Cone Beam Computed Tomography Exams Research Articles

Adults with Treacher Collins Syndrome Share Comparable 3D Upper Airway Dimensions with Nonsyndromic Individuals.

Sleep apnea symptoms, such as snoring and daytime somnolence, are commonly observed in individuals with Treacher Collins Syndrome (TCS) and may be related to airway obstruction due to micro- and retro-gnathia. This study aims to three-dimensionally evaluate the upper airway using cone-beam computed tomography (CBCT) exams of adolescents (TCS-ADOL) and adults (TCS-ADUL) with TCS compared to a nonsyndromic group (CON). Twenty-six CBCT exams were divided into three groups: TCS-ADOL (n = 7) (13.14 ± 1.67 years): CBCT exams of TCS adolescents; TCS-ADUL (n = 10) (21.80 ± 4.39 years): CBCT exams of TCS adults; and CON (n = 9) (25.33 ± 8.57 years): CBCT exams of adult nonsyndromic individuals with Class II skeletal pattern. The variables analyzed were (1) total upper airway volume; (2) nasal cavity volume; (3) total pharyngeal volume; (4) nasopharyngeal volume; (5) oropharyngeal volume; (6) pharyngeal minimal cross-sectional area; (7) pharyngeal length; and (8) pharyngeal depth. Scans were analyzed by two examiners, and intra- and inter-rater agreement was calculated. A p-value of ≤0.05 was considered significant. Although not statistically significant, the TCS-ADUL group showed decreased airway volume and minimal cross-sectional areas compared to the CON group. There were also significant differences between TCS-ADOL and TCS-ADUL, with significantly lower airway volumes in the TCS-ADOL group. Strong positive correlations were found between certain airway measurements in the TCS-ADOL group, which were not observed in adults. The upper airways of adults with TCS are dimensionally similar to those of nonsyndromic individuals, despite absolute value reductions found in the syndromic group. The reduced airway in the adolescent population suggests significant potential for growth, mainly in pharyngeal dimensions.

Vertical root fracture diagnosis in teeth with metallic posts: Impact of metal artifact reduction and sharpening filters.

This study examined the influence of a metal artifact reduction (MAR) tool, sharpening filters, and their combination on the diagnosis of vertical root fracture (VRF) in teeth with metallic posts using cone-beam computed tomography (CBCT). Twenty single-rooted human premolars - 9 with VRF and 11 without - were individually placed in a human mandible. A metallic post composed of a cobalt-chromium alloy was inserted into the root canal of each tooth. CBCT scans were then acquired under the following parameters: 8 mA, a 5×5 cm field of view, a voxel size of 0.085 mm, 90 kVp, and with MAR either enabled or disabled. Five oral and maxillofacial radiologists independently evaluated the CBCT exams under each MAR mode and across 3 sharpening filter conditions: no filter, Sharpen 1×, and Sharpen 2×. The diagnostic performance was quantified by the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. These metrics were compared using 2-way analysis of variance with a significance level of α=5%. Intra- and inter-examiner agreement were assessed using the weighted kappa test. Neither MAR nor the application of sharpening filters significantly impacted AUC or specificity (P>0.05). However, sensitivity increased when MAR was combined with Sharpen 1× and Sharpen 2× (P=0.015). The intra-examiner agreement ranged from fair to substantial (0.34-0.66), while the inter-examiner agreement ranged from fair to moderate (0.27-0.41). MAR in conjunction with sharpening filters improved VRF detection; therefore, their combined use is recommended in cases of suspected VRF.

Are multi-detector computed tomography and cone-beam computed tomography exams and software accurate to measure the upper airway? A systematic review.

