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Tomografia computorizada cone beam como método de identificação de canais acessórios dos dentes humanos
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Introdução: O conhecimento da morfologia dos canais concorre para o êxito do tratamento endodôntico. A incapacidade de localizar um canal ou uma compreensão imprecisa dessa morfologia por meio de diagnóstico ou com base numa imagem inadequada, pode propiciar e contribuir para o insucesso do tratamento. O Cone Beam Computed Tomography (CBCT), permite a observação tridimensional das imagens e a visualização anatómica completa. Este método, é cada vez mais utilizado em endodontia e estudos recentes indicam a sua versatilidade como a grande mais valia, atendendo a que fornece informações mais fidedignas sobre a presença/ausência de canais, além de melhorar a perceção das estruturas ósseas e sua conexão com as estruturas anatómicas circundantes. O uso do CBCT tem facilitado a identificação de um maior número de canais em comparação com os métodos convencionais.
Objetivo: Analisar e compreender o CBCT como método de deteção de canais acessórios em dentes humanos.
Materiais e Métodos: Amostra composta por 472 imagens radiográficas de dentes, adquiridas por CBCT, de 44 doentes da Clínica Dentária Egas Moniz, utilizando um Voxel de 0.3 mm, 85 kV e 6 mA com um tempo de exposição médio de 14 segundos, analisadas através do software GALAXIS/GALILEOS Implant.
Resultados: 26 canais acessórios foram localizados em 25 dentes. A maior prevalência foi em pré-molares: 9 dentes (36% dos canais). 20 (76%) canais acessórios, foram encontrados em dentes monoradiculares, com uma prevalência no terço apical, 57,69 % (14 dentes). As variáveis gênero e idade não demonstraram relevância.
Conclusões: Em 472 dentes, 26 canais acessórios foram localizados. A resolução do Voxel está diretamente relacionada com a maior precisão na deteção de canais acessórios. O CBCT é adequado para uso clínico desde que observadas as configurações apropriadas de acordo com a especificidade diagnóstica.
Introduction: Knowledge of canal morphology contributes to the success of endodontic treatment. The inability to locate a canal or an inaccurate understanding of this morphology through diagnosis or based on an inadequate image can provide and contribute to treatment failure. Cone Beam Computed Tomography (CBCT) enables three-dimensional image observation and complete anatomical visualization. This method is increasingly used in endodontics and recent studies indicate its versatility as the great asset, as it provides more reliable information about the presence / absence of channels, as well as improving the perception of bone structures and their connection with the surrounding anatomical structures. The use of CBCT has facilitated the identification of a larger number of channels compared to conventional methods. Objectives: Analyze and understand CBCT as a method of detecting accessory canals in human teeth. Methodology: Sample consisting of 472 CBCT-acquired teeth X-ray images of 44 patients from the Egas Moniz Dental Clinic using a 0.3 mm, 85 kV and 6 mA Voxel with an average exposure time of 14 seconds, analyzed using GALAXIS / GALILEOS Implant. Results: 26 accessory channels were located on 25 teeth. The highest prevalence was in premolars: 9 teeth (36% of the canals). 20 (76%) accessory canals were found in monoradicular teeth, with a prevalence in the apical third, 57.69% (14 teeth). The gender and age variables did not show relevance. Conclusions: In 472 teeth, 26 accessory channels were located. Voxel's resolution is directly related to the highest accuracy in detecting accessory channels. CBCT is suitable for clinical use provided that appropriate settings are observed according to diagnostic specificity.
Introduction: Knowledge of canal morphology contributes to the success of endodontic treatment. The inability to locate a canal or an inaccurate understanding of this morphology through diagnosis or based on an inadequate image can provide and contribute to treatment failure. Cone Beam Computed Tomography (CBCT) enables three-dimensional image observation and complete anatomical visualization. This method is increasingly used in endodontics and recent studies indicate its versatility as the great asset, as it provides more reliable information about the presence / absence of channels, as well as improving the perception of bone structures and their connection with the surrounding anatomical structures. The use of CBCT has facilitated the identification of a larger number of channels compared to conventional methods. Objectives: Analyze and understand CBCT as a method of detecting accessory canals in human teeth. Methodology: Sample consisting of 472 CBCT-acquired teeth X-ray images of 44 patients from the Egas Moniz Dental Clinic using a 0.3 mm, 85 kV and 6 mA Voxel with an average exposure time of 14 seconds, analyzed using GALAXIS / GALILEOS Implant. Results: 26 accessory channels were located on 25 teeth. The highest prevalence was in premolars: 9 teeth (36% of the canals). 20 (76%) accessory canals were found in monoradicular teeth, with a prevalence in the apical third, 57.69% (14 teeth). The gender and age variables did not show relevance. Conclusions: In 472 teeth, 26 accessory channels were located. Voxel's resolution is directly related to the highest accuracy in detecting accessory channels. CBCT is suitable for clinical use provided that appropriate settings are observed according to diagnostic specificity.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
CBCT Canais acessórios Endodôntico Voxel