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Jucan MM, Coffman C, Mauldin GE, Fink LA. Endodontic Treatment Outcome of 45 Incisor Teeth in Dogs Determined by Intraoral Radiography. J Vet Dent 2023; 40:338-346. [PMID: 37680051 DOI: 10.1177/08987564231201063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
A retrospective study was conducted to determine the outcome of endodontic treatment of incisor teeth in dogs. Medical and dental records from four private veterinary specialty practices over an 8-year period (2013-2021) were reviewed. Forty-five incisor teeth from 41 dogs with ages from 1 to 11-years-old were included in the study. The indications for endodontic treatment were complicated crown fracture in 23 incisors (51.1%), non-vital tooth in 15 incisors (33.3%) and complicated crown-root fracture in seven incisors (15.5%). Evaluation criteria included availability of complete medical and dental records, patient demographics, and at least one follow-up visit as recent as 6 months after the initial root canal therapy. Endodontic treatment outcome was defined as successful, no evidence of failure, or failure. Root canal therapy was successful in 42 teeth (93.3%), no evidence of failure was found in three teeth (6.6%), and none of the cases showed failure of the treatment. Duration of follow-up ranged from 6 to 64 months. Only three variables appeared to have statistical significance: presence of preoperative periapical lucency (PAL) (P = .01), postoperative PAL (P < .001) and postoperative external inflammatory root resorption (P = .014). Based on this study, following "loose criteria" (success and no evidence of failure combined), 100% of the treatments were successful, making this option an excellent therapy choice in a veterinary specialty dentistry practice.
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Affiliation(s)
| | - Curt Coffman
- Arizona Veterinary Dental Specialists, Scottsdale, AZ, USA
| | | | - Lisa A Fink
- Arizona Veterinary Dental Specialists, Scottsdale, AZ, USA
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Al Yahya RS, Al Attas MH, Javed MQ, Khan KI, Atique S, Abulhamael AM, Bahammam HA. Root Canal Configuration and Its Relationship with Endodontic Technical Errors and Periapical Status in Premolar Teeth of a Saudi Sub-Population: A Cross-Sectional Observational CBCT Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1142. [PMID: 36673896 PMCID: PMC9859327 DOI: 10.3390/ijerph20021142] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/27/2022] [Accepted: 12/29/2022] [Indexed: 06/13/2023]
Abstract
Endodontic technical errors are the foremost cause of treatment failure. A thorough understanding of root canal configuration (RCC) is essential to prevent these iatrogenic errors. This study used CBCT images to determine the association between root canal configuration, endodontic technical errors, and periapical status. CBCT images of 101 patients, including total of 212 obturated premolars (256 canals) were assessed. RCCs were classified according to the Vertucci system. The presence of endodontic errors and periapical lesions associated with each RCC was noted. Presence or absence of coronal restoration and its association with periapical radiolucency was recorded. The most frequent RCC was Type I (199 cases; 77.73%), followed by Type II (26 cases; 10.15%), Type IV (22 cases; 8.59%), Type V (4 cases; 1.56%), Type III (4 cases; 1.56%), and Type VI (1 case; 0.39%). Under-filling and non-homogeneous filling were the most common technical errors. Prevalence of periapical radiolucency was 81% in the presence of technical errors. The absence of coronal restoration caused apical lesions in 93% of cases. The frequency of endodontic technical errors increased as the root canal configurations became more complex. Periapical lesions occurred more often in teeth with endodontic errors and/or absent coronal restoration.
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Affiliation(s)
- Rayan Suliman Al Yahya
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraidah 52571, Saudi Arabia
| | - Mustafa Hussein Al Attas
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraidah 52571, Saudi Arabia
| | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraidah 52571, Saudi Arabia
| | - Kiran Imtiaz Khan
- Department of Operative Dentistry, Frontier Medical and Dental College, Abbottabad 22030, KPK, Pakistan
| | - Sundus Atique
- College of Dental Medicine, Qatar University, Doha 2713, Qatar
| | - Ayman M. Abulhamael
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia
| | - Hammam Ahmed Bahammam
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia
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AlMohareb RA, Barakat RM, Mehanny M. Quantitative Analysis of Cone-Beam Computed Tomography Artifacts Induced by Nonmetallic Root Canal Filling Materials Using Different Fields of View: In Vitro Study. SCANNING 2022; 2022:4829475. [PMID: 35282567 PMCID: PMC8888051 DOI: 10.1155/2022/4829475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/03/2021] [Accepted: 11/06/2021] [Indexed: 06/14/2023]
Abstract
Cone-beam computed tomography (CBCT) imaging artifacts can hinder accurate diagnosis of several conditions. The aim of this study was to quantify CBCT artifacts created by nonmetallic root canal filling materials using two fields of view (FOV). Root canals of twenty extracted maxillary central incisors (n = 20) were instrumented and randomly divided into four equal groups: canals in Group 1 were filled with gutta-percha, canals in Group 2 with mineral trioxide aggregate (MTA) and gutta-percha, canals in Group 3 with gutta-percha and glass-fiber posts, and canals in Group 4 with MTA and glass-fiber posts. Each tooth was mounted on a silicon block and scanned three times using a CBCT machine, first with a prefilling scan (control) and then with postfilling scans, using two different FOV (40∗50 mm and 80∗50 mm). Imaging software was used to measure grayscale pixel values of canal cross sections. Data were analyzed using t-test and paired t-test statistical tests, with statistical significance set at p ≤ 0.05. Dentin at the apical and middle third of the teeth showed a significant decrease in minimum grayscale values in association with gutta-percha (p = 0.027, p = 0.034). However, a wide 80∗50 FOV showed a significant increase in maximum grayscale values of coronal (p = 0.048) and apical dentin (p = 0.049). Glass-fiber posts in middle third cross sections also corresponded to an increase in maximum grayscale values (p = 0.018). Gutta-percha produced dark band artifacts in the root's middle and apical thirds, whereas white streak artifacts were produced by gutta-percha in the coronal third and glass-fiber posts in the coronal and middle thirds when imaged with a wider FOV. A smaller FOV is therefore recommended for CBCT imaging, as it produces fewer artifacts.