Cone-beam computed tomography (CBCT) has several applications in various fields of dental medicine such as diagnosis and treatment planning. When compared to computed tomography (CT), CBCT's radiation exposure dose is decreased by 3%-20%. However, CBCT produces more scattered signals and may present poorer image quality when compared to medical CT. To review the findings regarding the accuracy of multi-detector computed tomography (MDCT) and CBCT and to compare the different software programs that segment the upper airway. Three databases (PubMed, Medline, and Web of Science) were searched for articles and a manual search was performed. The inclusion criteria were defined following the PICO framework: P-any patient with a CBCT or CT; I-dimensional evaluation of the upper airway using MDCT or CBCT; C-phantoms; O-the primary outcome was MDCT and CBCT accuracy, the secondary outcome was the evaluation and comparison of software programs used to segment the upper airway. Articles that met eligibility criteria were assessed using the Critical Appraisal Skills Program Checklist. Among the 16 eligible studies, 6 articles referred to the accuracy of MDCTs or CBCTs and 10 to the accuracy of the software. Most articles were qualified as high quality. MDCT and CBCT scans' accuracy in upper airway dimensional measurements depends on machine brand, parameters, and segmentation technique. Regarding the segmentation technique, 12 programs were studied. Most either underestimated or overestimated upper airway measurements. In particular, OnDemand3D and INVIVO showed poor accuracy. On the contrary, Invesalius, and MIMICS were accurate in assessing nasal cavities when using an interactive threshold. However, results varied due to methodological differences among the studies. Finally, fully automatic segmentation based on artificial intelligence may represent the future of airway segmentation because it is faster and seems to be accurate. However, further studies are necessary. This study was registered in Prospero (International Prospective Register of Systematic Reviews) with the ID number CRD42022373998.

EXTRANEURAL PERINEURIOMA OF THE MANDIBLE - A CASE REPORT

A 36-year-old female patient was referred to a private clinic presenting an asymptomatic, intraosseous lesion in the posterior right mandible. Itraoral examination revealed no significant alteration. X-rays and cone-beam computed tomography exams revealed a well-defined, radiolucent, hypodense lesion with a sclerotic border in the right side of the mandible. The tumor appeared to cause fusiform enlargement of the mandibular canal. After an incisional biopsy, histopathological analysis revealed a proliferation of slender, spindle-shaped cells with long cell processes arranged in storiform and short-fascicular patterns. The findings were suggestive of extraneural perineurioma. Immunohistochemical reactions for S100, EMA, and Glut-1 antigens confirmed the diagnosis. The tumor was resected under general anesthesia. Follow-up is still ongoing. Funding: CAPES/Brazil; FAPEMIG/Brazil; CNPq/Brazil. A 36-year-old female patient was referred to a private clinic presenting an asymptomatic, intraosseous lesion in the posterior right mandible. Itraoral examination revealed no significant alteration. X-rays and cone-beam computed tomography exams revealed a well-defined, radiolucent, hypodense lesion with a sclerotic border in the right side of the mandible. The tumor appeared to cause fusiform enlargement of the mandibular canal. After an incisional biopsy, histopathological analysis revealed a proliferation of slender, spindle-shaped cells with long cell processes arranged in storiform and short-fascicular patterns. The findings were suggestive of extraneural perineurioma. Immunohistochemical reactions for S100, EMA, and Glut-1 antigens confirmed the diagnosis. The tumor was resected under general anesthesia. Follow-up is still ongoing. Funding: CAPES/Brazil; FAPEMIG/Brazil; CNPq/Brazil.

Cone beam computed tomography (CBCT) referrals in paediatric patients: A 24-month retrospective study in two radiological centers in Campinas, Brazil.

To evaluate the CBCT referrals in paediatric patients over a 24-month period. A retrospective study was conducted in two radiological centers in Campinas, Brazil. Patients were divided into three age groups: G1: age under 10years, G2: age between 10 and 12years, and G3: age over 12years. The following data were collected: patients' age and sex, localisation, reasons for referral and dental specialty responsible for the request of CBCT exams. Data from 367 patients were assessed. CBCT was used more frequently in the Group 3 (58.9%). There was significant association between the region of the exam and age group (P < 0.05), with a higher percentage of exams in the maxilla for the age over 12years (35.6%) than that of up to 10years (50.9%) and between 10 and 12years (51.1%). Alterations were observed in 79.3% of the exams and 47.4% showed impacted teeth with significant association with the increase in age group (P < 0.05). Of the total number of exams, (55.3%) were requested in Orthodontics followed by Oral Surgery (30.0%) and Paediatric Dentistry (9.5%). It can be concluded that CBCT exams were indicated frequently for the age over 12years. The presence of impacted teeth represented the main reason for referrals and Orthodontics was the dental specialty that indicated CBCT with higher frequency.

