Film and digital periapical radiographs for the measurement of apical root shortening

Assessment of Digital Intraoral Periapical Radiograph for the Detection of Apical Root Resorption in Inflammatory Periapical Pathologies: A Radiovisiography Study

Introduction Resorption often takes the form of external inflammatory root resorption. Apical periodontitis or an apical cyst is the most typical cause of external inflammatory root resorption. Failure of endodontic treatment can occur if severe apical root resorption occurs.This is due to the difficulty of reaching these sites.Apical root resorption is usually discovered during routine radiographs and is usually in its later stages. If the lesion is advanced, extraction is the only viable solution. An accurate diagnosis of incipient root resorption is essential. This research is designed to analyze the effectiveness of digital intraoral periapical radiographs in assessing apical root resorption (ARR) related to periapical pathologies. Material and methods This cross-sectional radiographic observational research was conducted in a dental college and hospital in central India. Radiovisiography (RVG) images of 190 patients' teeth with inflammatory periapical pathologies were evaluated to determine the presence or absence of resorption in the apical area of the root. After the radiographic assessment of the apical root resorption, the extraction of the affected teeth was done under all aseptic conditions. The periapical tissue was sent for histological analysis and the extracted tooth sample was examined for the presence or absence of apical root resorption. Results In comparison to apical periodontitis, the proportion of severe root resorption patients was significantly higher in abscess and periapical granuloma. Using Pearson's Chi-square test, the difference in patient proportions according to the kind of resorption in the three radiological diagnosis groups was statistically significant with a p-value of 0.0058. Conclusion It was concluded that on radiographic examination, digital intraoral periapical radiographs were found to be accurate in determining periapical apical pathologies and apical root resorption.

A randomized clinical trial of the effectiveness of 0.018-inch and 0.022-inch slot orthodontic bracket systems: part 3-biological side-effects of treatment

OBJECTIVE

To compare orthodontically induced inflammatory root resorption (OIIRR) and patient perception of pain during orthodontic treatment between 0.018-inch and 0.022-inch slot bracket systems.

SUBJECTS AND METHODS

Eligible participants aged 12 years or above were allocated to treatment with the 0.018-inch or 0.022-inch slot MBT appliance (3M Unitek, Monrovia, California, USA) using block randomization in groups of 10. OIIRR was assessed radiographically using standardized periapical radiographs before and after 9 months from the start of treatment. Patient perception of pain was assessed using a validated patient questionnaire at 6 months from the start of treatment. Parametric tests (t-test) and non-parametric tests (chi-square with Fisher's exact tests and Kruskal-Wallis test) assessed differences between the groups (P < 0.05). The correlation between severity of OIIRR and abnormal root morphology, history of dental trauma, and pain during treatment was assessed.

RESULTS

Of the 187 participants randomized (1:1 ratio), 34 withdrew or were excluded (protocol deviations or poor cooperation). There were 77 patients in the 0.018-inch slot group and 76 patients in the 0.022-inch slot group (overall mean age: 19.1 years). Baseline characteristics were similar between groups (P > 0.05). There was no significant difference in the severity of the OIIRR nor patient perception of pain between the two study groups (P = 0.115 and P = 0.08 respectively). The correlation between the severity of OIIRR and abnormal root morphology or history of dental trauma was not statistically significant (P = 0.086 and P = 0.313). Moreover, there was no significant correlation between the severity of OIIRR and pain during treatment (R = 0.045, P = 0.617).

LIMITATIONS

It was impossible to blind clinicians or patients to allocation, and oral hygiene and periodontal outcomes were not assessed.

CONCLUSIONS

The effect of bracket slot size on the severity of OIIRR and patient perception of pain are not significant.

TRIAL REGISTRATION

The trial was registered with ClinicalTrials.gov on 5 March 2014, registration number: NCT02080338.