Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 475
Filtrar
1.
Am J Orthod Dentofacial Orthop ; 159(2): 234-245, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33546828

RESUMO

Autotransplantation of a mature premolar in adults can be a treatment of choice for tooth replacement when combined with well-planned orthodontic treatment. This case report describes the successful treatment of a 39-year-old patient with severe crowding and a hopelessly fractured tooth on the maxillary left side. Maxillary dental crowding was relieved by extraction of a premolar on the right side, and this extracted tooth was autotransplanted to replace the fractured tooth. A mandibular incisor was extracted to correct anterior crossbite. The total treatment period was 20 months. The treatment results showed a good long-term prognosis after transplantation of a mature premolar with normal surrounding alveolar bone level for over 6 years of follow-up. Occlusion and periodontal health were excellent in the long term.


Assuntos
Fraturas dos Dentes , Adulto , Dente Pré-Molar/cirurgia , Humanos , Incisivo , Mandíbula , Maxila , Fraturas dos Dentes/diagnóstico por imagem , Fraturas dos Dentes/cirurgia , Transplante Autólogo
2.
BMJ Case Rep ; 14(1)2021 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-33509889

RESUMO

Electronic cigarettes (also known as e-cigarettes or electronic nicotine delivery systems) were invented in China in 2003 then introduced to the British market in 2007. They remain popular among the public and are deemed to be effective in reducing tobacco smoking (the UK being one of the first countries to embrace them in a harm reduction policy). However, reports in the media of e-cigarettes exploding are of concern, considering the potential functional and psychological impairment that lifelong disfigurement will cause, especially given their uptake among people of any age. We present a case of this rare, but dramatic, effect of e-cigarette use as a warning to the public.


Assuntos
Queimaduras/etiologia , Sistemas Eletrônicos de Liberação de Nicotina , Explosões , Fraturas Cominutivas/etiologia , Fraturas Maxilares/etiologia , Fraturas dos Dentes/etiologia , Fraturas Cominutivas/diagnóstico por imagem , Humanos , Imageamento Tridimensional , Masculino , Fraturas Maxilares/diagnóstico por imagem , Traumatismos Maxilofaciais/diagnóstico por imagem , Traumatismos Maxilofaciais/etiologia , Mucosa Bucal/lesões , Tomografia Computadorizada por Raios X , Fraturas dos Dentes/diagnóstico por imagem , Traumatismos Dentários/diagnóstico por imagem , Traumatismos Dentários/etiologia , Raiz Dentária/lesões , Adulto Jovem
3.
BMJ Case Rep ; 13(3)2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32169975

RESUMO

Mandibular incisors show variations in their root canal anatomy from regular pattern in some cases. Magnification plays a vital role to identify those unusual canal morphologies. A certain modification in access cavity preparation is required to locate those extra canals. Not only the functional restoration but also aesthetic harmony should be restored while treating anterior teeth. In these cases, post space preparation should be done with extra care to prevent vertical root fracture. This case report illustrates the importance of proper radiograph and magnification in the successful identification and management of complex canal systems in mandibular incisors.


Assuntos
Resinas Acrílicas/uso terapêutico , Resinas Compostas/uso terapêutico , Cavidade Pulpar/diagnóstico por imagem , Incisivo/lesões , Poliuretanos/uso terapêutico , Fraturas dos Dentes/diagnóstico por imagem , Coroas/normas , Cavidade Pulpar/anatomia & histologia , Estética , Humanos , Incisivo/anatomia & histologia , Masculino , Traumatismos Mandibulares/complicações , Radiografia/métodos , Tratamento do Canal Radicular/métodos , Fraturas dos Dentes/terapia , Raiz Dentária/anatomia & histologia , Resultado do Tratamento , Adulto Jovem
4.
Clin Oral Investig ; 24(10): 3671-3681, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32080760

