The present study used microcomputed tomography (micro-CT) images to assess the prevalence, number, and location of apical ramifications (ARs) in the root canals of different dental groups in a Brazilian population. Three hundred and sixty-seven extracted human teeth, totaling 475 roots, were scanned by micro-CT at 19.6 µm spatial resolution. The obtained images were evaluated by two observers in consensus, and a descriptive analysis was performed to verify the prevalence, number, and location of ARs in each dental group. Chi-square test was used to compare the prevalence of ARs in different types of roots, and one-way analysis of variance compared the number of ARs in the apical 1 mm, 2 mm, and 3 mm of the root. Significance level was established at 5% (α=0.05). ARs were present in 253 (53.3%) of the 475 roots evaluated. A total of 607 ARs were detected, with the vast majority (530) located at one and two millimeters from the main foramen. The highest prevalence of ARs was observed in maxillary canines (65%); maxillary premolars - single-rooted (83.3%), buccal root (80%), and palatine root (73.3%); mandibular premolars (64.2%); mesiobuccal root of maxillary molars (76.6%); and mesial root of mandibular molars (66.6%). For the Brazilian population, most of the ARs are located in the apical 1 and 2 mm of the root, with greater prevalence in the posterior teeth and maxillary canines. These findings suggest the need for additional attention while planning endodontic treatments, including strategies to effectively clean and fill the apical region.
Agradeço em primeiro lugar a Deus, pelo dom da vida, por iluminar o meu caminho nesta jornada.Ao curso de Mestrado em Administração da Unicamp e às pessoas com quem convivi nesse espaço ao longo desses anos. A experiência de um conhecimento compartilhado com amigos foi o melhor aprendizado da minha formação acadêmica.Agradeço também a todos os professores que me acompanharam durante a pósgraduação, em especial ao Prof. Dr. Antônio Carlos Pacagnella Júnior, que com muita paciência e flexibilidade me auxiliou na elaboração deste trabalho.Agradeço esta, assim como todas as minhas conquistas, à minha amada família; minha mãe Aparecida, meu pai Edson, meu irmão Matheus e minha cachorra Una; por seu carinho e segurança, sempre muito solícitos, interessados e compreensivos às minhas variações de humor durante esse período.Agradeço ao meu namorado, Matheus, que suportou os meus incansáveis comentários sobre esta pesquisa. Com ele, as pausas entre um parágrafo e outro de produção tornaram-se momentos de descontração E, por fim, a todos aqueles que de alguma forma estiveram e estão próximos de mim, fazendo esta vida valer cada vez mais a pena, muito obrigada! EPÍGRAFE "Caminhante, não há caminho, se faz caminho ao andar" Antonio Machado RESUMOA presente pesquisa objetiva avaliar o nível de maturidade em gestão de projetos em que os hospitais universitários do Estado de São Paulo se encontram, além de identificar na literatura modelos de avaliação de maturidade aplicáveis a hospitais universitários e caracterizar e analisar a gestão de projetos nesses locais. Para isso, foi utilizada abordagem qualitativa e realizado um estudo de casos múltiplos envolvendo o
The present study aimed to compare the filled volume by gutta-percha and sealer in the apical region of the main canal and ramifications, after instrumentation at two different working lengths using nano-computed tomography (nano-CT). Twenty-two premolars with apical ramifications were selected after micro-computed tomography evaluation and were randomly divided into groups for further endodontic instrumentation at two different working lengths: G1 - Root canals shaped 1 mm short of the apical foramen (n=11), and G2 - Root canals shaped at the apical foramen (n=11). After completing root treatment, nano-CT images were acquired, and the filled volume by gutta-percha and sealer in the main canal apical 0-4 mm and 0-1 mm ranges, and apical ramifications were objectively measured by an operator specialized in both radiology and endodontics, blinded for both groups. The Mann-Whitney test was applied to compare both groups regarding the filling of the main canal apical ranges and apical ramifications with a significance level of 5% (α ≤ 0.05). It was observed that root canals shaped at the apical foramen had a larger volume of the main canal filled than root canals shaped 1 mm short of the apical foramen, at both apical ranges (0-4 and 0-1 mm) (p<0.05). Regarding the filling of the apical ramifications, there was no significant difference between groups (p>0.05). In conclusion, the root canals shaped at apical foramen exhibited increased filling volume of the main canal in the apical region. However, neither of both working lengths influenced filling of the apical ramifications.
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