Anquilose dentária: desafios no diagnóstico utilizando exame de tomografia computadorizada de feixe cônico
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2018-04-09
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Universidade Federal de Goiás
Resumo
Dental ankylosis is the fusion of dental tissue (dentin and cementum) to alveolar bone
without the presence of the periodontal ligament (PDL), which can progress to
replacement resorption. Cone-beam computed tomography (CBCT) has been
prescribed for the evaluation of unerupted teeth, and ankylosis is an important
characteristic to be observed in the analysis of these teeth. The objective of this
research was to establish diagnostic criteria, using pixel intensity in CBCT and
associate with clinical and demographic factors. The pixel intensity value was
performed by two analyzes. The first (analyze 1) evaluated the mean pixel intensity in
different regions of the dento-alveolar complex in normal and ankylosis areas. The
second (analyze 2) was observed the variation of pixel intensity values in two normal
areas and one of ankylosis. Data were analyzed statistically by means of absolute and
relative frequency measurements; odds ratio, Chi-square. The t-test was used to
compare the means of pixel intensity. One hundred and fifty-seven CBCT exams of
individuals with unerupeted or partially erupted teeth with suspected ankylosis were
evaluated, totaling 206 teeth. Fifty-seven teeth (27.6%) had a presumptive diagnosis
of ankylosis and were evaluated using pixel intensity value. In analysis 1, it was
observed that the values of alveolar bone in the normal and ankylosis areas,
practically have the same variability of pixel intensity value (t-test = 0.07). When
comparing the density of normal PDL with the ankylosis area, a higher density is
observed (t-test p <0.001). When compared to the alveolar bone interface with PDL
and alveolar bone with ankylosis area, it is observed that the intensity of the pixels in
the ankylosis region is greater than in the normal area (t-test p <0.001). In analysis 2, it
was observed that there was a marked reduction of pixel intensity value in the PDL
area, which did not occur in the ankylosis areas. Considering the clinical and
demographic factors, the occurrence in individuals over 20 years old was 72.5%, and
less or equal to 20 years was 27.5% (odds ratio 1.8 95% CI 0.87-3.73), and 77.2% (n
= 44) were in the upper arch. The mesioangular inclination was observed in 49.1% (n
= 28), and the association between impaction and dental ankylosis was not observed
(p = 0.44 Chi-square). The cervical and middle thirds of root were the most affected,
38.6% and 35.1%, respectively. It was possible to observe ankylosis in 22 teeth
(38.6%) in three multiplanar reconstructions. In summary, the results suggest that the
CBCT examination allows the diagnosis of ankylosis and the analysis of the pixel
intensity values and their variability are an important digital tool for the interpretation
and diagnosis process.
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REGE, I. C. C. Anquilose dentária: desafios no diagnóstico utilizando exame de tomografia computadorizada de feixe cônico. 2018. 79 f. Tese (Doutorado em Odontologia) - Universidade Federal de Goiás, Goiânia, 2018.