RESUMO

OBJECTIVE: Ex-vivo evaluation of the detectability of vertical root fractures (VRFs) using digital subtraction radiography (DSR) and conventional digital periapical radiography (CDPR); investigation of the effect of root canal filling, x-ray angulation, and thickness of the VRF in the diagnostic accuracy. MATERIALS AND METHODS: Sixty root canals were mechanically prepared and radiographed either with a gutta-percha root canal filling or without, at 0o and ± 10o. VRFs were introduced with a universal testing machine. The width and angulation of the fracture line with the radiographic beam were calculated. DSR was performed comparing radiographs obtained prior to and after the VRF induction. Five examiners evaluated the resultant images and analysis was performed using receiver operator characteristic (ROC) statistics and binary logistic regression tests. RESULTS: No significant differences in sensitivity, specificity, and the areas under the ROC curves (AUC) between the CDPR and DSR were detected (p > 0.05), except for root canal filled teeth where the AUC for DSR was higher (p < 0.05). Using DSR, a VRF was 1.3 times more likely to be diagnosed [95% confidence intervals (CI): 1.045-1.59; p = 0.018]. A correct diagnosis was 2.399 times more likely to occur in non-filled teeth regardless of the radiographic technique (95% CI 1.940-2.965; p = 0). The regression coefficients were positive for width and negative for angle. CONCLUSIONS: DSR showed a better diagnostic accuracy of VRFs compared with CDPR, in single root canal filled teeth. The angulation, the width, and the presence of a root canal filling affected the diagnostic potential. CLINICAL RELEVANCE: DSR is a cost- and time-effective imaging technique that could contribute in early diagnosis of VRFs.


Assuntos
Fraturas dos Dentes , Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar , Guta-Percha , Humanos , Radiografia Dentária Digital , Materiais Restauradores do Canal Radicular , Obturação do Canal Radicular , Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária
5.
J Endod ; 46(2): 264-270, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31812360

RESUMO

INTRODUCTION: The aim of this study was to assess 2 cone-beam computed tomographic systems on the detection of artificially induced vertical root fractures (VRFs) and artifact intensity using birooted teeth restored with different intracanal materials. METHODS: The sample consisted of 20 extracted birooted premolars. Root fracture was induced in half of the sample. Seven intracanal material combinations were used in each tooth, 1 at a time: unrestored, gutta-percha, a buccal root with gutta-percha and a lingual root with a fiberglass post, a buccal root with gutta-percha and a lingual root with a metal core fiberglass post, fiberglass posts, metal core fiberglass posts, and NiCr posts. Cone-beam computed tomographic scans were acquired using CS 9000 3D (Carestream Dental Rochester, NY) and OP300 (Instrumentarium Dental Inc, Tuusula, Finland) units. Exposure parameters were fixed at 90 kV and 8 mA. The voxel size and field of view were set at 0.085 mm and 5 × 5 cm for OP300 and 0.076 mm and 5 × 3.75 cm for CS 9000, respectively. Two observers assessed all images using a 5-point confidence scale for VRF detection and a 4-point score for artifact interference. The sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve were compared using 2-way analysis of variance and the Tukey test (α = 0.05). Artifact interference was evaluated by descriptive statistics and the chi-square test. RESULTS: There were significant differences between scanners (P > .05) and among the different intracanal material groups (OP300) (P < .05) for specificity. When a metal post was present in both roots, severe artifact interference was observed in all images. CONCLUSIONS: CS 9000 3D presented better performance than OP300 on VRF detection of endodontically treated teeth. Unrestored teeth and teeth filled with fiberglass posts were considered the groups with the lowest artifact interference and the highest VRF detection results.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Fraturas dos Dentes , Dente não Vital , Finlândia , Guta-Percha , Humanos , Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem , Dente não Vital/diagnóstico por imagem
6.
Clin Oral Investig ; 24(4): 1387-1393, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31641863

