RESUMO
OBJECTIVE: A systematic review was performed to evaluate the performance of panoramic radiography (PR) vs CT or cone beam CT (CBCT) in the diagnosis of pathological maxillary sinuses. METHODS: This review was registered in the PROSPERO database under the number CRD42020211766. Observational studies that compared PR with CT/CBCT were used to evaluate pathological changes in the maxillary sinuses. A complete search of seven primary databases and gray literature was carried out. The risk of bias was assessed according to the Newcastle-Ottawa tool, and the GRADE tool was used to assess the quality of evidence. A binary meta-analysis was performed to assess the effectiveness of evaluating pathological alterations in the maxillary sinuses in PR and CT/CBCT. RESULTS: Seven studies were included in our study, out of which four were included in a quantitative analysis. All studies were classified as low risk of bias. Five studies compared PR with CBCT and two studies compared PR to CT. The most common pathological alteration in maxillary sinuses reported was mucosal thickening. CT/CBCT was seen to be the most effective method for assessing pathological changes in the maxillary sinus when compared to PR (RR = 0.19, 95% confidence interval [CI] = 0.05 to 0.70, p = 0.01). CONCLUSION: CT/CBCT are the most appropriate imaging methods to evaluate pathological changes in the maxillary sinuses, while PR is still limited in the evaluation of these changes being considered only for initial diagnosis.
Assuntos
Seio Maxilar , Tomografia Computadorizada por Raios X , Humanos , Seio Maxilar/diagnóstico por imagem , Radiografia Panorâmica , Tomografia Computadorizada de Feixe CônicoRESUMO
This study aimed to evaluate the potential of strontium ranelate (SR) in medication-related jaw osteonecrosis (MRONJ) after tooth extraction in ovariectomized rats. Thirty ovariectomized rats were divided into three groups (n = 10): bisphophonate (BP) group (zoledronic acid; 0.4 mg/kg/week), SR group (625 mg/kg/day), and control group (saline solution). The lower first molars were extracted after 60 days of drug therapy. Drug administration was continued for another 30 days after tooth extraction. The mandibles were subjected to clinical, histological, radiographic, and microtomographic evaluations. Only the BP group showed clinical changes, characterized by the presence of 70% (n = 7) and 20% (n = 2) of ulcers and extraoral fistulas. Radiographic evaluation demonstrated bone sequestration only in the BP group (n = 7, 70%). Microtomographic analysis revealed increased bone porosity after ovariectomy, particularly in the the control group (p < 0.05). The BP group showed a higher bone surface density, bone volume, and trabecular number than SR and control groups, but with less trabecular separation (p < 0.05). All the animals in the BP group demonstrated histological osteonecrosis. There was no evidence of osteonecrosis in the control and SR groups, which was characterized by the absence of empty osteocyte gaps and associated with the gradual healing of the extraction area. Also, an increased number of blood vessels and a reduced number of osteoclasts were observed in the SR group (p < 0.05). Therefore, SR treatment increased angiogenesis and osteoclastogenesis in the healing socket and was not associated with MRONJ development after tooth extraction in ovariectomized rats.
Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Conservadores da Densidade Óssea , Osteonecrose , Animais , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/diagnóstico por imagem , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/etiologia , Conservadores da Densidade Óssea/efeitos adversos , Difosfonatos , Feminino , Ratos , Tiofenos/uso terapêutico , Extração Dentária/efeitos adversos , Ácido ZoledrônicoRESUMO
BACKGROUND: Several drugs are capable of promoting changes in bone metabolism. The aim of this study was to evaluate the effect of long-term low-dose aspirin (LDA) therapy on implant osseointegration. METHODS: Male Wistar rats were divided into 4 groups (n = 8/group) according to oral gavage solution received prior (42 days) to the implant surgery on the tibia. The control group was treated with saline solution for 7 (CG-7) and 28 (CG-28) days. The use of low-dose aspirin was performed in AG groups (6.75 mg/kg of aspirin) for 7 (AG-7) and 28 (AG-28) days. After experimental periods, histomorphometric evaluation of bone-to-implant contact (BIC) and the bone area between threads (BABT) was performed. RESULTS: Reduced BIC values were detected in AG-7 (62.8% ± 17.1) group compared to AG-28 (91.9% ± 5.4), CG-7 (82.7% ± 15.2), and CG-28 (89.9% ± 9.7). BABT evaluation revealed lower values in AG-7 (70.9% ± 15.2) compared to AG-28 (95.4% ± 3.7) and CG-28 (87.1% ± 10.2) groups. CONCLUSIONS: The treatment with low doses of aspirin promoted a discrete inhibitory effect in the early stages (7 days) of repair after implant placement, specifically in the bone deposition. However, these effects were not detected in the late stages (28 days), considering BIC and BABT parameters.