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Affiliation(s)
- Rahaf A AlMohareb
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Reem M Barakat
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Mohamed Mehanny
- Basic Dental Science, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Sirri MR, Burhan AS, Hajeer MY, Nawaya FR. Evaluation of corticision-based acceleration of lower anterior teeth alignment in terms of root resorption and dehiscence formation using cone-beam computed tomography in young adult patients: A randomized controlled trial. Int Orthod 2021; 19:580-590. [PMID: 34688568 DOI: 10.1016/j.ortho.2021.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/01/2021] [Accepted: 10/02/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION No randomized controlled trial (RCT) has compared flapless corticision with the conventional treatment in the non-extraction treatment of crowded lower anterior teeth (LAT) in terms of external apical root resorption (EARR) and dehiscence formation (DF). The aim of this RCT was to investigate these two complications during levelling and alignment of the LAT using cone-beam computed tomography (CBCT) imaging. METHODS Patients with mild to moderate crowding of the LAT were included. Subjects were randomly allocated to either the corticision-assisted orthodontic treatment group (CORT) or the traditional orthodontic treatment group (TRAD). In the CORT, three vertical incisions were performed after brackets' placement. CBCT images were taken before starting treatment and after treatment completion to assess the EARR and the DF. Two-sample t-test and Chi-Square tests were used to detect significant differences. RESULTS In general, 312 roots of the lower anterior teeth (156 in each group) were examined. Fifty-two patients (14 males and 38 females, mean age 21.38) were recruited. (CORT; n=26, 6 males, 20 females, mean age 21.30); (TRAD; n=26, 8 males, 18 females, mean age 21.46). No statistically significant difference was found between the two groups regarding the overall mean value of EARR following alignment (P=0.436). The greatest recorded resorption values were 0.81 and 1.02 in the CORT and TRAD groups, respectively. At the end of levelling and alignment, there was no statistically significant difference between the two groups regarding the distribution of DF (P=0.780). CONCLUSION Corticision as an acceleration technique did not produce any significant side effects on the roots of lower anterior teeth and did not cause additional alveolar bone defects (dehiscence formation) compared to the conventional non-accelerated method of alignment.
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Affiliation(s)
- Mohamad Radwan Sirri
- University of Damascus Dental School, Department of Orthodontics, Damascus, Syria
| | - Ahmad S Burhan
- University of Damascus Dental School, Department of Orthodontics, Damascus, Syria
| | - Mohammad Y Hajeer
- University of Damascus Dental School, Department of Orthodontics, Damascus, Syria.
| | - Fehmieh R Nawaya
- Faculty of Dentistry, Syrian Private University, Department of Paediatric Dentistry, Damascus, Syria
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Minhoto GB, Khoury RD, Orozco EIF, Prado RF, Valera MC. Effect of chronic unpredictable stress on the progression of experimental apical periodontitis in rats. Int Endod J 2021; 54:1342-1352. [PMID: 33724486 DOI: 10.1111/iej.13515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 11/29/2022]
Abstract
AIM To establish an experimental model combining chronic stress and apical periodontitis by assessing the development of periapical lesions in rats in three different time points. METHODOLOGY Forty-eight male Wistar rats were randomly assigned into two equal groups: Apical periodontitis (AP) and AP + Stress (AP + S). The animals of the AP group were not exposed to stressful conditions whereas the AP + S group were exposed to a variety of stressors on a daily basis until the end of the experiment. After three weeks of chronic unpredictable stress, apical periodontitis was induced in both groups by exposing the pulpal tissue of the mandibular first molar to the oral environment. Each group was further subdivided into three subgroups according to the euthanasia period: 14, 21 and 28 days after pulp exposure. The animals were weighed, and the blood was collected for corticosterone serum dosage by radioimmunoassay. The mandibles were removed and submitted to histopathological and microtomography analyses to assess the inflammatory response and the progression of periapical lesions. Comparisons between the AP and AP + S groups were performed using Student's t-test and Mann-Whitney U-test for parametric and nonparametric data, respectively. The one-way anova test followed by Tukey's test (parametric data) and Kruskal-Wallis followed by Dunn's test (nonparametric data) were used for comparisons between the three time points within the same group (P < 0.05). RESULTS The AP + S group had a significantly lower average percentage of weight gain at 14 days and 21 days after AP induction (P < 0.05). Significantly higher levels of corticosterone were found in the AP + S group at 21 days (P < 0.05). The AP + S group had a significantly greater intensity and extension of inflammatory infiltrate with larger areas of bone loss compared to the AP groups at 21 days (P < 0.05). The volume of the periapical lesions in the AP + S group was significantly larger than that of the AP group 21 days following pulp exposure (P < 0.05). CONCLUSIONS The chronic unpredictable stress model applied for 6 weeks exacerbated the inflammatory response and increased bone loss associated with AP, especially 21 days after its induction. This model appears to be suitable for investigating the bidirectional relationship between apical periodontitis and chronic stress.