RESUMO

OBJECTIVES: The aim of this study was to detect microcracks and cuspal deflection in tooth crown following the application of temporary filling using microcomputed tomography (micro-CT). MATERIALS AND METHODS: A mesio-occluso-distal cavity preparation was performed, followed by endodontic access cavity preparation and root canal shaping. Cavities were classified into two groups according to the type of temporary filling material used; Coltosol F (Coltene Whaledent) (Group I) and intermediate restorative material (IRM; Dentsply Sirona) (Group II). Micro-CT images before and after temporary filling material placement were obtained and then compared for the presence of microcracks. Microcracks considered in our data analysis were the new ones that were detected after temporary filling material placement. The mean number of new microcracks per tooth recorded for both groups were compared using Mann-Whitney U test. The number of teeth with new microcracks in both groups was compared by chi-square test. Repeated measures t test was conducted to observe the effect of temporary filling on the intercuspal distance (ICD). Also, the mean difference in the ICDs detected after temporary filling placement in both groups were compared by independent t test. The significance level was set at 5%. RESULTS: Eleven microcracks were detected in group I, whereas only three microcracks were observed in group II (p < 0.01). The mean numbers of new microcracks were 0.84 and 0.21 in group I and II, respectively (p < 0.01). There was no significant difference in the ICDs in group I (0.006±0.02 mm) and group II (0.018 ± 0.03 mm) (p > 0.26). Most of the microcracks were found in the dentin structure. The cavity's box area was more affected by new microcracks, compared with the cavity's coronal area. The new microcracks were mainly observed in the mesiodistal direction. No complete fractures were reported in our study. CONCLUSIONS: Both temporary fillings induced microcracks; Coltosol F can induce more microcracks than IRM in premolar teeth after 1-week storage. Most of the microcracks were observed in the dentin structure of the cavity's box area running mesiodistally. CLINICAL RELEVANCE: The results indicated that the tested temporary fillings developed microcracks on the tooth crown with slight deflection of the cusps.


Assuntos
Materiais Restauradores do Canal Radicular , Fraturas dos Dentes/diagnóstico por imagem , Microtomografia por Raio-X , Dente Pré-Molar , Coroas , Dentina , Humanos , Preparo de Canal Radicular , Tratamento do Canal Radicular
7.
Oral Radiol ; 36(4): 337-343, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31535278

RESUMO

OBJECTIVES: The aim of this study was to evaluate the use of a convolutional neural network (CNN) system for detecting vertical root fracture (VRF) on panoramic radiography. METHODS: Three hundred panoramic images containing a total of 330 VRF teeth with clearly visible fracture lines were selected from our hospital imaging database. Confirmation of VRF lines was performed by two radiologists and one endodontist. Eighty percent (240 images) of the 300 images were assigned to a training set and 20% (60 images) to a test set. A CNN-based deep learning model for the detection of VRFs was built using DetectNet with DIGITS version 5.0. To defend test data selection bias and increase reliability, fivefold cross-validation was performed. Diagnostic performance was evaluated using recall, precision, and F measure. RESULTS: Of the 330 VRFs, 267 were detected. Twenty teeth without fractures were falsely detected. Recall was 0.75, precision 0.93, and F measure 0.83. CONCLUSIONS: The CNN learning model has shown promise as a tool to detect VRFs on panoramic images and to function as a CAD tool.


Assuntos
Fraturas dos Dentes , Inteligência Artificial , Tomografia Computadorizada de Feixe Cônico , Humanos , Radiografia Panorâmica , Reprodutibilidade dos Testes , Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem
8.
Niger J Clin Pract ; 22(6): 833-841, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31187770

RESUMO

Objective: To evaluate the mechanical properties of a glass hybrid (GH) restorative system (EQUIA Forte/GC) and compare it with a microhybrid composite (G-aenial Posterior/GC) by compressive strength (CS) and fracture resistance (FR) tests. Materials and Methods: Cylindrical specimens were subjected to a CS test (n = 12). There were about 48 mandibular molars were used for a FR test and divided into four groups: Group 1 (positive control), sound teeth; Group 2 (negative control), extended size Class 2 cavities prepared on the mesial surfaces of teeth; Group 3, extended size Class 2 cavities restored with a composite; and Group 4, extended size Class 2 cavities restored with GH. Specimens were subjected to loading until a fracture occurred. Data were analyzed statistically (α = 0.05). Results: The fracture modes were examined by scanning electron microscope (SEM). The CS values of the composite and GH were 278.20 ± 17.34 MPa and 164.62 ± 25.72 MPa, respectively (P < 0.05). No differences were observed between the FR of restored groups (P > 0.05). Conclusions: The GH exhibited sufficient mechanical properties as a restorative material, and could be preferred for extensive caries lesions on posterior teeth.


