Metallic objects, such as intracanal posts and restorations, may produce severe interference, thus diminishing the quality of CBCT imaging. Objective: The purpose of this study was to analyze the influence of conventional and bioceramic gutta-percha points on the production of artifacts in CBCT images. Methods: Extracted single- -rooted premolar teeth (n=20) were instrumented and scanned with a CBCT device to create three groups: the Control group, the Gutta-Percha group and the Bioceramic Gutta-Percha group. Two types of analysis were executed: an objective one, using the Region of Interest (ROI) to measure the pixel density of each tooth, and a subjective one, to compare the groups’ images. For the statistical analysis, Student’s t-test, descriptive statistics and the frequency distribution analysis were used for both objective and subjective analyses. Results: The agreement between the observers ranged from moderate to excellent. Similar grayscale values were obtained in both the GP and BCGP groups. These results were endorsed by the p-values obtained with Student’s t test. For the subjective analysis, the observers indicated the BCGP group as the one that developed the highest number of artifacts. Conclusions: Both materials produced artifacts in the CBCT images. However, in the subjective analysis, the BCGP group showed higher levels of artifact production than the GP group, which could result in the misdiagnosis of root fracture and in a worse prognosis for that tooth.
Osteonecrosis occurs by cellular death of the bone tissue due to an irreversible external factor. This disorder may be clinically unidentified in the early stages and result in degradation of the bone architectural structure, leading to pain, bone destruction, and loss of function. Thus, imaging exams become relevant to the recognition and definition of the bone necroses. The aim of this study was to review the literature on imaging exams frequently used for the diagnosis and evaluation of patients undergoing drug therapies associated with osteonecrosis of the jaw, such as panoramic radiography, computed tomography, magnetic resonance imaging and bone scintigraphy.
Comparison between panoramic radiography and CBCT imaging on the diagnosis of second molar external root resorption associated with an impacted mandibular third molar: two case reports Submit Manuscript | http://medcraveonline.com IntroductionThird molar impaction is a usual condition found at the dental practice. Occasionally, it is necessary to remove the tooth in order to avoid other problems such as pericoronitis, swelling, odontogenic cysts or tumors, bone loss and external root resorption (ERR) of the adjacent second molar.1 However, the decision of extracting or maintaining a third molar is controversial.2 If an impacted third molar is not extracted after a certain stage of its formation, it may contribute to second molar ERR.1 According to Tsesis et al. 3 ERR is a pathological process that occurs at the permanent tooth outer surface and it may be induced by pulpal infection or periodontal inflammation related causes, or pressure associated with orthodontic movements, impacted tooth or pathoses. Periapical and panoramic radiographies (PR) are the standard imaging modalities for determining third molar characteristics. These imaging exams are readily available and dental professionals are acquainted with images interpretation. However, they are two-dimensional images, thus impairing a more detailed analysis of the region. Additionally, panoramic radiographies (PR) present a certain degree of distortion. 4 The limitation generated by the absence of a third dimension resulted in methods that do not inform precisely the actual location of the third molar, its anatomy or its relationship with adjacent structures. 4 Cone beam computed tomography (CBCT) imaging allows a tridimensional evaluation of teeth and their adjacent anatomical structures, 4 resulting in a detailed visualization of the third molar as well as its neighboring structures, and subsequently, a meticulous diagnosis of ERR. CBCT is widely recommended for third molar surgical removal planning. 4 Among the advantages of this imaging modality, some authors mention spatial resolution, multiplanar reconstruction simultaneous analyses and structures superimposition avoidance.5 Hence, the aim of this study was to report two cases of mandibular impacted third molar associated with second molar external root resorption, comparing panoramic radiography and CBCT imaging. Case reportsCase 1: A 24 year-old Caucasian male patient was submitted to a follow-up PR nine months after the extraction of tooth 38. The radiologist observed a severely inclined, mesialized and impacted 48. Its roots were contiguous to the mandibular canal roof and it was possible to recognize a severe dilaceration at the mesial root apex. Tooth 47 was endodontically treated and an overlap was noted between 48 crown and dental follicle, and 47 distal root ( Figure 1A). Tooth 48 was recommended for extraction and a CBCT was requested for planning the surgical intervention. The patient was submitted to a CBCT exam with the following characteristics: field of view (FOV) 5.0 cm by 5.5 cm, v...