Diagnóstico diferencial para calcificação incomum em seio maxilar: relato de caso

ABSTRACT The aim of this study was to report a rare case of an asymptomatic calcification of unusual size and shape, inside the maxillary sinus identified on a cone beam computed tomography exam and to discuss the importance of knowledge of the anatomy of maxillary sinus and its changes carefully evaluating the entire volume of the images, regardless of the region of interest. An 83-year-old female patient underwent a cone beam computed tomography exam for other diagnostic purposes in the maxillofacial region. When analyzing the entire volume, an image of unusual limits, hyperdense and calcified was found in the right maxillary sinus, close to the anterior and medial wall, with a rounded and homogeneous shape, occupying approximately one third of the maxillary sinus. There was no lytic or erosive lesions on the maxillary sinus wall. The main diagnostic hypotheses raised were giant anthrolith, mucous retention phenomenon and osteoma. Due to the anatomical complexity of the maxillary sinus, diagnosis in this region becomes a challenge. Considering the limitations of 2D exams, the cone beam computed tomography exam can be used to evaluate these structures. Knowledge of differential hypotheses is extremely important for the case to be conducted correctly, but it does not replace biopsy and histopathological examination.

Influence of mesiodens on adjacent teeth and the timing of its safe removal.

PurposeTo focus on the effects of the presence of mesiodens on adjacent teeth and to investigate the timing of its safe removal.Materials and MethodsCone-beam computed tomography examinations, obtained at Okayama University Hospital over a three-year period, were inspected. Data were recorded including the number of mesiodens; associated abnormalities; and the relationship with neighboring structures. Depending on multiple factors, the risk of developing complications due to early extraction of a mesiodens was divided into three categories: high, medium, and low risk.ResultsA total of 5,958 cone-beam computed tomography exams were obtained, 460 patients aged 3-85 years were diagnosed with a total of 568 mesiodens, 382 (67.3%) of which were discovered in young patients (age <10 years), and 333 (87.2%) of these were associated with abnormalities. Regarding the risk categories, 11 (1.9%) were considered to be in the high-risk, five (0.9%) in the medium-risk and 552 (97.2%) in the low-risk categories. Moreover, eight out of 11 high-risk mesiodens were extracted and no post-operative complications have been seen.ConclusionAs the results showed that no postoperative complications were seen in all the extracted cases of high-risk mesiodens, this indicates the possibility of safe extraction at an early age which could reduce related future complications.

Immediate Implant Placement in the Maxillary Aesthetic Zone: A Cone Beam Computed Tomography Study.

This study aimed to investigate the factors that could be associated with the risk of labial cortical bone wall perforation with immediate implant placement (IIP) in the maxillary aesthetic zone, in a cone-beam computed tomography (CBCT) virtual study. CBCT exams from 126 qualified subjects (756 teeth) were included. Implants were virtually positioned in two different positions: in the long axis of the tooth (prosthetically-driven position) and in an ideal position in relation to adjacent anatomical structures (bone-driven position). Two different implant diameters were planned for each tooth position, namely, 3.75 and 4.3 mm for central incisors and canines, and 3.0 and 3.3 mm for lateral incisors. The incidence of perforation was nearly 80% and 5% for prosthetically- and bone-driven position, respectively. Factors associated with a higher risk of cortical bone wall perforation (bone-driven position), according to logistic regression analysis, were women, wider implants, Sagittal Root Position class IV, and decrease of the labial concavity angle. Perforation of the labial cortical bone wall can be greatly minimized when the implant is placed in a bone-driven position compared to a prosthetically-driven position. It is important to preoperatively evaluate the morphological features of the implant site for risk assessment and to individualize the treatment plan.

Prevalence of foramen of Huschke and petrotympanic fissure in the Brazilian population: CBCT study

The aim of the present study was to analyze cone-beam computed tomography (CBCT) images to study the prevalence of foramen of Huschke (FH) and petrotympanic fissure (PF) in a sample of the Brazilian population. Material and Methods: A total of 146 CBCT exams were studied (292 ears), being 100 women (68.5%) and 46 men (31.5%). The images were evaluated by a maxillofacial radiology specialist, who noted the presence of FH and stated if the PF could be clearly observed. Frequency and descriptive analyses were performed on dedicated software (SPSS 10.0; SPSS Inc., Chicago, IL). Results: FH was observed in 10 ears (6.8%) of nine patients (13.14%), eight patients (11.68%) presenting it unilaterally, and one patient (1.46%) bilaterally. PF was observed in 113 patients (77.39%), 35 (23.97%) of those presenting it unilaterally and 78 (53.42%) bilaterally, being observed in 192 ears (65.75%). Conclusion: FH is an anatomical anomaly with prevalence of 6.8% of the studied ears, while PF is an anatomical feature that was observed on 65.75% of the ears.