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Affiliation(s)
- G B Minhoto
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - R D Khoury
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - E I F Orozco
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - R F Prado
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - M C Valera
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
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Knight A, Blewitt I, Al-Nuaimi N, Watson T, Herzog D, Festy F, Patel S, Foschi F, Koller G, Mannocci F. Rapid Chairside Microbial Detection Predicts Endodontic Treatment Outcome. J Clin Med 2020; 9:jcm9072086. [PMID: 32635158 PMCID: PMC7408726 DOI: 10.3390/jcm9072086] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/30/2020] [Indexed: 01/03/2023] Open
Abstract
Background. The aim of this longitudinal, one-year cohort study was to explore the hypothesis that fluorescence sampling of the root canal space prior to obturation could predict the outcome of root canal treatment (RCT). Methods. Sixty-five teeth underwent primary RCT and were followed up clinically and radiographically. The outcome was determined radiographically with periapical radiographs (PR) and cone beam computed tomography (CBCT) scans. Results. Success at 12 months was predictable based on the fluorescence score. When the fluorescence score (defined as the percentage of signal over total signal including background) was lower than 67, there was a 4.5 times (Odds ratio (OR) = 0.028; 95% confidence interval (CI): 0.003, 0.291, p = 0.001) greater chance of success (90% overall). When the readings were above this threshold, the success rate was 20%. Conclusion. A chairside sampling method is able to predict the outcome of RCT, through the use of paper point sampling and fluorescence staining. This has reduced the prevalence of persistent infections by guiding the optimum time for obturation. ClinicalTrials.gov trial NCT03660163.
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Affiliation(s)
- Alan Knight
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Ian Blewitt
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Nassr Al-Nuaimi
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
- Department of Conservative Dentistry, College of Dentistry, University of Baghdad, Baghdad 10001, Iraq
| | - Tim Watson
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Dylan Herzog
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Frederic Festy
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Shanon Patel
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
- Specialist practice, London W1G 8SB, UK
| | - Federico Foschi
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
- Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
| | - Garrit Koller
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Francesco Mannocci
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
- Correspondence: ; Tel.: +44(0)-2071-881-573
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Etöz M, Amuk M, Avcı F, Yabacı A. Investigation of the effectiveness of CBCT and gray scale values in the differential diagnosis of apical cysts and granulomas. Oral Radiol 2020; 37:109-117. [PMID: 32613300 DOI: 10.1007/s11282-020-00459-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/20/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE The aim of this study was to investigate the effectiveness of cone-beam CT (CBCT) findings and gray scale values (GSV) in the differential diagnosis of apical cysts and granulomas. METHODS Two independent researchers retrospectively analyzed the CBCT images of 21 teeth and histopathologically diagnosed them as having radicular cysts or apical granulomas. In the CBCT images, apical lesions were evaluated and categorized according to 7 criteria. These criteria were determined as relationship of lesions with dental roots, periphery of the lesion, shape, darker focus in the center, root resorption, displacement in related teeth, and cortical bone perforation. In addition, the minimum and maximum gray scale values of the lesions were measured and compared. RESULTS There was a statistically significant relationship between histopathological (HP) diagnosis and well-defined cortical border and lesion shape (p = 0.003, p = 0.014, respectively). According to the HP diagnosis, no statistically significant difference was found among other variables (p > 0.05) CONCLUSION: The presence of a well-defined cortical border or partial cortical border is a distinctive criterion for cysts. Additionally, the shape of the lesion was found to be a significant criterion for the separation of the two lesions. The shape of cystic lesions was circular and apical granulomas had a more curved shape. There was no relationship between the histopathological diagnosis of lesions and CBCT gray scale values.
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Affiliation(s)
- Meryem Etöz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Turkey.
| | - Mehmet Amuk
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Turkey
| | - Fatma Avcı
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Turkey
| | - Ayşegül Yabacı
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
- Department of Biostatistics, Faculty of Medicine, Uludag University, Bursa, Turkey
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Accuracy of Periapical Radiography and CBCT in Endodontic Evaluation. Int J Dent 2018; 2018:2514243. [PMID: 30410540 PMCID: PMC6206562 DOI: 10.1155/2018/2514243] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 10/02/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction A radiological evaluation is essential in endodontics, for diagnostic purposes, planning and execution of the treatment, and evaluation of the success of therapy. The periapical radiography is nowadays the main radiographic investigations used but presents some limits as 3D anatomic alteration, geometric compression, and possible anatomical structures overlapping that can obscure the area of interest. CBCT (cone beam computed tomography) in endodontics allows a detailed assessment of the teeth and surrounding alveolar anatomy for endodontic diagnosis, treatment planning, and follow-up. Objective The purpose of this study was to evaluate the accuracy of CBCT in comparison with conventional intraoral radiographs used in endodontic procedures. Materials and Methods Statistical analysis was performed on 101 patients with previous endodontic treatments with the relative radiographic documentation (preoperative, postoperative, and follow-up intraoral X-ray) that had underwent at CBCT screening for surgical reasons. The CBCT scans were evaluated independently by two operators and compared with the corresponding periapical images. Results Our analysis shows that the two radiological investigations statistically agree in 100% of cases in the group of patients without any endodontic sign. In the group of patients with an endodontic pathology, detected with CBCT, endodontic under extended treatments (30.6%), MB2 canals in nontreated maxillary molars (20.7%), second canals in nontreated mandibular incisors (9%), root fractures (2.7%), and root resorption (2.7%) were not always visible in intraoral X-ray. Otherwise, positivity in the intraoral X-ray was always confirmed in CBCT. A radiolucent area was detected in CBCT exam in 46%, while the intraoral X-ray exam was positive only in 18%. Conclusions Our study shows that some important radiological signs acquired using CBCT are not always visible in periapical X-ray. Furthermore, CBCT is considered as a II level exam and could be used to solve diagnostic questions, essential to a proper management of the endodontic problems.
