The use of dental radiographies is nowadays indispensible for the clinician, and the evolution of x-rays provide quality images of the anatomic structures. The indications for a radiographic exam must be based on a clinical examination of the patient. Although the most used radiographies in dentistry are the retroalveolar and the panoramic one, it is considered that the indication for a CBCT scanning should be professional justified and evaluated as a balance between the benefits and the risk of exposure at radiation. The CBCT scans provide good quality images of the anatomic structures, with an accurate delimitation of the pathologic lesions, fact that allows the practitioner to proper evaluate the surrounding structures. CBCT technique uses an x-ray beam shaped like a cone that records 3D images in a single gantry rotation (360 degrees) within 6-20 seconds, with a radiation dose that depends on several factors. The comparison of the radiation dose of the CBCT (11-674 mSv) and the panoramic radiography (2.7�24.3 mSv) demonstrates that the CBCT requires a higher dose of radiation, but the high image quality is competing with the ones obtained with MSCT (280�1,410 mSv). The panoramic radiography uses an x-ray beam that is angled at aproximately 8 degrees, providing the practitioner a 2D radiographic image of the anatomic structures. The disadvantages of the panoramic radiography are the overlapping of the anatomic structures, the distortion and the blurry image. The study is based on the measurements of cystic lesions of the mandibular and maxillary bone that were present on radiographies and CBCT scans of 25 patients. The result of the measurements was that significative differences were found between the panoramic image of the cyst and the reconstructive image that the CBCT.
In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.
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