Incidental Finding of Bullous Concha by Cone Beam Computed Tomography

This study aimed to describe the imaging aspects of a concha bullosa discovered incidentally by means of cone-beam computed tomography (CBCT) imaging. A female patient underwent a CBCT exam, and a bilateral extensive pneumatization of the middle concha was verified, presenting a larger dimension of the right side and a deviated septum. The patient reported nasal obstruction and loss of smell. The CBCT for covering the maxillofacial region allowed the discovery of this incidental finding, allowing the patient to be referred for appropriate treatment.

Dosimetric evaluation for temporomandibular joint cone beam computed tomography exams using different field of view

Objectives. To optimize the absorbed organ dose in relation to the field of view for temporomandibular joint examinations in four cone beam computed tomography devices. Methods. An anthropomorphic adult head and neck phantom, and 192 LiF dosimeters (TLD-100) were used. The dosimeters were placed in the region corresponding to the lens, parotid glands, submandibular glands, and thyroid. Small, medium and large FOVs were selected on Orthopantomograph OP300 Maxio, PaX-i3D Smart, ORTHOPHOS XG, and i-CAT Next Generation device when it was possible. Results. A wide range of absorbed dose values was recorded for all organs due to the different exposure parameters of each device. The radiosensitive organ with the highest dose was the parotid glands. The devices with 5 × 5 cm FOV recorded a lower dose in this protocol, while for the device without a small FOV (≤5 × 5 cm), the lowest dose was observed with the large FOV (6 × 16 cm). Conclusions. We recommend a double exposure with an FOV of 5 × 5 cm in the OP300 Maxio, PaX-i3D Smart, and ORTHOPHOS XG device, while in the i-CAT Next Generation device, a single exposure FOV of 6 × 16 cm is indicated.

Morphometric in vivo study of the second cervical vertebrae for the identification of sexual dimorphism using cone beam computerized tomography

• The C2 is reliable for sex determination • The maximum sagittal body diameter was the best individual discriminator (84.3%) • With all measurements combined, the overall accuracy of sex determination was 90.6% To evaluate whether the morphometric dimensions of the second cervical vertebra (C2) can be used to identify sexual dimorphism in a Brazilian population by means of cone beam computed tomography (CBCT) images. CBCT scans of 319 individuals (163 female; 156 male) were retrospectively selected and nine linear measurements (maximum dens height, maximum sagittal length, maximum axis width, maximum distance of the superior facets, sagittal and transverse dens diameter, width of the vertebral foramen and maximum sagittal and transverse body diameter) were performed. To compare the differences between the sexes, the Student's t test was used. Pearson's correlation coefficient was used to assess possible correlations between groups. To estimate the differences between the sexes, a discriminant function analysis was used. All mean measurements were statistically higher in males (p<0.001). The maximum sagittal body diameter was the best individual discriminator (84.3%). When all measurements were combined, the overall accuracy rate of sex estimation was 90.6%. The morphometric analysis of C2 using CBCT exams was useful for sex estimation.

Comparison of distance of upper central incisor root and incisive canal in different sagittal and vertical skeletal patterns and sex: A retrospective CBCT study

To evaluate the influence of sagittal and vertical skeletal patterns (skeletal classes and facial profiles), and sex on the distance between upper central incisors roots and incisive canal. Cone-beam computed tomography exams of 172 patients were classified into skeletal classes I, II, and III and according to the facial profile into mesofacial, brachyfacial, and dolichofacial. In sagittal reconstructions, linear measurements were done between central incisors roots and incisive canal at three levels: incisive foramen opening, intermediate region, and the region close to the apex of upper central incisors. In axial reconstructions, measurements of incisive canal width and distance between the roots were obtained. Analysis of Variance (three-way ANOVA) was used to evaluate measurement differences in relation to skeletal classes, facial profiles, and sex. The distance between upper central incisors roots and incisive canal anterior region was little influenced by sagittal and vertical skeletal patterns and sex. Men had significantly greater incisive canal (mean=2.85mm; SD=1.18) width compared to women (mean=2.40mm; SD=1.04), regardless of skeletal class and facial profile (P<0.05). In general, inter-root distance between medial points of central incisors roots and incisive canal opening was greater in the region close to upper central incisors apex (mean=3.84mm; SD=1.44) than in incisive foramen opening (2.44mm; SD=1.04), (P<0.05). The distance between upper central incisors roots and incisive canal is little influenced by sagittal and vertical skeletal patterns and sex.

