1
|
Gliga A, Imre M, Grandini S, Marruganti C, Gaeta C, Bodnar D, Dimitriu BA, Foschi F. The Limitations of Periapical X-ray Assessment in Endodontic Diagnosis-A Systematic Review. J Clin Med 2023; 12:4647. [PMID: 37510762 PMCID: PMC10380197 DOI: 10.3390/jcm12144647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/29/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Diagnosis is a key aspect in endodontic treatment, in a decade where invasive interventions are misapprehended as social tendency instead of medical necessity. All diagnostic facets should be considered before intending the operative phase. Intraoral endodontic radiology-based diagnosis has been shown to be limited. Periapical X-ray is the most used endodontic imaging, yet it does not provide high accuracy. Traditionally, dentists have been trained to diagnose a cyst by certain aspects (size, shape and appearance); hence, an assumption that teeth are affected by "periapical cyst" were subjected to unnecessary extraction or apicoectomy. The aim of this systematic review is to critically appraise the publications that relate the histological diagnosis of a periapical lesion (considered the gold standard) to intraoral X-ray investigation. Ovid Medline, PubMed, ScienceDirect, Mendeley and Scopus were searched for English-language studies comparing periapical diagnosis obtained by using two techniques (histopathology and X-ray). Sixteen articles were included for the final analysis (qualitative and quantitative evaluation) out of which only two supported the statement that periapical diagnosis can be coherently assessed through periapical imaging. Although there is not enough evidence to deliver a definitive conclusion, there are many publications that refute the diagnosis of a cyst via periapical X-ray.
Collapse
Affiliation(s)
- Alexandru Gliga
- Department of Operative Dentistry, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Unit of Endodontics, Department of Medical Biotechnologies, Periodontology, Restorative and Paediatric Dentistry, University of Siena, 53100 Siena, Italy
| | - Marina Imre
- Department of Complete Denture, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Simone Grandini
- Unit of Endodontics, Department of Medical Biotechnologies, Periodontology, Restorative and Paediatric Dentistry, University of Siena, 53100 Siena, Italy
| | - Crystal Marruganti
- Unit of Endodontics, Department of Medical Biotechnologies, Periodontology, Restorative and Paediatric Dentistry, University of Siena, 53100 Siena, Italy
| | - Carlo Gaeta
- Unit of Endodontics, Department of Medical Biotechnologies, Periodontology, Restorative and Paediatric Dentistry, University of Siena, 53100 Siena, Italy
| | - Dana Bodnar
- Department of Operative Dentistry, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Bogdan Alexandru Dimitriu
- Department of Endodontology, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Federico Foschi
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London SE19RT, UK
- Peninsula Dental School, University of Plymouth, Plymouth PL6 8BT, UK
| |
Collapse
|
2
|
de Carvalho MS, de Almeida-Junior LA, Ribeiro YJS, Arnez MFM, da Silva RAB, de Carvalho FK, Paula-Silva FWG. Detection of Apical Dental Resorption Caused by Endodontic Infection in Mice Using Fluorescence and Bright-Field Microscopy. SCANNING 2023; 2023:4619503. [PMID: 37101708 PMCID: PMC10125736 DOI: 10.1155/2023/4619503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 11/12/2022] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
The aim of this study was to evaluate the sensitivity, specificity, and predictive values of the fluorescence microscopy method in the detection of apical dental reabsorption after induction of apical periodontitis in animal models. Forty-first molars of mice, aged 6 to 8 weeks, had their root canals exposed to the oral environment or were maintained healthy as controls (n = 20). After 14 and 42 days, mice were euthanized and tissues were collected for histological evaluation by means of bright field and fluorescence microscopy. The accuracy of fluorescence microscopy in identifying apical external dental resorption was investigated using a diagnostic validation test based on the sensitivity (S) and specificity (E) properties. Bright-field microscopy revealed a higher number of specimens with scores of 1 to 3 - absence of apical dental resorption (n = 29; 52%), while fluorescence microscopy revealed a higher number of specimens with scores of 4 to 6 - presence of apical dental resorption (n = 37; 66%). Out of 56 specimens, 26 were TP, 11 were FP, and 19 were TN. No FN result was observed. Fluorescence microscopy presented a sensitivity value of 1, similar to the bright-field method, while specificity was lower (0.633). The accuracy of the fluorescent method to detect apical dental resorption was 0.804. Fluorescence microscopy revealed a higher number of false positive apical dental resorption than bright-field microscopy. The detection of apical dental resorption was not impacted by the sensitivity of the method but by its specificity.