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Jang JK, Kwak SW, Ha JH, Kim HC. Anatomical relationship of maxillary posterior teeth with the sinus floor and buccal cortex. J Oral Rehabil 2017; 44:617-625. [PMID: 28547776 DOI: 10.1111/joor.12525] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 11/28/2022]
Abstract
This study aimed to evaluate the possibility of root fenestration or oroantral communication by evaluating the distance from root apex to the sinus floor and buccal cortex in maxillary posterior teeth using cone-beam computed tomography (CBCT) images. The study included 2182 roots of the maxillary posterior teeth from 219 patients after reviewing CBCT images of 462 patients according to the location of roots by two endodontists. The distances from each root apex to the maxillary sinus floor and buccal and palatal cortices were evaluated according to sex and age, and the mean values were compared by one-way analysis of variance and Mann-Whitney U-test. The distance between root apex and maxillary sinus floor was the greatest in maxillary first premolars and shortest in the mesio-buccal roots of maxillary second molars. The distances from root apex to the buccal and palatal cortical bones were significantly greater in male patients than those in female patients (P < 0·05). The palatal roots of maxillary first molars exhibited the highest incidence as well as the greatest mean length (1·96 mm) of protrusion into the maxillary sinus. The distance from root apex to the sinus floor was found to increase with age, except in case of maxillary second premolars. Understanding the relationship of maxillary posterior teeth with the sinus floor and buccal cortex could provide clinicians valuable information to help reduce iatrogenic damage.
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Affiliation(s)
- J K Jang
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea
| | - S W Kwak
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea
| | - J H Ha
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - H C Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea
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Villoria EM, Lenzi AR, Soares RV, Souki BQ, Sigurdsson A, Marques AP, Fidel SR. Post-processing open-source software for the CBCT monitoring of periapical lesions healing following endodontic treatment: technical report of two cases. Dentomaxillofac Radiol 2016; 46:20160293. [PMID: 27936918 DOI: 10.1259/dmfr.20160293] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To describe the use of open-source software for the post-processing of CBCT imaging for the assessment of periapical lesions development after endodontic treatment. METHODS CBCT scans were retrieved from endodontic records of two patients. Three-dimensional virtual models, voxel counting, volumetric measurement (mm3) and mean intensity of the periapical lesion were performed with ITK-SNAP v. 3.0 software. Three-dimensional models of the lesions were aligned and overlapped through the MeshLab software, which performed an automatic recording of the anatomical structures, based on the best fit. Qualitative and quantitative analyses of the changes in lesions size after treatment were performed with the 3DMeshMetric software. RESULTS The ITK-SNAP v. 3.0 showed the smaller value corresponding to the voxel count and the volume of the lesion segmented in yellow, indicating reduction in volume of the lesion after the treatment. A higher value of the mean intensity of the segmented image in yellow was also observed, which suggested new bone formation. Colour mapping and "point value" tool allowed the visualization of the reduction of periapical lesions in several regions. CONCLUSIONS Researchers and clinicians in the monitoring of endodontic periapical lesions have the opportunity to use open-source software.
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Affiliation(s)
- Eduardo M Villoria
- 1 School of Dentistry, Postgraduate Program in Dentistry, Pontificial Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Antônio R Lenzi
- 2 School of Dentistry, Postgraduate Program in Dentistry, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rodrigo V Soares
- 1 School of Dentistry, Postgraduate Program in Dentistry, Pontificial Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bernardo Q Souki
- 1 School of Dentistry, Postgraduate Program in Dentistry, Pontificial Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Asgeir Sigurdsson
- 3 School of Dentistry, Department of Endodontics, New York University, New York, NY, USA
| | - Alexandre P Marques
- 2 School of Dentistry, Postgraduate Program in Dentistry, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sandra R Fidel
- 2 School of Dentistry, Postgraduate Program in Dentistry, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Venskutonis T. Periapical tissue evaluation: analysis of existing indexes and application of Periapical and Endodontic Status Scale (PESS) in clinical practice. GIORNALE ITALIANO DI ENDODONZIA 2016. [DOI: 10.1016/j.gien.2016.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Tawfik HE, Abu-Seida AM, Hashem AA, El-Khawlani MM. Treatment of experimental furcation perforations with mineral trioxide aggregate, platelet rich plasma or platelet rich fibrin in dogs’ teeth. ACTA ACUST UNITED AC 2016; 68:321-7. [PMID: 27033179 DOI: 10.1016/j.etp.2016.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 03/16/2016] [Accepted: 03/23/2016] [Indexed: 02/08/2023]
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Okada K, Rysavy S, Flores A, Linguraru MG. Noninvasive differential diagnosis of dental periapical lesions in cone-beam CT scans. Med Phys 2015; 42:1653-65. [PMID: 25832055 DOI: 10.1118/1.4914418] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE This paper proposes a novel application of computer-aided diagnosis (CAD) to an everyday clinical dental challenge: the noninvasive differential diagnosis of periapical lesions between periapical cysts and granulomas. A histological biopsy is the most reliable method currently available for this differential diagnosis; however, this invasive procedure prevents the lesions from healing noninvasively despite a report that they may heal without surgical treatment. A CAD using cone-beam computed tomography (CBCT) offers an alternative noninvasive diagnostic tool which helps to avoid potentially unnecessary surgery and to investigate the unknown healing process and rate for the lesions. METHODS The proposed semiautomatic solution combines graph-based random walks segmentation with machine learning-based boosted classifiers and offers a robust clinical tool with minimal user interaction. As part of this CAD framework, the authors provide two novel technical contributions: (1) probabilistic extension of the random walks segmentation with likelihood ratio test and (2) LDA-AdaBoost: a new integration of weighted linear discriminant analysis to AdaBoost. RESULTS A dataset of 28 CBCT scans is used to validate the approach and compare it with other popular segmentation and classification methods. The results show the effectiveness of the proposed method with 94.1% correct classification rate and an improvement of the performance by comparison with the Simon's state-of-the-art method by 17.6%. The authors also compare classification performances with two independent ground-truth sets from the histopathology and CBCT diagnoses provided by endodontic experts. CONCLUSIONS Experimental results of the authors show that the proposed CAD system behaves in clearer agreement with the CBCT ground-truth than with histopathology, supporting the Simon's conjecture that CBCT diagnosis can be as accurate as histopathology for differentiating the periapical lesions.