Assuntos
Resinas Compostas , Força Compressiva , Cárie Dentária/terapia , Vidro , Fraturas dos Dentes/diagnóstico por imagem , Preparo da Cavidade Dentária , Restauração Dentária Permanente , Humanos , Teste de Materiais , Microscopia Eletrônica de Varredura , Dente Molar
9.
J Endod ; 45(6): 750-755.e2, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31056300

RESUMO

INTRODUCTION: Magnetic resonance imaging (MRI) has the potential to aid in determining the presence and extent of cracks/fractures in teeth because of better contrast without ionizing radiation. The objectives were to develop MRI criteria for root crack/fracture identification and to establish reliability and accuracy in their detection. METHODS: MRI-based criteria for crack/fracture appearance was developed by an MRI physicist and a panel of 6 dentists. Twenty-nine human adult teeth previously extracted after a clinical diagnosis of a root crack/fracture were frequency matched to 29 controls. Samples were scanned using an in vivo MRI protocol and the reference standard (ie, ex vivo limited field of view cone-beam computed tomographic [CBCT] imaging). A blinded, 4-member panel evaluated the images with a proportion randomly retested to establish intrarater reliability. Overall observer agreement, sensitivity, and specificity were computed for each imaging modality. RESULTS: Subjectively, MRI has increased crack/fracture contrast and is less prone to artifacts from radiodense materials relative to CBCT imaging. Intrarater reliability for MRI was fair to excellent (κ = 0.38-1.00), and for CBCT imaging, it was moderate to excellent (κ = 0.66-1.00). Sensitivity for MRI was 0.59 (95% confidence interval [CI], 0.39-0.76; P = .46), and for CBCT imaging, it was 0.59 (95% CI, 0.59-0.76; P = .46). Specificity for MRI was 0.83 (95% CI, 0.64-0.94; P < .01), and for CBCT imaging, it was 0.90 (95% CI, 0.73-0.98; P < .01). CONCLUSIONS: Despite advantages of increased contrast and the absence of artifacts from radiodense materials in MRI, comparable measures of sensitivity and specificity (to limited field of view CBCT imaging) suggest MRI quality improvements are needed, specifically in image acquisition and postprocessing parameters. Given the early stage of technology development, there may be a use for MRI in detecting cracks/fractures in teeth.


Assuntos
Imagem por Ressonância Magnética , Fraturas dos Dentes , Adulto , Tomografia Computadorizada de Feixe Cônico , Humanos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem
10.
Dentomaxillofac Radiol ; 48(6): 20180327, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31095425

RESUMO

OBJECTIVES: To compare the accuracy of cone-beam CT ex vivo and in vivo for the detection of artificially created large and small vertical root fractures in extracted teeth restored with post-core. METHODS: Individual metal cast post-cores were fixed in the root canals of 50 extracted single-rooted human teeth. In 30 teeth fractures were created by tapping posts with a hammer. The teeth were sterilised in autoclave and embedded into bite-plates made of silicon impression material. Cone-beam CT scanning was performed ex vivo and in vivo . For the in vivo scanning, teeth in sterile plastic bags were inserted into the mouths of volunteers. Then the teeth were sectioned with low-speed saw and the widths of the VRFs were measured microscopically. The teeth were distributed into 2 groups in accordance with the measured fractures' widths: large (wider than 180-250 µm) and small (80-150 µm). Five observers assessed the presence of vertical root fractures on axial CBCT slices. Sensitivity, specificity, accuracy and inter examiner agreement were calculated. RESULTS: The accuracy of cone-beam CT in vitro for large and small vertical root fractures detection was 0.56 and 0.40 respectively (p = 0.043). The sensitivity values were 0.53 and 0.27 for large and small vertical root fractures, respectively (p = 0.043). The visualisation of fracture lines in vivo was impossible in 90 % of cases, because of low image quality. Inter examiner reliability analysis showed κ values ranging from 0.02 to 0.54. CONCLUSIONS: Fracture width affected the in vitro detectability of vertical root fractures by cone-beam CT in teeth with metal cast post-cores. The detectability of root fractures in vivo was decreased because of low image quality, making the assessment of sound tooth tissue impossible.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Fraturas dos Dentes , Humanos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária
11.
Photodiagnosis Photodyn Ther ; 26: 324-326, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31042556