Assuntos
Osseointegração , Titânio , Animais , Aspirina , Masculino , Ratos , Ratos Wistar , Tíbia/cirurgiaRESUMO
Objetivo: O objetivo do estudo foi avaliar a prevalência de variações anatômicas no complexo nasossinusal por meio de tomografia computadorizada (TC) em pacientes com sinusite não odontogênica. Métodos: Um estudo observacional e retrospectivo consistiu em 860 prontuários com indicação de tomografias computadorizadas multislice para avaliação de sinusite. A sinusite odontogênica foi caracterizada pela presença de espessamento da mucosa sinusal maior que 2 milímetros e ausência de alterações dentárias na região. Posteriormente, foram avaliadas as variações do complexo nasossinusal e realizada uma análise descritiva. Em seguida, 33 tomografias computadorizadas foram analisadas com sinusopatia não odontogênica, e o complexo nasossinusal foi avaliado quanto à presença das seguintes variações anatômicas como desvio do septo nasal associado a esporão ósseo, concha média bolhos, aumento do seio frontal entre outras. Resultados: Variações anatômicas foram observadas em 87,9% dos casos, sendo 15 do gênero masculino (46,0%) e 18 do gênero feminino (54,0%) e distribuídos em 45,5% dos pacientes entre 41-60 anos. A variação anatômica mais frequente foi a concha média bolhosa (37,9%), seguida de septações no seio maxilar (10,3%) e seio frontal alargado (13,8%). Conclusão:Verificou-se uma considerável incidência de variações anatômicas associadas à sinusite não odontogênica, com evidência para a concha média bolhosa.
Aim: The aim of the study was to assess the prevalence of anatomical variations in the sinonasal complex using computed tomography (CT) in patients with non-odontogenic sinusitis. Methods: This observational and retrospective study involved the analysis of 860 multislice CT scans prescribed for sinusitis evaluation. Non-odontogenic sinusitis was characterized by the presence of sinus mucosal thickening exceeding 2 millimeters and the absence of dental changes in the region. Subsequently, sinonasal complex variations were evaluated, and a descriptive analysis was conducted. Subsequently, 33 CT scans with non-odontogenic sinusopathy were analyzed, and the sinonasal complex was evaluated for the presence of the following anatomical variations: deviation of the nasal septum associated with a bony spur, bullous middle concha, unilateral hypoplasia of the maxillary sinus, among others. Results: Anatomical variations were observed in 87.9% of cases, with 15 males (46.0%) and 18 female (54.0%), distributed among patients aged 41-60 years (45.5%). The most frequent anatomical variation was the bullous middle concha (37.9%), followed by septations in the maxillary sinus (10.3%) and enlarged frontal sinus (13.8%). Conclusion: A considerable incidence of anatomical variations associated with non-odontogenic sinusitis was observed, with evidence of a bullous middle concha.