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Affiliation(s)
- Kazunori Okada
- Department of Computer Science, San Francisco State University, San Francisco, California 94132
| | - Steven Rysavy
- Biomedical and Health Informatics Program, University of Washington, Seattle, Washington 98195
| | - Arturo Flores
- Computer Science and Engineering, University of California, San Diego, California 92093
| | - Marius George Linguraru
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, Washington, DC 20010 and Departments of Radiology and Pediatrics, George Washington University, Washington, DC 20037
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Jorge ÉG, Tanomaru-Filho M, Guerreiro-Tanomaru JM, Reis JMDSN, Spin-Neto R, Gonçalves M. Periapical repair following endodontic surgery: two- and three-dimensional imaging evaluation methods. Braz Dent J 2015; 26:69-74. [PMID: 25672388 DOI: 10.1590/0103-6440201300252] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 12/22/2014] [Indexed: 11/22/2022] Open
Abstract
This study quantitatively assessed the periapical bone repair following endodontic surgery, using planimetric evaluation based on two- (conventional and digital intraoral radiographic images - IRs) and three-dimensional (cone beam computed tomography - CBCT) evaluation. Eleven maxillary anterior teeth (of 11 patients) with periapical bone lesions and indication for surgical endodontic treatment were selected. IRs and CBCT images were acquired before the endodontic surgery, and 48 h, 4, and 8-months after the surgery. In each period of evaluation, the area (mm2) of the bone lesion was measured in the images, and the values for the three methods were compared. The area in the CBCT images was measured in the mesio-distal sections comprising the largest diameter of the lesion. Data were submitted to repeated measures 2-way ANOVA and t-tests with Bonferroni correction. There was significant difference between the periods of evaluation (p=0.002) regarding the assessed periapical bone lesion area. There was no statistically significant difference between the methods of evaluation (p=0.023). In the CBCT images the lesion areas were 10% larger than those observed in the conventional IRs (22.84 mm2) and 15% larger than those observed in the digital IRs (21.48 mm2). From the baseline (40.12 mm2) to 4 (20.06 mm2) and 8-months (9.40 mm2), reductions of 50 and 77% in the lesion area, respectively, were observed (p<0.0001). From 4 to 8-months, this value was 53%. Progressive bone repair could be seen from 48 h to 8-months following endodontic surgery based on two- (conventional and digital IRs) and three-dimensional (CBCT) evaluation. CBCT images provided results similar to those assessed by means of IRs.
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Affiliation(s)
- Érica Gouveia Jorge
- Department of Restorative Dentistry, Araraquara Dental School, UNESP - Univ Estadual Paulista, Araraquara, SP, Brazil
| | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, Araraquara Dental School, UNESP - Univ Estadual Paulista, Araraquara, SP, Brazil
| | | | | | - Rubens Spin-Neto
- Department of Dentistry and Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Marcelo Gonçalves
- Department of Diagnosis and Surgery, Araraquara Dental School, UNESP - Univ Estadual Paulista, Araraquara, SP, Brazil
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Venskutonis T, Plotino G, Tocci L, Gambarini G, Maminskas J, Juodzbalys G. Periapical and endodontic status scale based on periapical bone lesions and endodontic treatment quality evaluation using cone-beam computed tomography. J Endod 2014; 41:190-6. [PMID: 25498834 DOI: 10.1016/j.joen.2014.10.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 10/03/2014] [Accepted: 10/18/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The purpose of this study was to present a new periapical and endodontic status scale (PESS) that is based on the complex periapical index (COPI), which was designed for the identification and classification of periapical bone lesions in cases of apical periodontitis, and the endodontically treated tooth index, which was designed for endodontic treatment quality evaluation by means of cone-beam computed tomographic (CBCT) analysis. METHODS Periapical and endodontic status parameters were selected from the already known indexes and scientific literature for radiologic evaluation. Radiographic images (CBCT imaging, digital orthopantomography [DOR], and digital periapical radiography) from 55 patients were analyzed. All parameters were evaluated on CBCT, DOR, and digital periapical radiographic images by 2 external observers. The statistical analysis was performed with software SPSS version 19.0 (SPSS Inc, Chicago, IL). Chi-square tests were used to compare frequencies of qualitative variables. The level of significance was set at P ≤ .05. RESULTS Overall intraobserver and interobserver agreements were very good and good, respectively. CBCT analysis found more lesions and lesions of bigger dimension (P < .001). CBCT imaging was also superior in locating lesions in the apical part on the side compared with DOR and in the diagnosis of cortical bone destruction compared with both methods (P < .001). Through CBCT analysis, more root canals and more canals associated with lesions were found. The most informative and reproducible periapical and endodontic status parameters were selected, and a new PESS was proposed. CONCLUSIONS The classification proposed in the present study seems to be reproducible and objective and adds helpful information with respect to the existing indexes. Future studies need to be conducted to validate PESS.
