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Elera Morales CC, Castro Ruiz CT. [Validity of digital periapical radiography and cone beam computed tomography in the detection of peri-implant bone defects: in vitro study]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e141. [PMID: 38288316 PMCID: PMC10810066 DOI: 10.21142/2523-2754-1101-2023-141] [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: 01/11/2023] [Accepted: 03/10/2023] [Indexed: 01/31/2024] Open
Abstract
Abstract To compare the diagnostic accuracy of digital radiography (DR) and cone beam computed tomography (CBCT) in the detection of peri-implant bone defects. Materials and methods Implants were placed in 5 fresh bovine ribs (3 without peri-implant bone defects, 12 with 1.4mm peri-implant bone defects) and images were taken using (i) portable x-ray system (DEXCOWIN 3000), (ii) intraoral x-ray sensor (SENSOR H1/SENSOR H2), (iii) volume-limited HSCT with 3D Accuitomo 80 (CASTELLINI). Images of each were randomly presented to 10 examiners. Confidence in the diagnosis of the presence or absence of a peri-implant radiolucency was recorded on a scale of bone defect definitely absent, doubts about the defect if absent or present, defect definitely present. Analyzes was performed using a kappa test. Results There has been a coincidence between the direct digital radiography and the cone beam computed tomography in piece A of 83.3%, in piece B of 100% and in piece C of 88%, giving an average total coincidence 90.43%.Conclusion: Direct digital radiography provided the same results as cone beam computed tomography in the detection of peri-implant bone defects at an early stage. Digital radiographs are a reliable and valid method and perform significantly better than cone beam computed tomography for detecting peri-implant bone defects at an early stage.
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Affiliation(s)
- César C Elera Morales
- Carrera de Estomatología, Universidad Científica del Sur. Lima, Perú. , Universidad Científica del Sur Carrera de Estomatología Universidad Científica del Sur Lima Peru
| | - Carmen T Castro Ruiz
- Carrera de Estomatología, Universidad Científica del Sur. Lima, Perú. , Universidad Científica del Sur Carrera de Estomatología Universidad Científica del Sur Lima Peru
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The Changes in Size of Periapical Lesions after Root Canal Treatments Assessed by Digital Periapical Radiography and Cone-Beam Computed Tomography: A 2-Years Prospective Clinical Study. Medicina (B Aires) 2022; 58:medicina58101437. [PMID: 36295597 PMCID: PMC9611959 DOI: 10.3390/medicina58101437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/08/2022] [Accepted: 10/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background and Objectives: There is limited information regarding comparison of long-term dynamics of periapical bone destruction estimated by digital periapical radiography (DPR) and by cone-beam computed tomography (CBCT). This study aimed to compare the radiographically assessed periapical changes of endodontically treated teeth over 2 years of follow-up and to analyse disagreements in periapical lesion size estimates around the same roots using DPR and CBCT. Materials and Methods: A total of 176 endodontically treated teeth, of 128 patients with apical periodontitis, were assessed by DPR and CBCT, at baseline and after 2 years. All periapical radiolucencies were categorised by severity (S0, S1, S2, S3) concerning their size. Descriptive statistics were used to report distribution of the radiolucencies at baseline and at follow-up, and their size transitions over 2 years. Site-specific comparison of the radiolucencies identified by two methods was performed using Z test and Pearson’s chi-square test. Results: majority of the detected radiolucencies were scored as S0: 65% and 68% at baseline; 89% and 83% at follow-up, by DPR and CBCT, respectively. Site-specific score comparison showed that disagreements comprised 18% and 20% of the total number of radiolucencies detected by DPR and CBCT, respectively. There were more disagreements between DPR and CBCT within categories S1 and S2 + S3 compared to S0: at baseline, they comprised 17–33% and after two years 62–95% of all detected radiolucencies within the category. 65% of non-matching score transitions over two years occurred between S0 and S1. The CBCT-based evaluation resulted in negative treatment outcomes for 10 more root canals than the DPR-based result. Conclusions: Most remarkable disagreement between DPR and CBCT recordings was observed within the radiolucency categories S2 and S3. However, the diagnostic accuracy of both radiographic methods was questionable as it resulted in a high proportion of non-matching S0-S1 lesion transitions over 2 years.