Collapse
Affiliation(s)
- Marcio Santos de Carvalho
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
| | | | - Yuri Jivago Silva Ribeiro
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
| | | | | | | | | |
Collapse
|
3
|
Yoo YJ, Oh JH, Lee W, Woo KM. Regenerative Characteristics of Apical Papilla-derived Cells from Immature Teeth with Pulpal and Periapical Pathosis. J Endod 2016; 42:1626-1632. [PMID: 27639638 DOI: 10.1016/j.joen.2016.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 07/19/2016] [Accepted: 08/07/2016] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The purpose of this study was to ascertain the regenerative characteristics of apical papilla-derived cells (APDCs) from immature teeth with pulpal and periapical pathosis and thus to provide proof-of-principle evidence for further regenerative endodontic research. METHODS Pulpal and periapical pathosis was induced in immature permanent double-rooted premolars of beagles, which were randomly assigned to experimental treatment groups: group AO (n = 14), pulp disruption and access left open; group PS (n = 14), supragingival plaque suspension-soaked cotton pellet was introduced, and access was sealed; and control (n = 7), untreated. The teeth were extracted at 2- and 4-week periods after experimental treatments. APDCs were cultured from the extracted teeth, and their cellular proliferation, differentiation characteristics, and stemness were assessed. The data were statistically analyzed. RESULTS After 4 weeks of intentional pulpal and periapical pathosis induction period, all teeth in group PS showed features of apical periodontitis with necrotic pulp, and their APDCs showed significantly increased proliferation rate and osteogenic/odontogenic differentiation capabilities (P < .05). The stemness was maintained in all APDCs, although the stem cell population was smaller in group PS at 2-week period when the inflammatory responses were most fulminant (P < .05). CONCLUSIONS The APDCs from immature teeth retained the regenerative characteristics with the differences according to their pulpal and periapical pathosis. The results of this study partly provide the evidence for regenerative endodontic research.
Collapse
Affiliation(s)
- Yeon-Jee Yoo
- Department of Conservative Dentistry, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Joung-Hwan Oh
- Department of Molecular Genetics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea; Department of BK21 Plus Program, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - WooCheol Lee
- Department of Conservative Dentistry, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Kyung Mi Woo
- Department of Molecular Genetics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea; Department of BK21 Plus Program, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea; Department of Pharmacology and Dental Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.
| |
Collapse
|
4
|
Kim D, Ku H, Nam T, Yoon TC, Lee CY, Kim E. Influence of Size and Volume of Periapical Lesions on the Outcome of Endodontic Microsurgery: 3-Dimensional Analysis Using Cone-beam Computed Tomography. J Endod 2016; 42:1196-201. [DOI: 10.1016/j.joen.2016.05.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/09/2016] [Accepted: 05/15/2016] [Indexed: 01/12/2023]
|
5
|
An GK, Morse DE, Kunin M, Goldberger RS, Psoter WJ. Association of Radiographically Diagnosed Apical Periodontitis and Cardiovascular Disease: A Hospital Records–based Study. J Endod 2016; 42:916-20. [DOI: 10.1016/j.joen.2016.03.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 03/07/2016] [Accepted: 03/13/2016] [Indexed: 11/25/2022]
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
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.
Collapse
|
8
|
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]
|
9
|
Constantaras ME, Charlier CJ. Diagnostic imaging in veterinary dental practice. External replacement resorption. J Am Vet Med Assoc 2013; 242:1645-7. [PMID: 23725424 DOI: 10.2460/javma.242.12.1645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Marika E Constantaras
- Fox Valley Veterinary Dentistry and Surgery, 3123 N Clybourn, Chicago, IL 60618, USA.
| | | |
Collapse
|
10
|
Hamanaka EF, Poi WR, Salzedas LMP, Alves LC, Panzarini SR, Sonoda CK, Martins CM. A method for the geometric standardization of intraoral radiographs for long-term follow up of replanted teeth: a case report. Dent Traumatol 2012; 29:121-6. [DOI: 10.1111/j.1600-9657.2012.01145.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Elizane Ferreira Hamanaka
- Department of Surgery and Integrated Clinics; School of Dentistry of Araçatuba, São Paulo State University (UNESP); Araçatuba; SP; Brazil
| | - Wilson Roberto Poi
- Department of Surgery and Integrated Clinics; School of Dentistry of Araçatuba, São Paulo State University (UNESP); Araçatuba; SP; Brazil
| | - Leda Maria Pescinini Salzedas
- Department of Surgery and Integrated Clinics; School of Dentistry of Araçatuba, São Paulo State University (UNESP); Araçatuba; SP; Brazil
| | - Lucieni Campoli Alves
- Department of Surgery and Integrated Clinics; School of Dentistry of Araçatuba, São Paulo State University (UNESP); Araçatuba; SP; Brazil
| | - Sônia Regina Panzarini
- Department of Surgery and Integrated Clinics; School of Dentistry of Araçatuba, São Paulo State University (UNESP); Araçatuba; SP; Brazil
| | - Celso Koogi Sonoda
- Department of Surgery and Integrated Clinics; School of Dentistry of Araçatuba, São Paulo State University (UNESP); Araçatuba; SP; Brazil
| | - Christine Men Martins
- Department of Surgery and Integrated Clinics; School of Dentistry of Araçatuba, São Paulo State University (UNESP); Araçatuba; SP; Brazil
| |
Collapse
|
11
|
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]
|
12
|
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]
|
13
|
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]
|