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Affiliation(s)
- Tadas Venskutonis
- Department of Dental and Oral Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Gianluca Plotino
- Department of Endodontics, Sapienza University of Rome, Rome, Italy
| | - Luigi Tocci
- Department of Endodontics, Sapienza University of Rome, Rome, Italy
| | | | - Julius Maminskas
- Department of Prosthodontics, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gintaras Juodzbalys
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Accuracy of cone-beam computed tomography and periapical radiography in apical periodontitis diagnosis. J Endod 2014; 40:2057-60. [PMID: 25306306 DOI: 10.1016/j.joen.2014.09.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 08/27/2014] [Accepted: 09/01/2014] [Indexed: 01/08/2023]
Abstract
INTRODUCTION This study aimed to investigate the correlation and the agreement between periapical radiography (PR) and cone-beam computed tomography (CBCT) correlating to histologic findings in the diagnosis of apical periodontitis (AP). METHODS One hundred thirty-four premolar root canals from 10 dogs were treated after AP induction. Four months later, the animals were killed, and standard digital PRs were obtained. The area of AP was measured by using ImageJ software. CBCT (i-CAT) images from each arch were obtained, and AP area and volume were measured by using Osiri-X software. The apical inflammatory infiltrate was evaluated under light microscopy. The correlation between imaging methods was evaluated by using the Pearson coefficient. The Bland-Altman method was used to assess the agreement between PR and CBCT data. The Spearman coefficient was used to correlate the imaging data and histologic findings. RESULTS Despite a strong correlation between PR and CBCT areas, the agreement limits were very broad (95% limits of agreement, 0.19-1.08). PR only measured, on average, 63% of CBCT values. Although there was a strong correlation between PR area and CBCT volume, the Bland-Altman method suggests that the larger the CBCT volume, the more underestimated the PR value. When APs had a volume smaller than 6 mm(3), the PR estimation of CBCT data was unpredictable. A positive correlation was found for PR area, CBCT area, CBCT volume, and histology data. CONCLUSIONS The diagnosis of AP based on PR data is clinically limited, and it should not be used for scientific investigations.
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Abstract
Veterinary dentists commonly encounter apical periodontitis in dogs. An overview of the disease is presented, concentrating on pathogenesis and mechanisms of healing. Assessment modalities are reviewed and interpretations of treatment success and failure are discussed. The limitations of readily available diagnostic equipment are illustrated. The benefits of identifying the causative agent and resultant pathosis should not be overlooked. Well-designed clinical studies evaluating various methods of long-term follow-up for apical periodontitis in dogs are needed.
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Tanomaru-FIlho M, Jorge ÉG, Guerreiro-Tanomaru JM, Reis JMS, Spin-Neto R, Gonçalves M. Two- and tridimensional analysis of periapical repair after endodontic surgery. Clin Oral Investig 2014; 19:17-25. [DOI: 10.1007/s00784-014-1225-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 03/06/2014] [Indexed: 10/25/2022]
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The association of chronic apical periodontitis and endodontic therapy with atherosclerosis. Clin Oral Investig 2013; 18:1813-23. [PMID: 24338091 PMCID: PMC4145204 DOI: 10.1007/s00784-013-1156-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 11/25/2013] [Indexed: 01/08/2023]
Abstract
Objectives Chronic apical periodontitis (CAP) appears to be a risk factor for coronary heart disease. The aims of the study were to estimate the significance of AP for the atherosclerotic burden and to examine the potential effect of endodontic treatment. Materials and methods The whole-body computed tomography (CT) examinations of 531 patients with a mean age of 50 ± 15.7 years were evaluated retrospectively. The atherosclerotic burden of the abdominal aorta was quantified using a calcium scoring method. The parameters of periodontitis were measured using the CT scan. Results The patients had a total of 11,191 teeth. The volume of the aortic atherosclerotic burden for patients with at least one CAP lesion was 0.32 ± 0.92 ml, higher than for patients with no CAP (0.17 ± 0.51 ml; p < 0.05). The atherosclerotic burden increased with age and number of CAP lesions without root canal treatment, but not with number of CAP lesions with endodontic treatments (p < 0.05 each). In logistic regression models, age (Wald 90.8), CAP without endodontic treatment (Wald 39.9), male gender (Wald 9.8), and caries per tooth (Wald 9.0) correlated positively and the number of fillings (Wald 11) correlated negatively with the atherosclerotic burden (p < 0.05 each). Apical radiolucencies in teeth with endodontic treatment were irrelevant with respect to atherosclerosis. Conclusions CAP correlated positively with the aortic atherosclerotic burden. In regression models, CAP without endodontic treatment was found to be an important factor, not however apical radiolucencies in teeth with endodontic treatment. Clinical relevance Further research is needed to clarify the possible clinical significance of these associations.
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Liang YH, Jiang L, Gao XJ, Shemesh H, Wesselink PR, Wu MK. Detection and measurement of artificial periapical lesions by cone-beam computed tomography. Int Endod J 2013; 47:332-8. [DOI: 10.1111/iej.12148] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 06/04/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Y.-H. Liang
- Department of Cariology and Endodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - L. Jiang
- Department of Cariology and Endodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - X.-J. Gao
- Department of Cariology and Endodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - H. Shemesh
- Department of Endodontology; Academic Center of Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
| | - P. R. Wesselink
- Department of Endodontology; Academic Center of Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
| | - M.-K. Wu
- Department of Endodontology; Academic Center of Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
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Glodny B, Nasseri P, Crismani A, Schoenherr E, Luger AK, Bertl K, Petersen J. The occurrence of dental caries is associated with atherosclerosis. Clinics (Sao Paulo) 2013; 68:946-53. [PMID: 23917658 PMCID: PMC3714742 DOI: 10.6061/clinics/2013(07)10] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 03/13/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Previous studies have suggested that marginal periodontitis is a risk factor for developing atherosclerosis. The objective of this study was to determine whether caries may also be associated with atherosclerosis. METHODS The computed tomography data sets of 292 consecutive patients, 137 women and 155 men with a mean age of 54.1±17.3 years, were analyzed. Caries were quantified based on the number of decayed surfaces of all the teeth, and periodontitis was quantified on the basis of the horizontal bone loss in the jaw. The presence of chronic apical periodontitis (CAP) was assessed, and the aortic atherosclerotic burden was quantified using a calcium scoring method. RESULTS The patients with <1 caries surfaces/tooth had a lower atherosclerotic burden (0.13±0.61 mL) than patients with ≥1 caries surfaces/tooth. The atherosclerotic burden was greater in patients with a higher number of lesions with pulpal involvement and more teeth with chronic apical periodontitis. In the logistical regression models, age (Wald 49.3), number of caries per tooth (Wald 26.4), periodontitis (Wald 8.6), and male gender (Wald 11) were found to be independent risk factors for atherosclerosis. In the linear regression analyses, age and the number of decayed surfaces per tooth were identified as influencing factors associated with a higher atherosclerotic burden, and the number of restorations per tooth was associated with a lower atherosclerotic burden. CONCLUSION Dental caries, pulpal caries, and chronic apical periodontitis are associated positively, while restorations are associated inversely, with aortic atherosclerotic burden. Prospective studies are required to confirm these observations and answer the question of possible causality.