Assuntos
Sinusite , Tomografia Computadorizada por Raios X , Variação Anatômica , Seio MaxilarRESUMO
Objetivo: Avaliar a prevalência da radiolucência justa-apical (RJA) e sua relação com os terceiros molares inferiores, em 1054 radiografias panorâmicas. Métodos: A amostra foi constituída por radiografias panorâmicas digitais de indivíduos maiores de 18 anos, com pelo menos um terceiro molar inferior. As imagens foram analisadas para a presença de RJA em relação à corticalização, localização, relação com o canal mandibular, angulação e profundidade de impactação do terceiro molar. Os dados foram analisados através de estatística descritiva e pelo teste Qui-quadrado, sendo que valores de p < 0,05 foram considerados como significativos. Resultados:Foi encontrada uma prevalência de 2,75% de RJA, sendo predominante no sexo feminino (p = 0,01). A RJA foi visualizada em maior número corticalizada (58,63%), lateroapical (48,27%), em dentes parcialmente intraósseo (68,97%) e mesioangulados (55,17%). Em relação ao canal mandibular, houve maior prevalência na posição sobreposta ao canal mandibular (65,52%). Conclusão: A prevalência de RJA foi de 2,75% do total de 1054 radiografias panorâmicas avaliadas. Em relação ao canal mandibular, apresentou maior prevalência sobreposto. Além disso, a maior parte das RJA se apresentaram corticalizadas, em posição lateroapical, associada a dentes em posição mesioangular. Descritores: Radiografia panorâmica. Dente serotino. Nervo mandibular.Prevalência de radiolucência justa-apical e sua relação com terceiros molares inferiores em radiografias panorâmicas
Aim: To evaluate the prevalence of juxta-apical radiolucency (JAR) and its relationship with the lower third molars and adjacent structures, in 1,054 panoramic radiographs. Methods: The sample consisted of digital panoramic radiographs of individuals over 18 years of age, with at least one lower third molar. The images were analyzed for the presence of JAR in relation to corticalization, location, impaction depth, relationship with the mandibular canal, angulation, and impaction of the third molar. Data were analyzed using descriptive statistics and the chi-square test, and values of p < 0.05 were considered significant.Results: A prevalence of 2.75% of JAR was found, with a statistical difference between JAR and gender (p = 0.01), which proved to be predominant in females. The JAR was seen in greater numbers as corticalized (58.63%), lateroapical (48.27%), and mesioangulated (55.17%), as well as in erupted teeth (31.03%). In relation to the mandibular canal, it presented a higher prevalence when superimposed upon the mandibular canal (65.52%). Conclusions:The prevalence of RJA was 2.75% of the 1,054 evaluated panoramic radiographs. In relation to the mandibular canal, it presented a higher prevalence of superimposition. In addition, most of the RJA were corticalized, in a lateroapical position, associated with teeth in a mesioangular position. Uniterms: Panoramic radiography. Third molar. Mandibular nerve.
Assuntos
Radiografia Panorâmica , Nervo Mandibular , Dente Molar , Dente SerotinoRESUMO
Abstract This study aimed to evaluate the potential of strontium ranelate (SR) in medication-related jaw osteonecrosis (MRONJ) after tooth extraction in ovariectomized rats. Thirty ovariectomized rats were divided into three groups (n = 10): bisphophonate (BP) group (zoledronic acid; 0.4 mg/kg/week), SR group (625 mg/kg/day), and control group (saline solution). The lower first molars were extracted after 60 days of drug therapy. Drug administration was continued for another 30 days after tooth extraction. The mandibles were subjected to clinical, histological, radiographic, and microtomographic evaluations. Only the BP group showed clinical changes, characterized by the presence of 70% (n = 7) and 20% (n = 2) of ulcers and extraoral fistulas. Radiographic evaluation demonstrated bone sequestration only in the BP group (n = 7, 70%). Microtomographic analysis revealed increased bone porosity after ovariectomy, particularly in the the control group (p < 0.05). The BP group showed a higher bone surface density, bone volume, and trabecular number than SR and control groups, but with less trabecular separation (p < 0.05). All the animals in the BP group demonstrated histological osteonecrosis. There was no evidence of osteonecrosis in the control and SR groups, which was characterized by the absence of empty osteocyte gaps and associated with the gradual healing of the extraction area. Also, an increased number of blood vessels and a reduced number of osteoclasts were observed in the SR group (p < 0.05). Therefore, SR treatment increased angiogenesis and osteoclastogenesis in the healing socket and was not associated with MRONJ development after tooth extraction in ovariectomized rats.
