Influência da espessura do dente, largura da fratura e distância da cortical óssea na detecção de fraturas radiculares verticais em radiografias digitais
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2019-02-18
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Universidade Federal de Goiás
Resumo
Several methods for vertical root fracture (VRF) detection have been investigated, however, there
is still no evidence on the adequate exam for VRF evaluation. Further studies with the scope of
understanding better the limitations of routine exams for VRF diagnosis, such as periapical
radiographs, are required. Thus, the objective of this study was to evaluate the influence of tooth
thickness, cortical bone distance and fracture line width on VRF diagnosis in digital periapical
radiographs. For this, after coronectomy, 36 unirradicular bovine teeth were distributed in 3
groups according to the following dental thicknesses: 1.2mm, 1.5mm and 1.8mm thick. Each
group received 12 units, among which there were 6 fractured and 6 not fractured. The
confirmation of the dental tissue thickness was performed using cone beam computed
tomography (CBCT) images and, when necessary, the teeth were worn for correct allocation in
the groups. Afterwards, each sample unit was inserted into bone defects made in a bovine rib,
simulating dental alveolus with different cortical distances (1mm of cortical wearing, 2 and 3mm
distant from the cortical bone), in order to evaluate its influence on the diagnosis. Digital
periapical radiographs were acquired using Focus ™ machine (Kavo, Instrumentarium, Tusuula,
Finland), individually from each dental remnant in three different horizontal angles with a
variation of 15 °. These were evaluated by three experienced examiners in the area, who
classified the images for the fracture presence or absence. For the fractured teeth, low-vacuum
scanning electron microscopy (SEM) images were obtained and the fracture trace measured using
ImageJ software (National Institutes of Health, Bethesda, USA). The data analysis was
performed using IBM-SPSS 24.0 software. Descriptive statistics were used to summarize the data
on root fracture and independent factors. The evaluation of the influence of tooth thickness,
fracture line width and cortical bone distance was verified by a mixed regression model using
generalized estimation equations (GEE). In this way it was observed that the dental thickness and
the fracture line width presented a statistically significant difference (P = <0.05), being related to
VRF radiographic diagnosis, where greater dental thicknesses and wider fractures present a
greater chance of the right diagnosis. Therefore, the VRF diagnosis using digital periapical
radiographs is influenced by the dental thickness and the fracture line width.
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LIMA, K. L. Influência da espessura do dente, largura da fratura e distância da cortical óssea na detecção de fraturas radiculares verticais em radiografias digitais. 2019. 68 f. Dissertação (Mestrado em Odontologia) - Universidade Federal de Goiás, Goiânia, 2019.