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Alves Dos Santos GN, Faria-E-Silva AL, Ribeiro VL, Pelozo LL, Candemil AP, Oliveira ML, Lopes-Olhê FC, Mazzi-Chaves JF, Sousa-Neto MD. Is the quality of root canal filling obtained by cone-beam computed tomography associated with periapical lesions? A systematic review and meta-analysis. Clin Oral Investig 2022; 26:5105-5116. [PMID: 35618962 DOI: 10.1007/s00784-022-04558-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 05/17/2022] [Indexed: 11/03/2022]
Abstract
AIM To evaluate the influence of root canal filling quality on periapical lesion status using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The bibliographic search was conducted in electronic databases of PubMed, Embase, Scopus, and Web of Science without restrictions related to the year of publication and language. Inclusion criteria were prospective or retrospective cohort studies that followed periapical pathosis for, at least, 1 year. Three reviewers independently evaluated the eligibility for inclusion, extracted data, and assessed the risk of bias. The quality of the studies was based on the Newcastle-Ottawa Scale. This meta-analysis was performed to evaluate the quality of treatment by the homogeneity and apical extension of the filling. RESULTS Of the 1179 studies initially recovered, six cohort studies were included, out of which four were considered with a low risk of bias. The results showed that the absence of gaps in the filling reduced the chance of unhealed periapical lesions by 2.39 times (RR = 2.39; 95% CI: 1.62-3.53; p < 0.00001; I2 = 55%). An apical filling extension of 0-2 mm below the apex also contributed significantly to the absence of unhealed periapical lesions (RR = 1.49; 95% CI: 1.15-1.94; p = 0.003; I2 = 2%). CONCLUSION The homogeneity and apical extension of the filling influenced the presence of unhealed periapical lesions in endodontically treated teeth evaluated using CBCT. CLINICAL RELEVANCE Apical extension of the filling ranging between 0 and 2 mm short of the apical foramen and the homogeneity of the filling without gaps are directly related to the success rate of root canal treatment.
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Affiliation(s)
- Guilherme Nilson Alves Dos Santos
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | | | - Vitor Luís Ribeiro
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | - Laís Lima Pelozo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | - Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Fabiane Carneiro Lopes-Olhê
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil.
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Gudac J, Hellén-Halme K, Machiulskiene V. Prognostic validity of the Periapical and Endodontic Status Scale for the radiographically assessed 2-year treatment outcomes in teeth with apical periodontitis: a prospective clinical study. BMC Oral Health 2021; 21:354. [PMID: 34281553 PMCID: PMC8290628 DOI: 10.1186/s12903-021-01723-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/07/2021] [Indexed: 11/28/2022] Open
Abstract
Background Endodontic treatment planning and treatment success evaluation are largely based on radiographic assessment of anatomical and treatment-related parameters of teeth with apical periodontitis (AP). This prospective clinical study aimed to assess radiographically the 2-year endodontic treatment outcomes for teeth with AP, and to evaluate prognostic validity of Periapical and Endodontic Status Scale (PESS). Methods A total of 128 patients, representing 176 teeth with AP were examined by cone-beam computed tomography at baseline and at 24 months after endodontic treatment. Treatment outcome was evaluated using estimates of periapical radiolucency and the relationship between anatomical structures and location. The strength of the associations between these and treatment-related parameters was tested by logistic regression analysis. PESS sensitivity and specificity were calculated for every treatment risk group (low, moderate, high) of teeth. Results One hundred and fifty-seven teeth, representing 350 root canals had a positive treatment outcome, while 19 teeth, representing 53 root canals had a negative treatment outcome at 24 months. The probability of negative outcome was 25 times higher in the moderate/high-risk group than in the mild-risk group of teeth (OR = 25.1; 95%CI [12.2–51.5]). Pre-treatment complications and retreatment cases with radiolucency were associated with negative outcomes (OR = 35.9; 95%CI [12.6–102.4]; OR = 26.437; 95%CI [10.9–64.1], respectively). PESS sensitivity and specificity was over 80% in all risk groups except for high risk group, due to very low number of cases. Conclusions Endodontic treatment outcome depends on the severity of periapical changes. The presence of complications and retreatment cases with periapical lesions are associated with negative treatment outcome. The PESS is a valid instrument to predict outcome of teeth with low-moderate treatment risk of AP.
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Affiliation(s)
- Jelena Gudac
- Clinic of Dental and Oral Pathology, Lithuanian University of Health Sciences, Eiveniu str. 2, 50161, Kaunas, Lithuania.
| | - Kristina Hellén-Halme
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Carl Gustafs väg 34, 21421, Malmö, Sweden
| | - Vita Machiulskiene
- Clinic of Dental and Oral Pathology, Lithuanian University of Health Sciences, Eiveniu str. 2, 50161, Kaunas, Lithuania
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