RESUMO
Objetivo: Os objetivos deste estudo foram avaliar a prevalência do posicionamento dos terceiros molares inferiores seguindo a classificação de Winter e Pell & Gregory, e determinar os níveis de dificuldade para a exodontia através do índice de Pederson. Materiais e Métodos: Estudo radiográfico, transversal e retrospectivo avaliou 100 radiografias panorâmicas provenientes dos prontuários odontológicos atendidos nos ambulatórios de Cirurgia bucal, de pacientes entre 15 e 61 anos de idade, no período de 2015 a 2017. As radiografias panorâmicas foram avaliadas por meio do software ImageJquanto aos posicionamentos dos terceiros molares inferiores pela classificação de Winter e Pell & Gregory, enquanto o nível de dificuldade foi avaliado pelo índice de Pederson. Os resultados obtidos foram submetidos à análise estatística descritiva. Resultados: A maior prevalência de terceiros molares inclusos foi observada em mulheres, com idade média de 26 anos. Quanto a posição dos dentes inclusos, a posições vertical (44,0%), nível A (74,7%) e classe III (69,9%) foram as mais prevalentes. Na escala de Pederson, a dificuldade cirúrgica "muito difícil" foi a mais encontrada. Discussão: nossos resultados sugerem estabelecer um melhor planejamento cirúrgico e prognóstico aos pacientes, minimizando a possibilidade de complicações durante e após as extrações de terceiros molares inferiores. Conclusão: Ambas classificações auxiliam o cirurgião-dentista a estabelecer um melhor planejamento e prognóstico aos pacientes. A aplicabilidade das radiografias panorâmicas, associados a avaliação clínica, justificam menores possibilidades de complicações pós-cirúrgicas em terceiro molar inferior.
Aim: The objectives of this study were to evaluate the prevalence of the mandibular third molars position in according to the Winter and Pell & Gregory classification, and to determine the levels of difficulty for exodontia through the Pederson index. Materials and Methods: Radiographic, cross-sectional and retrospective study evaluated 100 panoramic radiographs of patients between 15 and 61 years old, from dental records seen at the Oral Surgery department in the period from 2015 to 2017. The panoramic radiographs were evaluated using ImageJ software regarding the positioning of the lower third molars by the Winter and Pell & Gregory classification, while the level of difficulty was evaluated by the Pederson index. The results obtained were submitted to descriptive statistical analysis.Results: The highest prevalence of included third molars was observed in women, with an age average of 26 years. Regarding the position of the included teeth, the vertical position (44.0%), level A (74.7%), and class III (69.9%) were the most prevalent. In the Pederson scale, the "very difficult" surgical difficulty was the most found. Discussion: results suggest establishing better surgical planning and prognosis for patients, minimizing the possibility of complications during and after extractions of mandibular third molars.Conclusion: Both classifications help the dental surgeon to establish better planning and prognosis for patients. The applicability of panoramic radiographs, associated with clinical evaluation, justifies a fewer possibility of complications in the lower third molar post-extraction
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Cirurgia Bucal , Radiografia Panorâmica , Dente Serotino , Dente não Erupcionado , Estudos RetrospectivosRESUMO
Objetivo: Avaliar a prevalência de calcificação de placa ateromatosa (PAC) na região de bifurcação da carótida em radiografias panorâmicas realizadas em uma população brasileira. Métodos: Nesse estudo realizou-se a avaliação da prevalência de imagem sugestiva de PAC em 450 radiografias panorâmicas de pacientes atendidos no período entre 2015 e 2017. As radiografias foram analisadas para a presença de PAC. Resultados: Dezesseis pacientes (3,55%) apresentaram imagens sugestivas de PAC. A maior prevalência foi no gênero feminino (4,5%), a faixa etária mais prevalente foi entre 61 e 80 anos (12,2%) e a localização mais frequente foi unilateral (81,2%). Conclusão: A presença de PAC na região de bifurcação da carótida foi encontrada em 3,55% dos pacientes, sendo mais prevalentes em mulheres leucodermas, acima de 60 anos e unilateral.
Aim: To evaluate the prevalence of calcified atheromatous plaque (CAP) in the region of carotid bifurcation in panoramic radiographs in a Brazilian population. Methods: This study evaluated the prevalence of images suggestive of CAP in 450 panoramic radiographs of patients in the period between 2015 and 2017. Results: Sixteen patients (3.55%) presented images that were suggestive of CAP. The highest prevalence was in the female sex (4.5%), the most prevalent age group was between 61 and 80 years old (12.2%), and the most frequent location was unilateral (81.2%). Conclusion: The presence of CAP in the region of carotid bifurcation was found in 3.55% of the patients, and proved to be more prevalent in white women over 60 years of age and unilateral.