RESUMO

INTRODUCTION: The aim of this case report was to describe the process of diagnosis and treatment of a cracked tooth using quantitative light-induced fluorescence (QLF). CASE REPORT: A 43-year-old male presented at our dental clinic with a complaint of cold pain in #17 tooth. A routine oral examination with radiography was performed for evaluation of the oral condition and treatment planning. Additionally, QLF image capture was performed using Qraycam and Qraypen (AIOBIO, Seoul, Republic of Korea), to collect white-light and fluorescence images. The #17 tooth was observed to have a crack line, showing red fluorescence, from the distal to mesial aspect on the occlusal surface. Even though there was no visible root fracture in the radiographic image, bone loss was observed. Therefore, we performed periodontal treatment. One month later, a root canal treatment was performed because the patient still complained of pain in the #17 tooth. During this treatment, one fluorescent image and one white light image set was captured with the Qraypen. A crack line showing red fluorescence was observed, while the line was not visible to the naked eye. After treatment, the patient has had no complaint related to this tooth for 3 years until today. CONCLUSIONS: Clinically, use of QLF confirmed the presence of a crack before and during a root canal treatment. Therefore, it is postulated that the QLF technology could objectively facilitate the diagnosis and treatment of a cracked tooth.


Assuntos
Fluorescência Quantitativa Induzida por Luz , Fraturas dos Dentes/diagnóstico por imagem , Adulto , Humanos , Masculino , Fraturas dos Dentes/terapia
12.
Clin Oral Investig ; 23(12): 4433-4439, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30982180

RESUMO

OBJECTIVES: This study aimed to investigate the effect of fracture orientation on the detection accuracy of vertical root fractures (VRFs) in non-endodontically treated teeth using four different cone beam computed tomography (CBCT) units. MATERIALS AND METHODS: Thirty eight out of 148 extracted human permanent teeth were chosen randomly, and VRFs were artificially induced to result in 20 mesiodistally and 18 buccolingually oriented root fractures. The fracture width was subsequently measured. All the teeth were scanned with four CBCT units. CBCT images were evaluated independently by two observers. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated for each observer and fracture orientation. The AUC between the two fracture orientations was compared using Z test. RESULTS: The mean fracture width was 140 µm (standard deviation 26.8 µm). A statistically significant difference was found between the mesiodistal and buccolingual VRFs for the AUC from the CBCT unit 3D Accuitomo 170 (p = 0.02). There were no statistically significant differences between the mesiodistal and buccolingual VRFs for AUCs from the CBCT units NewTom VGi (p = 0.21), ProMax 3D Mid (p = 0.23), and i-CAT FLX (p = 0.21). CONCLUSION: Fracture orientations of teeth with VRFs in non-endodontically treated teeth may play a role in the detection accuracy of CBCT images, but this effect seems to be dependent on the CBCT unit used. CLINICAL RELEVANCE: Although for most of the CBCT units tested, the fracture orientation of VRF in non-endodontically treated teeth seems not to play a role for the diagnosis, clinical data is needed to further assess the impact of different devices on VRF detection.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem , Dente não Vital , Dente Pré-Molar , Humanos
13.
J Endod ; 45(7): 856-862, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31030978

RESUMO

INTRODUCTION: The purpose of this study was to evaluate the diagnostic accuracy of cone-beam computed tomographic (CBCT) imaging in the detection of subtle vertical root fractures (VRFs) in endodontically treated teeth in vivo and to discuss direct and indirect evidence for the diagnosis of subtle VRFs. METHODS: Twenty-nine endodontically treated teeth with suspected VRFs from 29 patients were examined using CBCT imaging. CBCT images were scored based on evaluation of the fracture line and vertical buccopalatal (lingual) bone loss. VRF was diagnosed only when a definite fracture line was detected on CBCT images, and findings of periodontal exploration or surgical extraction were considered the gold standard. The diagnostic sensitivity, specificity, and accuracy were assessed. RESULTS: Of the 29 teeth, 27 were positive and 2 were negative for VRF according to the gold standard. Sensitivity, specificity, and accuracy were 33.3%, 100%, and 37.9%, respectively, based on the direct finding of a fracture line on CBCT images. However, vertical buccopalatal (lingual) bone loss was found in 25 of 27 teeth with VRFs. CONCLUSIONS: Although the accuracy of CBCT imaging for the diagnosis of subtle VRFs in endodontically treated teeth in vivo was poor, vertical buccopalatal (lingual) bone loss is an important indirect sign for the diagnosis of VRFs, which can be found on CBCT images.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Fraturas dos Dentes , Dente não Vital , Humanos , Sensibilidade e Especificidade , Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/lesões
14.
Indian J Dent Res ; 30(1): 135-139, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30900674

