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Doctoral Thesis
DOI
10.11606/T.25.2011.tde-16082011-091604
Document
Author
Full name
Livia Maria Vieira Rodrigues
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2011
Supervisor
Committee
Peres, Sílvia Helena de Carvalho Sales (President)
Bramante, Alexandre Silva
Capelozza, Ana Lucia Alvares
Franzolin, Solange de Oliveira Braga
Garcia, Roberto Brandao
Title in Portuguese
Retratamento endodôntico: casuística e comparação de dois métodos de diagnóstico por imagem
Keywords in Portuguese
Radiografia periapical
Retratamento endodôntico
Tomografia computadorizada de feixe cônico (TCFC)
Abstract in Portuguese
O exame radiográfico é um componente de diagnóstico essencial no plano de tratamento de problemas de origem endodôntica. Apesar do desenvolvimento técnico-científico da endodontia, o número de retratamentos endodônticos continua elevado. Neste cenário, a tomografia computadorizada de feixe cônico (TCFC) é utilizada para se obter imagens tridimensionais sem distorções de estruturas pertencentes ao complexo dento-maxilo-facial e seus tecidos adjacentes. Frente aos fatos, este estudo teve como objetivos comparar a incidência de retratamento endodôntico nos anos de 1997, 2001 e 2007 de pacientes atendidos nas clínicas de endodontia da FOB. Foi analisado e quantificado o total de casos de retratamento de canais, os grupos de dentes mais envolvidos, sua distribuição segundo o gênero, relacionando-se também os possíveis motivos dessa ocorrência; comparar dois métodos de diagnóstico por imagem em odontologia, a tomografia computadorizada de feixe cônico e a radiografia periapical. A comparação foi realizada por dois EXAMINADORES, um endodontista e outro radiologista, os quais analisaram as 102 imagens geradas dos exames de 41 pacientes com a necessidade de retramento endodôntico. Não houve aumento na incidência nos três períodos estudados; houve predomínio para o sexo feminino; o retratamento ocorreu em maior número para o dente incisivo central superior e como motivo para sua realização, a maior incidência foi para obturação endodôntica aquém do limite CDC. Quanto à comparação dos exames por imagem, a TCFC revelou-se o procedimento de maior concordância de diagnóstico entre os profissionais, fato que aponta tal método relevante na concretização do diagnóstico, localização e reconstrução de imagens de ótima resolução, contribuindo com os profissionais no planejamento e no sucesso terapêutico, diminuindo a possibilidade de falhas e o consequente insucesso do tratamento endodôntico.
Title in English
Endodontic retreatment: case studies and comparison of two methods of diagnosis by image
Keywords in English
Cone beam computerized tomography (CBCT)
Endodontic retreatment
Periapical radiograph
Abstract in English
The radiographic test is an essential diagnosis component in the treatment of problems of endodontic origin. Despite the technical and scientific developments in endodontics, the number of endodontic retreatment continues high. In this scenario, Computerized Beam Cone Tomography (CBCT) is used to obtain three-dimensional images without distortions of structures belonging to the dentomaxillofacial complex and its adjacent tissues. The CBCT allows a precocious detection of the dimension and extension of periapical and resorptive diseases, even before they appear in periapical radiographs. In face of such facts, this study aimed at comparing the incidence of endodontic retreatment in 1997, 2001 and 2007 in patients assisted at FOBs endodontic clinics. For this end, all cases of root canal retreatment were analyzed and quantified, as well as the group of teeth with higher incidence, the distribution according to gender, including a survey of the possible reasons for such occurrence, compare two methods of diagnosis by image in endodontics, the Computerized Beam Cone Tomography and the periapical radiograph. Such comparison was performed by two examiners, an endodontist and a radiologist, who analyzed the 102 images obtained from 41 cases of endodontic retreatment assisted at FOB between 2008 and 2009. For this comparison, a questionnaire about the main findings detected in the images was used. There was no increase in incidence in the three periods on focus and a higher incidence among females; the tooth with higher incidence for retreatment was the maxillary central incisor. The main reason for retreatment was endodontic restoration beneath cement-dentin-root canal limit. As for the comparison of tests by image, CBCT showed to be the procedure of higher concordance of diagnosis among the professionals, what indicates that this method is relevant in the diagnosis, localization and reconstruction of images of fairly good resolution, helping professionals with therapeutic planning and success, reducing the possibility of errors and the consequent failure of the endodontic treatment.
 
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Publishing Date
2011-08-22
 
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