CBCT was the imaging exam that rendered a higher diagnostic accuracy for root fractures.

Objective To compare periapical radiograph (PR) and cone-beam computed tomography (CBCT) in the diagnosis of alveolar and root fractures.Material and Methods Sixty incisor teeth (20 higid and 40 with root fracture) from dogs were inserted in 60 anterior alveolar sockets (40 higid and 20 with alveolar fracture) of 15 macerated canine maxillae. Each fractured socket had a root fractured tooth inserted in it. Afterwards, each maxilla was submitted to PR in two different vertical angulation incidences, and to CBCT imaging with a small field of view (FOV) and high-definition protocol. Images were randomized and posteriorly analyzed by two oral and maxillofacial radiologists two times, with a two-week interval between observations.Results Sensitivity and specificity values were good for root fractures for PR and CBCT. For alveolar fractures, sensitivity ranged from 0.10 to 0.90 for PR and from 0.50 to 0.65 for CBCT. Specificity for alveolar fractures showed lower results than for root fractures for PR and CBCT. Areas under the ROC curve showed good results for both PR and CBCT for root fractures. However, results were fair for both PR and CBCT for alveolar fractures. When submitted to repeated measures ANOVA tests, there was a statistically significant difference between PR and CBCT for root fractures. Root fracture intraobserver agreement ranged from 0.90 to 0.93, and alveolar fracture intraobserver agreement ranged from 0.30 to 0.57. Interobserver agreement results were substantial for root fractures and poor/fair for alveolar fractures (0.11 for PR and 0.30 for CBCT).Conclusion Periapical radiograph with two different vertical angulations may be considered an accurate method to detect root fractures. However, PR showed poorer results than CBCT for the diagnosis of alveolar fractures. When no fractures are diagnosed in PR and the patient describes pain symptoms, the subsequent exam of choice is CBCT.

Orofacial injuries are common in sports activities and may vary in complexity and the tissues involved. Most sports-related trauma occurs when a player hits another player, an object or the ground. This report presents a case of an injury caused by a punchlike blow to the face during a handball college team practice session. The patient suffered a traumatic blow to the left side of the nose and mouth and promptly attended a dentist. After a clinical examination and a CBCT scan, the following injuries were diagnosed: upper lip laceration, upper left lateral incisor subluxation and anterior nasal spine fracture. More severe teeth injuries were likely prevented because the patient was wearing a mouthguard.

Our findings demonstrated that the elected protocol for the diagnosis of root and alveolar fractures was N. This protocol allowed similar diagnosis results than HD protocol; however, with a lower amount of radiation exposure for the patient (5.6 mGy for N vs 7.0 mGy for HD).

PurposeThe purpose of this study was to assess the accuracy, sensitivity, and specificity of the diagnosis of incipient furcation involvement with periapical radiography (PR) and 2 cone-beam computed tomography (CBCT) imaging protocols, and to test metal artifact interference.Materials and MethodsMandibular second molars in 10 macerated pig mandibles were divided into those that showed no furcation involvement and those with lesions in the furcation area. Exams using PR and 2 different CBCT imaging protocols were performed with and without a metallic post. Each image was analyzed twice by 2 observers who rated the absence or presence of furcation involvement according to a 5-point scale. Receiver operating characteristic (ROC) curves were used to evaluate the accuracy, sensitivity, and specificity of the observations.ResultsThe accuracy of the CBCT imaging protocols ranged from 67.5% to 82.5% in the images obtained with a metallic post and from 72.5% to 80% in those without a metallic post. The accuracy of PR ranged from 37.5% to 55% in the images with a metallic post and from 42.5% to 62.5% in those without a metallic post. The area under the ROC curve values for the CBCT imaging protocols ranged from 0.813 to 0.802, and for PR ranged from 0.503 to 0.448.ConclusionBoth CBCT imaging protocols showed higher accuracy, sensitivity, and specificity than PR in the detection of incipient furcation involvement. Based on these results, CBCT may be considered a reliable tool for detecting incipient furcation involvement following a clinical periodontal exam, even in the presence of a metallic post.

This retrospective study showed no difference in postextraction outcomes between renal transplant recipients who received and who did not receive AP before dental extractions.

Purpose This systematic review and meta-analysis assessed the diagnostic accuracy of imaging examinations for the detection of peri-implant bone defects and compared the diagnostic accuracy between titanium (Ti) and zirconium dioxide (ZrO 2 ) implants. Materials and Methods Six online databases were searched, and studies were selected based on eligibility criteria. The studies included in the systematic review underwent bias and applicability assessment using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool and a random-effect meta-analysis. Summary receiver operating characteristic (sROC) curves were constructed to compare the effect of methodological differences in relation to the variables of each group. Results The search strategy yielded 719 articles. Titles and abstracts were read and 61 studies were selected for full-text reading. Among them, 24 studies were included in this systematic review. Most included studies had a low risk of bias (QUADAS-2). Cone-beam computed tomography (CBCT) presented sufficient data for quantitative analysis in ZrO 2 and Ti implants. The meta-analysis revealed high levels of inconsistency in the latter group. Regarding sROC curves, the area under the curve (AUC) was larger for the overall Ti group (AUC=0.79) than for the overall ZrO 2 group (AUC=0.69), but without a statistically significant difference between them. In Ti implants, the AUCs for dehiscence defects (0.73) and fenestration defects (0.87) showed a statistically significant difference. Conclusion The diagnostic accuracy of CBCT imaging in the assessment of peri-implant bone defects was similar between Ti and ZrO 2 implants, and fenestration was more accurately diagnosed than dehiscence in Ti implants.

O objetivo deste estudo foi relatar uma metodologia de ensino de tomografia computadorizada de feixe cônico (TCFC) aplicada a estudantes de graduação, avaliando o conhecimento de estruturas anatômicas do complexo dentomaxilofacial. Os estudantes foram orientados quanto às estruturas anatômicas e às aplicações clínicas da TCFC em aulas teóricas e práticas, compreendendo 45 horas de aula. Foram submetidos a duas avaliações, a primeira na metade do semestre, e a segunda no término do semestre. Os escores das avaliações (três variáveis: 1) nome, 2) lado - esquerdo/direito e 3) reconstruções multiplanares (RMP) - imagens ortogonais de identificação) foram comparados para verificar se houve melhora na aprendizagem. Testes de medianas e Wilcoxon compararam os exames intermediário e final. Os valores medianos para a variável 1 foram 6,0 (intermediário) e 8,0 (final). Em relação à variável 2, a mediana variou de 9,0 (intermediário) a 10,0 (final). Quando os resultados da variável 3 foram analisados, ambas as medianas foram 10,0. Houve diferença significativa (teste de Wilcoxon, p<0,05) quando foram comparados os exames intermediário e final, nas três categorias. Correlações lineares foram estabelecidas entre as três categorias e foram estatisticamente significantes para duas associações (“nome da estrutura anatômica” com “lado da estrutura anatômica” e “nome da estrutura anatômica” com “imagens da MPR”). Os estudantes de graduação apresentaram uma melhora em termos do reconhecimento correto das estruturas anatômicas, nome e lado, bem como imagens de MPR quando comparadas as duas avaliações.