RESUMO

An 18-year-old female patient reported to the Department of Conservative and Endodontics with the chief complaint of fractured tooth with respect to 21 and increased pain and mobility tooth with respect to 22. Intraoral periapical radiograph of 21 revealed coronal loss of tooth structure involving enamel, dentin, and pulp, suggestive of split tooth with respect to 21. Intraoral examination revealed a fracture of coronal structure of 22 and increased mobility in the coronal aspect, suggestive of horizontal crown-root fracture. For management of 21, after endodontic phase, placement of fiberpost, and coronal buildup, intentional reimplantation was done to expose and reattach the vertically fractured root fragment. For management of 22, after endodontic phase, crown lengthening was done, and the fractured fragment was reattached by making it a Natural Richmond's Crown. Radiographs revealed a complete sealing of the fractured fragment and proper positioning of the tooth.


Assuntos
Coroas , Colagem Dentária/métodos , Adesivos Dentinários , Endodontia/métodos , Estética Dentária , Resinas Sintéticas , Coroa do Dente/lesões , Fraturas dos Dentes/terapia , Mobilidade Dentária/terapia , Raiz Dentária/lesões , Adolescente , Feminino , Humanos , Coroa do Dente/diagnóstico por imagem , Fraturas dos Dentes/diagnóstico por imagem , Mobilidade Dentária/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem , Resultado do Tratamento
15.
Indian J Dent Res ; 30(1): 140-143, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30900675

RESUMO

Cemental tear represents a rare form of root surface fracture which makes teeth prone to periodontal breakdown. The diagnosis of cemental tear becomes a challenge as it is usually neglected or misdiagnosed and is also underreported in the literature. Correct diagnosis and early treatment of cemental tear can prevent further periodontal breakdown and may preserve the affected tooth for a longer duration. This case presents the diagnosis, treatment, and an analysis of a right maxillary lateral incisor with an improper endodontic treatment coupled with a cemental tear. Despite surgical removal, the cemental tear led to the development of an endodontic periodontal lesion. This article intends to help recognize early signs and symptoms of cemental tear and establish timely diagnosis. It determines that if the periodontal destruction caused by cemental tears is diagnosed and treated early, it may be possible to prevent further periodontal breakdown and preserve the tooth for a longer period.


Assuntos
Cemento Dentário/lesões , Cemento Dentário/cirurgia , Endodontia/métodos , Doenças Periodontais/etiologia , Doenças Periodontais/cirurgia , Fraturas dos Dentes/diagnóstico por imagem , Fraturas dos Dentes/diagnóstico , Fraturas dos Dentes/cirurgia , Adulto , Apicectomia , Cemento Dentário/diagnóstico por imagem , Seguimentos , Humanos , Incisivo/diagnóstico por imagem , Incisivo/lesões , Masculino , Maxila , Doenças Periodontais/diagnóstico , Radiografia Dentária , Endodontia Regenerativa/métodos , Fraturas dos Dentes/complicações , Resultado do Tratamento
16.
Clin Oral Investig ; 23(3): 1263-1270, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29984377