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Affiliation(s)
- Bernhard Glodny
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria
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22
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Ball RL, Barbizam JV, Cohenca N. Intraoperative Endodontic Applications of Cone-Beam Computed Tomography. J Endod 2013; 39:548-57. [PMID: 23522555 DOI: 10.1016/j.joen.2012.11.038] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Revised: 11/15/2012] [Accepted: 11/15/2012] [Indexed: 11/18/2022]
Affiliation(s)
- Randy L Ball
- Department of Endodontics and Pediatric Dentistry, School of Dentistry, University of Washington, Seattle, Washington 98195-7448, USA
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Patel S, Wilson R, Dawood A, Foschi F, Mannocci F. The detection of periapical pathosis using digital periapical radiography and cone beam computed tomography - part 2: a 1-year post-treatment follow-up. Int Endod J 2013; 45:711-23. [PMID: 22775142 DOI: 10.1111/j.1365-2591.2012.02076.x] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM Part 2 of this clinical study aims to compare the radiographic change in periapical status of individual roots determined using digital periapical radiographs versus cone beam computed tomography (CBCT) 1year after primary root canal treatment and to determine the radiological outcome of treatment for each tooth. METHODOLOGY Periapical radiographs and CBCT scans of 123 teeth in 99 patients assessed 1year after completion of primary root canal treatment by a single operator were compared with their respective pre-treatment (diagnostic) periapical radiographs and CBCT scans. The presence or absence as well as the increase or decrease in size of existing periapical radiolucency was assessed by a consensus panel consisting of two calibrated examiners. The panel viewed the images under standardized conditions. Paired comparison of the outcome diagnosis of individual roots and teeth was performed using generalized McNemar's or Stuart-Maxwell test of symmetry analysis. RESULTS The 'healed' rate (absence of periapical radiolucency) for all roots combined was 92.7% using periapical radiographs and 73.9% for CBCT (P<0.001). This rate increased to 97.2% and 89.4%, respectively, when the 'healing' group (reduced size of periapical radiolucency) was included (P<0.001). A statistically significant difference in outcome diagnosis of single roots was observed between DPA and CBCT in single-rooted teeth and the buccal or mesio-buccal roots of multi-rooted teeth (P<0.05). Analysis by tooth revealed that the 'healed' rate (absence of periapical radiolucency) was 87% using periapical radiographs and 62.5% using CBCT (P<0.001). This increased to 95.1% and 84.7%, respectively, when the 'healing' group (reduced size of periapical radiolucency) was included (P<0.002). Outcome diagnosis of teeth showed a statistically significant difference between systems (P<0.001). Reconstructed CBCT images revealed more failures (17.6%) in teeth with no pre-operative periapical radiolucencies compared with periapical radiographs (1.3%) (P=0.031). In teeth with existing pre-operative periapical radiolucencies, reconstructed CBCT images also showed more failures (13.9%) compared with periapical radiographs (10.4%). CONCLUSION Diagnosis using CBCT revealed a lower healed and healing rate for primary root canal treatment than periapical radiographs, particularly in roots of molars. There was a 14 times increase in failure rate when teeth with no pre-operative periapical radiolucencies were assessed with CBCT compared with periapical radiographs at 1year.
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Affiliation(s)
- S Patel
- Department of Conservative Dentistry, King's College London Dental Institute, London, UK.
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Menzies RA, Lundström TS, Lewis JR, Reiter AM. Diagnostic Imaging in Veterinary Dental Practice. J Am Vet Med Assoc 2012; 240:379-81. [DOI: 10.2460/javma.240.4.379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Patel S, Wilson R, Dawood A, Mannocci F. The detection of periapical pathosis using periapical radiography and cone beam computed tomography - Part 1: pre-operative status. Int Endod J 2011; 45:702-10. [DOI: 10.1111/j.1365-2591.2011.01989.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Lennon S, Patel S, Foschi F, Wilson R, Davies J, Mannocci F. Diagnostic accuracy of limited-volume cone-beam computed tomography in the detection of periapical bone loss: 360° scans versus 180° scans. Int Endod J 2011; 44:1118-27. [DOI: 10.1111/j.1365-2591.2011.01930.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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The influence of cone-beam computed tomography and periapical radiographic evaluation on the assessment of periapical bone destruction in dog's teeth. ACTA ACUST UNITED AC 2011; 112:272-9. [DOI: 10.1016/j.tripleo.2011.01.031] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2010] [Revised: 10/30/2010] [Accepted: 01/19/2011] [Indexed: 11/22/2022]
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Abella F, Mercadé M, Duran-Sindreu F, Roig M. Managing severe curvature of radix entomolaris: three-dimensional analysis with cone beam computed tomography. Int Endod J 2011; 44:876-85. [PMID: 21671948 DOI: 10.1111/j.1365-2591.2011.01898.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To present a case of a mandibular first molar with an additional distolingual root [radix entomolaris (RE)] and to discuss the use of cone beam computed tomography (CBCT) for its identification and management during root canal treatment. SUMMARY A 52-year-old Caucasian woman was referred for root canal treatment of the right mandibular first molar (tooth 46). After clinical and radiographic examination, a symptomatic irreversible pulpitis was diagnosed. Three periapical radiographs with different horizontal angulations revealed the presence of an additional distolingual root. This extra root, termed RE, has an incidence of <5% in the Caucasian population. A CBCT examination was also taken, which revealed a severe root canal curvature, especially in the middle third, of this supernumerary root. CBCT provided more accurate information in terms of RE inclination and root canal curvature before commencing root canal treatment. The conventional access opening was modified into a more trapezoidal cavity, and five root canals were found. All canals were instrumented with new nickel-titanium (NiTi) files to reduce the risk of fractured instruments. After preparation, the root canals were filled using thermoplastified techniques. The 1-year follow-up periapical radiographs and CBCT images revealed a continuous periodontal space with no signs of apical periodontitis. KEY LEARNING POINTS • Cone beam computed tomography imaging is useful in identifying the root canal system and the surrounding structures. • An accurate detection of supernumerary roots, such as RE, can avoid complications during and after root canal treatment. • The analysis of root canal curvature is important because instrument fracture has been linked to angle and radius of curvature. • The use of new instruments can reduce the incidence of instrument fracture.
