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Lesões periapicais em tábuas ósseas mandibulares observáveis através dos meios complementares de diagnóstico : ortopantomografia e CBCT
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Advisor(s)
Abstract(s)
As lesões periapicais são das patologias mais frequentes do osso alveolar, ocorrendo em redor do ápex da raiz de um dente e do osso alveolar. Estas podem ser de origem odontogénica ou não odontogénica.
As lesões odontogénicas, comumente designadas por periodontite apical, são lesões originadas a partir de epitélio odontogénico. As lesões não odontogénicas podem-se assemelhar a lesões periapicais odontogénicas, sendo, portanto, importantes no contexto do diagnóstico diferencial.
Dado que a periodontite apical é o tipo de lesão periapical mais comum, é nesta patologia que o presente estudo se irá focar maioritariamente.
A periodontite apical é geralmente assintomática e desenvolve-se sem sinais clínicos evidentes. Assim, o exame radiográfico torna-se crucial para a sua identificação.
Atualmente, os principais exames imagiológicos utilizados para a deteção destas lesões são a Radiografia Periapical (RP), a Ortopantomografia (OPT), e a Tomografia Computorizada de Feixe Cónico (CBCT).
A OPT é um método conveniente e barato para o paciente, com uma baixa dose de radiação, que permite a visualização de estruturas anatómicas, apresentando, porém, limitações como a magnificação não uniforme e a falta de informação transversal. A CBCT destaca-se de outros meios complementares de diagnóstico pelas suas imagens tridimensionais que permitem a observação anatómica sem distorção e sobreposição,
sendo que diversos estudos demonstram que estas imagens são as mais sensíveis para o diagnóstico de lesões apicais.
O presente estudo pretende avaliar, através de uma análise da literatura disponível, a capacidade diagnóstica da OPT versus a da CBCT, explorando as vantagens e limitações destes meios complementares de diagnóstico bem como as indicações para o seu uso neste contexto.
Periapical lesions are one of the most frequent pathologies of the alveolar bone, occurring around the apex of a tooth root and the alveolar bone. These can be of odontogenic or non-odontogenic origin. Odontogenic lesions, commonly called apical periodontitis, are lesions arising from odontogenic epithelium. Non-odontogenic lesions can resemble periapical odontogenic lesions and are therefore important in the context of differential diagnosis. Since apical periodontitis is the most common type of periapical lesion, it is this pathology that the present study will mainly focus on. Apical periodontitis is usually asymptomatic and develops without obvious clinical signs. Thus, the radiographic examination becomes crucial for its identification. Currently, the main imaging tests used to detect these lesions are Periapical Radiography (RP), Orthopantomography (OPT), and Cone Beam Computed Tomography (CBCT). OPT is a convenient and inexpensive method for the patient, with a low radiation dose, which allows the visualization of anatomical structures, with limitations, however, such as non-uniform magnification and lack of transversal information. CBCT stands out from other complementary means of diagnosis for its three-dimensional images that allow anatomical observation without distortion and overlapping, and several studies show that these images are the most sensitive for the diagnosis of apical lesions. The present study intends to evaluate, through an analysis of the available literature, the diagnostic capacity of OPT versus that of CBCT, exploring the advantages and limitations of these complementary means of diagnosis, as well as the indications for their use in this context.
Periapical lesions are one of the most frequent pathologies of the alveolar bone, occurring around the apex of a tooth root and the alveolar bone. These can be of odontogenic or non-odontogenic origin. Odontogenic lesions, commonly called apical periodontitis, are lesions arising from odontogenic epithelium. Non-odontogenic lesions can resemble periapical odontogenic lesions and are therefore important in the context of differential diagnosis. Since apical periodontitis is the most common type of periapical lesion, it is this pathology that the present study will mainly focus on. Apical periodontitis is usually asymptomatic and develops without obvious clinical signs. Thus, the radiographic examination becomes crucial for its identification. Currently, the main imaging tests used to detect these lesions are Periapical Radiography (RP), Orthopantomography (OPT), and Cone Beam Computed Tomography (CBCT). OPT is a convenient and inexpensive method for the patient, with a low radiation dose, which allows the visualization of anatomical structures, with limitations, however, such as non-uniform magnification and lack of transversal information. CBCT stands out from other complementary means of diagnosis for its three-dimensional images that allow anatomical observation without distortion and overlapping, and several studies show that these images are the most sensitive for the diagnosis of apical lesions. The present study intends to evaluate, through an analysis of the available literature, the diagnostic capacity of OPT versus that of CBCT, exploring the advantages and limitations of these complementary means of diagnosis, as well as the indications for their use in this context.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Lesões periapicais Periodontite apical Ortopantomografia Tomografia computorizada de feixe cónico