RESUMO

OBJECTIVES: To evaluate the influence of artifacts produced by zirconium implant on the diagnosis of vertical root fracture (VRF) in teeth close and distant to the implant in cone beam computed tomography (CBCT) images. We also determined if kilovoltage (kVp) and metal artifact reduction (MAR) tool could influence this diagnosis. MATERIALS AND METHODS: Twenty single-root teeth were divided in control and fractured groups (n = 10). The teeth were randomly positioned in the first and second and right and left pre-molar alveoli of a dry human mandible. CBCT exams were acquired using a ProMax 3D unit with varying kVp (70, 80, or 90 kVp), with or without MAR, and with and without a zirconium implant placed in the alveolus of first right molar. The images were evaluated by five observers. The area under the receiver operating characteristic curve (ROC), sensitivity, and specificity were calculated and compared by analysis of variance with a significance level of 5%. RESULTS: In general, ROC and sensitivity were not affected by the factors studied (p > 0.05). The main effects occurred in specificity; when implant was used without MAR, the values were lower for tooth 45 for all kVps (p = 0.0001). CONCLUSIONS: Artifacts produced in the vicinity of teeth with suspected VRF impair the diagnosis by decreasing the specificity, because they can mimic the VRF line generating false positives. However, MAR improves the specificity, being its use recommended when metallic objects are present near teeth with suspected VRF. CLINICAL RELEVANCE: Since nowadays, many patients who undergo CBCT show implants and they definitively produce artifacts, it is important to evaluate the influence of such artifacts in the diagnosis of teeth that are close to the generator-artifact object.


Assuntos
Artefatos , Implantes Dentários , Fraturas dos Dentes/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Humanos , Mandíbula , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/lesões
17.
Int Endod J ; 52(2): 223-236, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30107037

RESUMO

AIM: To evaluate artefact intensity in cone beam computed tomography (CBCT) images of two alloys used in metal posts scanned using different exposure parameters. METHODOLOGY: The sample consisted of 20 single-rooted teeth divided into two groups for use with either a NiCr post or AgPd post. All teeth were scanned with and without their corresponding metal posts and with and without the presence of an extra restored tooth in the arch. The samples were scanned using CS 9000 3D scanner with two exposure protocols: 85 kV 6.3 mA and 85 kV 10 mA. Voxel size and FOV were fixed at 0.100 mm and 5 cm × 3.75 cm. The presence of artefacts was assessed qualitatively by two calibrated observers using the CBCT volume and paired 2D images, and quantitatively by one trained observer, using ImageJ software. Wilcoxon's signed rank, Mann-Whitney, kappa and chi-square tests were used for qualitative analyses. Two-way anova and Tukey's tests were used for quantitative analyses. All analyses were conducted considering the 95% confidence level (α < 0.05). RESULTS: For the CBCT volume qualitative analysis, significant differences were observed between the metal alloys in the presence of an extra restored tooth, with higher artefact intensity for AgPd when assessing hypodense halos and lines (P = 0.006). Images with two restored teeth had significantly more hypodense and hyperdense lines (P = 0.033). When evaluating exposure parameters and number of restored teeth, the paired image quality analysis revealed significant disagreement between observers for diagnostic image quality (P = 0.001). Quantitative artefact analysis revealed higher artefact intensity for the AgPd posts in the presence of two restored teeth. CONCLUSION: Although the exposure parameters tested did not interfere with artefact intensity, post alloys with a higher atomic number and the presence of another metal structure in the arch increased artefact intensity and impaired the diagnostic quality of CBCT images.


Assuntos
Artefatos , Tomografia Computadorizada de Feixe Cônico/métodos , Ligas Dentárias/química , Metais/química , Técnica para Retentor Intrarradicular , Raiz Dentária/diagnóstico por imagem , Dente Pré-Molar/diagnóstico por imagem , Ligas de Cromo/química , Humanos , Imageamento Tridimensional , Software , Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária/lesões
18.
J Formos Med Assoc ; 118(3): 671-678, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30145002

RESUMO

BACKGROUND/PURPOSE: Vertical root fracture (VRF) is a complication in endodontically treated teeth. This study aimed to assess the clinical outcomes of treatment of 6 VRF teeth with intentional replantation and root fragment bonding with 4-methacryloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butyl borane (4-META/MMA-TBB) resin. METHODS: A series of 6 complete VRF teeth (one incisor, one canine, one premolar, and 3 M) were treated through intentional replantation and root fragment bonding with 4-META/MMA-TBB resin. RESULTS: This study included 6 VRF teeth in 6 patients (one man and 5 women; mean age, 44 ± 8 years). All 6 teeth had VRF in the bucco-lingual direction and one tooth had concomitant VRF in the mesio-distal direction. The root thickness was classified as thick in all 6 teeth. Of the 6 VRF teeth, 4 had biting, percussion, or palpation pain, 4 had gingival swelling, 3 had sinus tracts, 3 had discomfort, and one had tooth mobility. Radiographically, 5 of the 6 teeth had periradicular radiolucent lesions, 4 of which exhibited complete regression and one of which exhibited nearly complete regression after root fragment bonding therapy. Because all 6 treated teeth exhibited sound function in the oral cavity after a follow-up period ranging from 33 to 74 (mean, 50 ± 15) months, the clinical outcomes were all considered to be successful. CONCLUSION: For a VRF tooth, in addition to tooth extraction, intentional replantation combined with root fragment bonding with 4-META/MMA-TBB resin is a successful treatment modality that can be used to preserve a complete VRF tooth.


