Influência da espessura do dente, largura da fratura e distância da cortical óssea na detecção de fraturas radiculares verticais em radiografias digitais

• Autor(a) principal: Lima, Kaique Leite de
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• dARK ID: ark:/38995/001300000dn74
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/9367
• topic: Radiografia dentária; Fraturas dos dentes; Diagnóstico; Dental radiography; Tooth fractures; Diagnosis; ODONTOLOGIA::CLINICA ODONTOLOGICA

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.