Objetivo: O presente estudo avaliou a influência de materiais obturadores endodônticos na produção de artefato de imagens de tomografia computadorizada de feixe cônico (TCFC), por meio da análise de densidade de imagem em incisivos centrais e dentes pré-molares unirradiculares. Métodos: Os dentes foram submetidos a instrumentação endodôntica e divididos em cinco grupos: um grupo controle (sem preenchimento endodôntico) e quatro grupos teste, cada um preenchido por um material obturador endodôntico diferente (PulpCanal Sealer, AHPlus, Sealer26 e BCSealer). Após a aquisição da TCFC, as imagens foram avaliadas para determinar variações de tons de cinza nos três terços da raiz (análise objetiva). A segunda análise (subjetiva) comparou o grupo controle com dois dos grupos teste, em um processo randomizado. Resultados: Na análise objetiva, o Sealer26 e o BCSealer mostraram diferença estatística para valores mínimos, em comparação com outros materiais obturadores endodônticos, para dentes anteriores e posteriores. Para valores máximos, apenas o grupo controle diferiu estatisticamente dos grupos teste. Ao comparar os valores dos pré-molares e dos incisivos centrais em tons cinza pelo teste de Kruskal-Wallis, foi encontrada diferença estatisticamente significativa para os valores mínimos. Na análise subjetiva, para dentes anteriores e posteriores, o PulpCanal Sealer foi o material mais frequentemente apontado pelos observadores como aquele que produziu mais interferência de artefato. Conclusões: Os materiais obturadores endodônticos nos dentes posteriores apresentaram comportamento semelhante; somente o PulpCanal Sealer no terço apical apresentou diferenças estatísticas em relação aos demais grupos. Para os dentes anteriores, o BCSealer apresentou valores mínimos maiores em relação aos outros materiais obturadores endodônticos, o que poderia representar maior interferência do artefato.
The objective of this study was to evaluate a hybrid learning methodology for cone beam computed tomography (CBCT) imaging applied to undergraduate students, through surveys and analysis of mid and end-term quizzes at anatomical structures by means of PowerPoint slides. The discipline ODE 0308 -Diagnostic imaging methods was taught in the last semester of four classes, which were divided into two groups: control group (Night time Class of 2018 and Class 2019) and test group (Daytime Class of 2018 and Class 2019). The students in the test group received the material for the hands-on class one week before the class, while the students in the control group received the material on the day of the hands-onl class. Students answered surveys by using a 5-point Likert scale; the survey was divided into the following sections: "learning environment", "instructors", "software and learning material", "assessment", and "what I learned about cone beam computed tomography". A written question addressing suggestions for improving the discipline was also part of the questionnaire. Statistical tests were performed to compare the quiz scores and questionnaire responses between test group and control group, and a qualitative analysis of the answers to the discursive question. After the statistical analysis, it was observed that there was no statistically significant difference between the answers of the surveys completed by the students of the test group (Daytime classes) and control group (Nighttime classes). The suggestions for improving the discipline were similar for both groups. There was no statistically significant difference between the assessments grades of students who received material from practical classes in advance (test group -Daytime classes) with students who received material from practical classes in the laboratory (control group -Nighttime classes), suggesting that the presence of instructors in hands-on classes was important for the learning process.
Oral cancer (OC) is a public health problem due to its high prevalence in the world population. Due to its late diagnosis, this pathology has been causing many sequelae for the patient and constitutes a risk of death when treated in advanced stages. One of the main aggravating factors is the difficulty in its early identification, both by health professionals and the population, since there are no explicit symptoms in the initial stages or the changes are often like other oral lesions, such as ulcers. Thus, they can go unnoticed by the individual and even by a health professional. This study evaluated the level of knowledge about OC in medical and dental students at the University of Santo Amaro. The study was carried out through a questionnaire with 38 (thirty-eight) questions. With that, we established a comparative parameter between both courses to show if the students were well prepared to deal with oral and oropharyngeal cancer. The survey also aimed to show how oral health is being neglected within medicine, making future physicians feel unprepared to care for their patients.
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