Assuntos
Tratamento do Canal Radicular/efeitos adversos , Extração Dentária , Fraturas dos Dentes/terapia , Reimplante Dentário/métodos , Raiz Dentária/lesões , Adulto , Compostos de Boro/uso terapêutico , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Metacrilatos/uso terapêutico , Metilmetacrilatos/uso terapêutico , Pessoa de Meia-Idade , Cimentos de Resina/uso terapêutico , Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária/cirurgia , Resultado do Tratamento
19.
Indian J Dent Res ; 29(6): 847-851, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30589019

RESUMO

Radiographic imaging is an important criteria in diagnosis, treatment planning, and follow-up of an endodontic treatment. When clinicians encounter with diagnostic difficulties and persistent symptoms, the need for advanced diagnostic aids, especially imaging methods, become imperative and essential. This paper reports a case, in which primary endodontic therapy having failed, the patient had persisting symptoms such as pain, swelling, and draining sinus along with signs and symptoms of maxillary sinusitis. Advanced diagnostic aids such as Cone Beam Computed Tomography was useful in accurate identification of the etiology, which was a fractured mesiobuccal root tip of maxillary molar. This is the first reported case, in which the fractured root tip has migrated to the maxillary sinus, during primary endodontic treatment, through the perforated antral floor causing odontogenic sinusitis. The operating microscope helped in the successful completion of endodontic retreatment along with fractured root fragment retrieval.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Migração de Corpo Estranho/complicações , Migração de Corpo Estranho/diagnóstico por imagem , Seio Maxilar/diagnóstico por imagem , Sinusite Maxilar/diagnóstico por imagem , Sinusite Maxilar/etiologia , Complicações Pós-Operatórias , Fraturas dos Dentes/complicações , Fraturas dos Dentes/diagnóstico por imagem , Migração de Dente/complicações , Migração de Dente/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem , Adulto , Doença Crônica , Humanos , Masculino , Maxila/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Tratamento do Canal Radicular/efeitos adversos
20.
Braz Dent J ; 29(6): 530-535, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30517474

RESUMO

In order to evaluate the volume of dentinal cracks taking into account the age of the dentin and the type of file system used for endodontic procedures, forty freshly extracted single-rooted lower incisive teeth presenting similar root volume, were divided into two groups according to the age of the patient: Group Young (18 - 30 years old) and Group Old (60 years old or more). Each specimen was scanned by microcomputed tomography (micro-CT) in three stages: (i) before any treatment, (ii) after endodontic treatment with Reciproc files (REC), and (iii) after subsequent endodontic retreatment. Each group was subdivided into two subgroups, according to the retreatment technique used: retreatment with REC or with ProTaper Universal Retreatment (PUR) files. For each subgroup, the images were analyzed for differences in the volume of dentinal cracks in the middle and apical thirds of the teeth , according to the dentin age. In both stages (before and after instrumentation), the micro-CT images of the old root dentin presented with higher volume of cracks than those of the young root dentin, statistical significance notwithstanding (p>0.01). The use of REC files appeared to have no statistically significant differences in the generation of cracks in any type of root dentin when compared with PUR files (p>0.01). When retreated with PUR, the old root dentin presented with a significantly higher volume of cracks (p<0.01) when compared with the old root dentin initially.


Assuntos
Dentina/diagnóstico por imagem , Dentina/lesões , Preparo de Canal Radicular/métodos , Fraturas dos Dentes/diagnóstico por imagem , Adolescente , Adulto , Fatores Etários , Humanos , Técnicas In Vitro , Pessoa de Meia-Idade , Retratamento , Microtomografia por Raio-X
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...