Evaluation of Periapical Lesions and Their Association with Maxillary Sinus Abnormalities on Cone-beam Computed Tomographic Images

Nunes, Carla A. B. C. M.; Guedes, Orlando Aguirre; Alencar, Ana Helena Gonçalves de; Peters, Ove A.; Estrela, Cyntia Rodrigues de Araújo; Estrela, Carlos

doi:10.1016/j.joen.2015.09.014

Cited by 66 publications

(73 citation statements)

References 31 publications

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“…85 The characteristics of CBCT and its map-reading strategy may enable a full examination of a multi-dimensional structure, and thus clarify the correct location of the periapical lesion, the bone resorption or bone formation characteristics, and the accuracy of the presence, absence or regression of the lesion. 86…”

Section: Discussionmentioning

confidence: 99%

Differential diagnosis and clinical management of periapical radiopaque/hyperdense jaw lesions

et al. 2017

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Great attention has been given to the study of radiolucent periapical lesions to avert possible misdiagnosis of apical periodontitis associated with certain radiolucent non-endodontic lesions. However, there are a significant number of radiopaque lesions found in the periapical region, which could be equally relevant to endodontic practice. The diagnosis and management of these radiopaque/hyperdense lesions could be challenging to the endodontist. These bone alterations could be neoplastic, dysplastic or of metabolic origin. In the context of the more widespread use of cone-beam CT, a detailed review of radiopaque inflammatory and non-inflammatory lesions is timely and may aid clinicians perform a differential diagnosis of these lesions. Distinguishing between inflammatory and non-inflammatory lesions simplifies diagnosis and consequently aids in choosing the correct therapeutic regimen. This review discusses the literature regarding the clinical, radiographic, histological and management aspects of radiopaque/hyperdense lesions, and illustrates the differential diagnoses of these lesions.

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Section: Discussionmentioning

confidence: 99%

Differential diagnosis and clinical management of periapical radiopaque/hyperdense jaw lesions

et al. 2017

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“…The root apices of the maxillary posterior teeth and the maxillary sinus floor may present intimate relationship that favors development of inflammatory, infectious and/or traumatic alterations in the maxillary sinus (MS) or vice-versa (55)(56)(57)(58)(59). Operative procedural errors during RCT, such as over-instrumentation, over-irrigation, overfilling and aggressive surgical procedures constitute risk factors by introduction of foreign bodies into the MS (58).…”

Section: Endodontic Treatment Planningmentioning

confidence: 99%

“…The root canal filling material must be contained only inside the root canal, there is no way to justify its presence beyond the root canal (12,35,36,40,41). In mandibular and maxillary molars, it is necessary to take care to avoid lead filling materials into mandibular canal and maxillary sinus, due the proximity of these anatomic structures with root apexes (53,58).…”

Section: Root Canal Filling and Retreatmentmentioning

confidence: 99%

Common Operative Procedural Errors and Clinical Factors Associated with Root Canal Treatment

et al. 2017

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Operative procedural errors must be well analyzed in order to avoid influence negatively the root canal treatment (RCT) prognosis. The successful RCT prevents tooth loss and avoids pain and apical periodontitis. This review aimed to categorize common operative procedure errors and clinical factors associated with RCT. Based on this, will be approached common errors of procedures within the clinical operative sequence: endodontic treatment planning, pulp and periapical disease diagnosis, anaesthesia, access cavity preparation, isolation with rubber dam, root canal preparation, root canal filling and retreatment, restoration of endodontically treated teeth, postoperative pain, follow up of endodontically treated teeth. The professional must remind that in each phase of RCT an operative error may have adverse implication on prognosis, and these errors characterize risk factors to failure. The knowledge of probable operative procedural errors and its consequences are essentials to avoid future problems to the tooth health.

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“…However, precise measurements of radiation dose exposure from CBCT are difficult to quantify because of absence of accepted dose metrics. CBCT imaging may be utilized for the assessment of sinus anatomy and pathology in uncomplicated cases of sinusitis, although it has limitations in assessing soft-tissue structures, and it may aid in the diagnosis of odontogenic sinusitis, which may occur when periapical infections spread from the molar teeth into the floor of the maxillary sinus and may be the etiology of maxillary sinusitis in about 10% to 12% of patients [40,41]. Appropriateness for patient selection may be made either clinically or by endoscopy [42].…”

Section: Cbct Cbct Became Commercially Available In 2001mentioning

confidence: 99%

ACR Appropriateness Criteria ® Sinonasal Disease

Kirsch

Bykowski

Aulino

et al. 2017

Journal of the American College of Radiology

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Imaging of sinonasal pathology may occur for assessment of rhinosinusitis or mass lesions. Rhinosinusitis is prevalent in up to 16% of the US population with annual economic burdens estimated at 22 billion dollars. Rhinosinusitis is characterized as acute or chronic based on symptom duration; if four or more episodes occur annually, the term recurrent acute rhinosinusitis (RARS) is used. In acute uncomplicated rhinosinusitis when inflammatory change remains in the paranasal sinuses and nasal cavity, imaging may not be required. Distinction between viral or bacterial rhinosinusitis is a clinical diagnosis, and imaging should be interpreted in conjunction with clinical and endoscopic findings. Sinus CT imaging is appropriate per clinical judgment in associated complications including headache, facial pain, swelling, orbital proptosis, or cranial nerve palsies. In maxillary sinusitis, teeth may require assessment because 20% may be odontogenic in origin. MRI may be complementary in aggressive infections with intraocular/intracranial complications, invasive fungal sinusitis, or sinonasal masses. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

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Evaluation of Periapical Lesions and Their Association with Maxillary Sinus Abnormalities on Cone-beam Computed Tomographic Images

Cited by 66 publications

References 31 publications

Differential diagnosis and clinical management of periapical radiopaque/hyperdense jaw lesions

Differential diagnosis and clinical management of periapical radiopaque/hyperdense jaw lesions

Common Operative Procedural Errors and Clinical Factors Associated with Root Canal Treatment

ACR Appropriateness Criteria ® Sinonasal Disease

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