos grupos G2, G3 e G4 (p<0,05). Ao comparar as outras soluções irrigantes entre si, não foram observadas diferenças estatisticamente significantes (p<0,05)