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Affiliation(s)
- F Abella
- Department of Endodontics, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
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Lim HJ, Lee SS, Kim WK, Ohn BH, Choi SM, Oh SR, Min SK, Lee J. Study on bone healing process following cyst enucleation using fractal analysis. J Korean Assoc Oral Maxillofac Surg 2011. [DOI: 10.5125/jkaoms.2011.37.6.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Hun-Jun Lim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University, Daejeon, Korea
| | - Seung-Soo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University, Daejeon, Korea
| | - Won-Ki Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University, Daejeon, Korea
| | - Byung-Hun Ohn
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University, Daejeon, Korea
| | - Sang-Moon Choi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University, Daejeon, Korea
| | - Se-Ri Oh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University, Daejeon, Korea
| | - Seung-Ki Min
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University, Daejeon, Korea
- Bone Regeneration Research Institute, Wonkwang University, Daejeon, Korea
| | - Jun Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University, Daejeon, Korea
- Bone Regeneration Research Institute, Wonkwang University, Daejeon, Korea
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D'Addazio PSS, Campos CN, Özcan M, Teixeira HGC, Passoni RM, Carvalho ACP. A comparative study between cone-beam computed tomography and periapical radiographs in the diagnosis of simulated endodontic complications. Int Endod J 2010; 44:218-24. [DOI: 10.1111/j.1365-2591.2010.01802.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Use of computerized tomography for diagnosis and follow-up after endodontic surgery: clinical case report with 8 years of follow-up. ACTA ACUST UNITED AC 2010; 109:629-33. [DOI: 10.1016/j.tripleo.2009.08.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Revised: 08/10/2009] [Accepted: 08/16/2009] [Indexed: 11/21/2022]
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Scarfe WC, Levin MD, Gane D, Farman AG. Use of cone beam computed tomography in endodontics. Int J Dent 2010; 2009:634567. [PMID: 20379362 PMCID: PMC2850139 DOI: 10.1155/2009/634567] [Citation(s) in RCA: 163] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Accepted: 12/15/2009] [Indexed: 01/04/2023] Open
Abstract
Cone Beam Computed Tomography (CBCT) is a diagnostic imaging modality that provides high-quality, accurate three-dimensional (3D) representations of the osseous elements of the maxillofacial skeleton. CBCT systems are available that provide small field of view images at low dose with sufficient spatial resolution for applications in endodontic diagnosis, treatment guidance, and posttreatment evaluation. This article provides a literature review and pictorial demonstration of CBCT as an imaging adjunct for endodontics.
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Affiliation(s)
- William C. Scarfe
- Division of Radiology and Imaging Science, Department of Surgical and Hospital Dentistry, The University of Louisville School of Dentistry, 501 South Preston Street, Louisville, KY 40292, USA
| | - Martin D. Levin
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19103, USA
| | - David Gane
- Kodak Dental Imaging/Practiceworks, 1765 The Exchange, Atlanta, GA 30339, USA
| | - Allan G. Farman
- Division of Radiology and Imaging Science, Department of Surgical and Hospital Dentistry, The University of Louisville School of Dentistry, 501 South Preston Street, Louisville, KY 40292, USA
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de Paula-Silva FWG, Júnior MS, Leonardo MR, Consolaro A, da Silva LAB. Cone-beam computerized tomographic, radiographic, and histologic evaluation of periapical repair in dogs' post-endodontic treatment. ACTA ACUST UNITED AC 2009; 108:796-805. [DOI: 10.1016/j.tripleo.2009.06.016] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2009] [Revised: 06/10/2009] [Accepted: 06/17/2009] [Indexed: 10/20/2022]
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Wu MK, Shemesh H, Wesselink PR. Limitations of previously published systematic reviews evaluating the outcome of endodontic treatment. Int Endod J 2009; 42:656-66. [DOI: 10.1111/j.1365-2591.2009.01600.x] [Citation(s) in RCA: 129] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Accuracy of Periapical Radiography and Cone-Beam Computed Tomography Scans in Diagnosing Apical Periodontitis Using Histopathological Findings as a Gold Standard. J Endod 2009; 35:1009-12. [DOI: 10.1016/j.joen.2009.04.006] [Citation(s) in RCA: 178] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Revised: 04/07/2009] [Accepted: 04/10/2009] [Indexed: 11/21/2022]
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Outcome of Root Canal Treatment in Dogs Determined by Periapical Radiography and Cone-Beam Computed Tomography Scans. J Endod 2009; 35:723-6. [DOI: 10.1016/j.joen.2009.01.023] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 01/16/2009] [Accepted: 01/28/2009] [Indexed: 11/23/2022]
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Tanomaru-Filho M, Jorge E, Duarte M, Gonçalves M, Guerreiro-Tanomaru J. Comparative radiographic and histological analyses of periapical lesion development. ACTA ACUST UNITED AC 2009; 107:442-7. [DOI: 10.1016/j.tripleo.2008.12.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2008] [Revised: 11/24/2008] [Accepted: 12/03/2008] [Indexed: 10/21/2022]
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