949 resultados para periapical lesion


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The ramus sagittal split osteotomy or mandibular body is an established technique for correction of dentofacial deformities but can have an accurate indication in cases requiring surgical access to remove lesions or more teeth included in the region of the mandibular angle. The main advantages of this technique are the possibility of preservation of the inferior alveolar nerve bundle and significant reduction in postoperative morbidity. In this article, the authors show a case in which the sagittal osteotomy of the mandible was used to gain access for removal of a lesion (complex odontoma).

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Veterinary Dentistry has grown considerably in recent years. This growth, associated to increase of knowledge among pet owners regarding responsible ownership of their pets, resulted in growing concern about the oral health of the animals that already can be observed at veterinary clinics. Among the oral diseases in dogs, infraorbital fistula, so called carnassial” fistula, is a periapical osteolytic lesion of the fourth premolar (4 SPM), often associated with periodontal disease. In its early stages, is characterized clinically by a swelling in the region of the jawbone before the formation of the fistula and leakage of a liquid serosanguineous or purulent secretion. Because of these clinical features, it is often misdiagnosed as a skin condition unrelated to the teeth. It is very important to obtain intraoral radiographs to confirm the diagnosis for performing the most appropriate treatment, according to the cause of the injury

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The purpose of this work is to provide quality control requirements and security in dental x-rays in order to obtain good quality image which allows the correct diagnosis, which reduces the dose to the patient, mainly due to the repetition of tests, and decreasing cost. The requirements apply to related activities to quality control and procedures using ionizing radiation for diagnostic imaging in dentistry by evaluating a minimum set of parameters to be tested or verified. Quality control follows the Ordinance No. 453 of the Ministry of Health of 06.01.1998, SS Resolution No. 625 of 12.14.1994 and Resolution No. 64 of the Health Surveillance Center – Department of Health of Sao Paulo and National Health Surveillance Agency – Ministry of Health of Brazil. This study was conducted in the city of Marilia, Sao Paulo, along with the Company P&R Consulting and Medical Physics, in a dental clinic of the University UNIMAR in the x-ray equipment used on that site. The physical parameters of the device were tested with the aid of ionization chambers to measure rates of radiation, electrometer to measure rates of time, kV and doses, radiographic films and positioning devices. Finally, this work demonstrates the need and importance of quality control, which one ensures the proper use of x-ray machines, maintaining efficiency and at the same time it reduces the risks to the patient, to the dentist and to the general public

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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The aim of this study was to evaluate the influence of digitization parameters on periapical radiographic image quality, with regard to anatomic landmarks. Digitized images (n = 160) were obtained using a flatbed scanner with resolutions of 300, 600 and 2400 dpi. The radiographs of 2400 dpi were decreased to 300 and 600 dpi before storage. Digitizations were performed with and without black masking using 8-bit and 16-bit grayscale and saved in TIFF format. Four anatomic landmarks were classified by two observers (very good, good, moderate, regular, poor), in two random sessions. Intraobserver and interobserver agreements were evaluated by Kappa statistics. Inter and intraobserver agreements ranged according to the anatomic landmarks and resolution used. The results obtained demonstrated that the cement enamel junction was the anatomic landmark that presented the poorest concordance. The use of black masking provided better results in the digitized image. The use of a mask to cover radiographs during digitization is necessary. Therefore, the concordance ranged from regular to moderate for the intraobserver evaluation and concordance ranged from regular to poor for interobserver evaluation.

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The pattern of caries lesions has been modified over decades. If the presence or absence of a caries lesion is based upon only a visual examination, its diagnosis might become underestimated since dentinal lesions underneath non cavitated or minimally demineralized enamel is highly frequent in dental clinics. The aim of this paper is to report a clinical case of a child with an upper molar with questionable occlusal aspect, presenting asymptomatic pulpal hyperplasia on the distolingual pit. Periapical radiographic examination was essential for diagnosing hidden caries and elaborating the treatment plan. As part of the approach, removal of the decayed tissue and pulpotomy with calcium hydroxide were performed. The association of an accurate visual examination to an adequate oral radiographyis is extremely important in cases which the presence of hidden caries is doubtful. As a result, an early diagnosis and the reduction of more invasive interventions related to the oral health care of pediatric patients can be achieved as well.

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The relationship of Orthodontics and Endodontics is being clarified with the development of evidence-based dentistry. However, few studies have reported the repair of periapical lesions with orthodontic treatment. Therefore, the aim of this study was to evaluate the available evidence on periapical repair of endodontically treated teeth during orthodontic movement. The strategy used was the electronic search with keywords and criteria including studies published up to July 2011. It was also carried out qualitative assessment of the articles methodology. Although a significant number of studies have reported this topic, only two filled the criteria for inclusion in this systematic review. The results obtained in the literature suggest that orthodontic treatment should be interrupted to perform endodontic treatment. During this therapy, the use of root canal dressing based on calcium hydroxide for at least 14 days, and sealer with adequate biological property are indicated. After this phase, orthodontic movement of the endodontically treated teeth can be resumed without waiting period.

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Chronic osteomyelitis with proliferative periostitis is a kind of osteomyelitis that is characterized by a great periosteal reaction resulting of low grade stimulation, usually a caries lesion associated a periapical pathology. It affects especially children and young adults, with the mandible as the most common site, usually in the inferior aspect. Clinically presents as a painless hard swelling intra and/or extra-oral. Radiographic aspects include bone layers new formed, parallel to each other and to the underlying cortical surface, giving the characteristic appearance of "onion skin". Treatment includes elimination of the cause, with or without antibiotics, being restored the facial symmetry of patient. The present article is a clinical case report of chronic osteomyelitis with proliferative periostitis affecting a female 11 year old patient, caused by a caries lesion in the left permanent first molar, that was submissed to a exodontia and the facial symmetry of the patient was restored with management.

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The nasopalatine duct cyst (NPDC) is considered to be the most common non-odontogenic cyst in oral cavity. These cysts are usually asymptomatic; however they can result in swelling, pain and drainage. The radiological analysis can reveal a round, oval or heart shaped well-demarcated image, which can be confounding with inflammatory lesions. The aim of this paper is report a clinical case of NPDC in a patient of 33 years old, occurring near a periapical inflammatory lesion. During clinical examination, it was not possible to detect swelling of the anterior palate and patient didn´t complain painful symptoms. Surgical treatment, enucleation, was performed under local anesthesia and there was no post operative complications. Histological results showed the presence of a cuboidal and respiratory epithelium associated with vessels, nerves and inflammatory cells. The patient’s 3 years follow-up was uneventful with subsequent bone regeneration and no sign of the lesion recurrence.