Objective: A high prevalence of post-treatment-apical periodontitis has been evidenced in 2D studies, associated to variables commonly evaluated as quality of endodontic treatment; currently, using CBCT the presence of missed canals is also one of the relevant variables associated to the failure of endodontic treatment. The objective was to evaluate the quality of endodontic treatment and the frequency of missed canals associated with teeth presenting apical periodontitis (AP) through CBCT in a Colombian sub-population. Methods: A cross-sectional study was conducted. CBCT scans with endodontically treated tooth (n = 318), were selected from 1100 exams from Colombian individuals between January 2017 and January 2020. The scans were taken using J Morita X550 CBCT Scanners (J Morita Corporation, Osaka, Japan), with voxel size between 0.125 and 0.20 mm. All endodontically treated teeth were analyzed for quality of treatment, the presence of missed canals and AP. All samples were independently analyzed by two endodontics specialists and an oral and maxillofacial radiology specialist. Chi-square or Fisher`s test and odds ratio calculation were applied to identify the association and risk relationship between the presence of AP and the study variables; P values <0.05 were considered statistically significant.Results: Missed canals were found in 18.61% (86/462) and 95.3% were associated with AP. The frequency of AP was 62.34% (288/462) for all the evaluated teeth. AP was found in 27.43 % (79/462) of the teeth with adequate endodontic treatment in contrast with 72.57% (209/462) of the teeth with inadequate ones (P < 0.01). The frequency of missed canals was highest in upper molars with 55.23% (58/105), with 96.55% presenting with AP. The second mesiobuccal canal was the most frequently missed canal, 88.52% (54/61), with AP in 90.74% (49/54) of the cases. Conclusion: There was a high risk of teeth with missed canal presenting AP. More than half of the teeth with missed canals were maxillary molars, the MB2 the most frequent missed canal, with apical periodontitis.
The infiltration of foreign materials not approved for medical purposes or of modeling substances used in soft tissue to modify the anatomical appearance for aesthetic purposes represents a serious health problem. These procedures lead to the development of delayed complications, including infections. The objective of this study was to characterize infections in patients with adverse reactions to the use of modeling substances in Cali, Colombia. A cross-sectional and descriptive study was used to determine the frequency of bacterial and fungal infections associated with complications from and adverse reactions to the use of modeling substances in 113 patients. We identified microorganisms in 22 patients and a frequency of 68.1% monomicrobial infections and 31.8% polymicrobial infections. The microorganisms identified in our study included Bacillus cereus, Mycobacterium fortuitum, and Pseudomonas stutzeri, among other microorganisms. The presence of adverse effects derived from the use of illegal modeling substances has been demonstrated; among these effects, infections occur with high frequency and place the health of the patient at risk and increase problems in health care.
Introducción: La existencia de variaciones anatómicas ocasiona fracasos en tratamientos endodónticos, por lo que es importante diagnosticarlas. El objetivo fue determinar la reproducibilidad y la validez de criterio de las radiografías con placa de fósforo y la radiovisografía con sensor para identificar las variaciones anatómicas detectadas por tomografía computarizada de haz cónico (CBCT) en premolares inferiores. Métodos: En 140 premolares se obtuvieron imágenes por CBCT, radiografía y radiovisografía. Se realizó lectura independiente por dos endodocistas, evaluándose la clasificación de Vertucci y las ramificaciones. Se determinó la reproducibilidad intraobservador e interobservador. Se calcularon sensibilidad, especificidad y áreas bajo la curva operador-receptor (AUC) utilizando como estándar de oro la CBCT. Resultados: La reproducibilidad intraobservador e interobservador fue mayor para radiografía. Para la Clase I de Vertucci, la radiografía presentó mayor sensibilidad (94,7%), especificidad (64,9%) y AUC (0,795) que la radiovisiografía (89,3%, 62,2% y 0,757, respectivamente), al igual que para la Clase V (Radiografía 69,2%, 93% y 0,811; Radiovisiografía 50%, 84,2% y 0,671, respectivamente). Ninguna de las técnicas aportó al diagnóstico de la Clase III (AUC <0,5). Las ramificaciones fueron infrecuentes (2,9%) y su detección fue baja (Sensibilidad 25% para radiografía y 0% para radiovisiografía). Discusión: Este es el primer estudio que evalúa la reproducibilidad y validez de estas dos técnicas radiográficas comparadas con la CBCT para la detección de variaciones anatómicas en dientes. Conclusiones: La radiografía con placa de fósforo presentó mayor reproducibilidad y validez para el diagnóstico de las Clase I y V de Vertucci, que fueron las variaciones más frecuentes. Como citar este artículo: Rincón-Rodriguez Martha Liliana, Martínez-Vega Ruth Aralí, Duarte Martha Lucely, Moreno Monsalve Jaime Omar. Reproducibilidad y validez de criterio de dos técnicas radiográficas para variaciones de premolares mandibulares comparadas con CBCT. Revista Cuidarte. 2022;13(1):e2300. http://dx.doi.org/10.15649/cuidarte.2300
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