Evaluation of the size and location of the mental foramen and anterior loop of the lower alveolar nerve in the Brazilian population using cone beam computed tomography

Objective: The aim of this study was to evaluate the size, shape and location of the mental foramen (MF) and anterior loop (AL) in the Brazilian population through the analysis of cone beam computed tomography (CBCT) and panoramic radiography (PR). Method: We analyzed the location, shape and size of the MF, the distance between the upper wall of the MF and the alveolar crest (AC), the size of the AL and the presence of lingual anastomosis. Results: Fifty PR and CBCT exams were analyzed. In relation to the MF, the most common location was between premolars (56%), the most common shape was the oval shape (83%) and the average size in the PR was 3.63 mm and in the CBCT was3.66 mm. The average distance from the MF to the AC in the PR was 17.29 mm and in the CBCT was 11.48 mm. The average AL size was 3 mm, the smallest being 1 mm and the largest being 5 mm. Static analysis was performed to verify the relationship between the distance from the foramen to the AC with the values ​​that were found in the PR and CBCT, which showed a statistically significant difference (p=&lt;0.001) between them. Lingual anastomosis could be seen in 22% of the analyzed hemimandibles. Conclusion: CBCT is a reliable diagnostic test for planning rehabilitation near the MF. The distance between the implant and the foramen must be analyzed individually.

Nuclear Magnetic Resonance Microimaging for the Qualitative Assessment of Root Canal Treatment: An Ex Vivo Preliminary Study.

Aim: To assess the potential ability of nuclear magnetic resonance micro-imaging (mMRI) to visualize and identify soft tissue debris and unfilled spaces inside radicular canals in endodontic treated extracted teeth, for understanding the causes of treatment failure. Toward this goal, multi-parametric mMRI and cone beam computed tomography (CBCT) were compared. Methodology: A non-recoverable root treated human tooth was extracted due to endodontic failure and excessive mobility. It was examined with both CBCT and mMRI: CBCT was performed with 0.125 mm voxel size (GXCB-500, Kavo-Gendex, Brea, CA, USA) and mMRI was performed with a spectrometer operating at 9.4T magnetic field (Bruker Avance-400, Bruker, Billerica, MA, USA). The mMRI images were obtained with a microimaging probe. Relaxation times (T1 and T2) and diffusion-weighted acquisition sequences were used to obtain multi-parametric maps of the extracted tooth (slice thickness of 200 µm and in plane resolution of 30 × 30 µm2). Results: T1 and T2 maps identified unfilled spaces around and close to Gutta-percha cones instead of CBCT images that were not able to highlight this aspect. T1, T2 and apparent diffusion coefficient (ADC) assumed different values in dentine and in voids, characterized by different dimensions. Moreover, they were able to discriminate between infiltrations of water only and deposits of biological material. Because Gutta-percha cones are constituted of hard, non-porous material, they do not provide a signal and in mMRI images appear as zones of noise. Conclusions: Unlike the CBCT exam, mMRI can detect soft tissue debris and unfilled spaces inside radicular canals. Therefore, this in vitro study showed the potential of mMRI to evaluate the quality of the root canal treatment, suggesting its potential benefit in determining the causes of endodontic failure, without the use of ionizing radiation.

Total Face Approach (TFA) 3D Cephalometry and Superimposition in Orthognathic Surgery: Evaluation of the Vertical Dimensions in a Consecutive Series.

Background: Cephalometry is fundamental in diagnosis, analysis, and planning of orthodontic-surgical treatment as it reveals skeletal relationship between the upper and lower jaw as well as facial aesthetic parameters. Nevertheless, 3D cephalometry has still not become the exam of choice in orthognathic treatment even though today CBCT (Cone Beam Computed Tomography) is routinely used in other branches of dentistry. Methods: In a sample of 13 patients undergoing bimaxillary orthognathic surgery a chin-vertex CBCT exam was prescribed prior to orthodontic treatment (OT) and 12 months after surgery (T1). The DICOM files uploaded to MaterialiseSimplant Ortho software pro 2.1 (Materialise Co., Leuven, Belgium) were analyzed following the multiplane 3D Total Face cephalometry protocol (TFA). Results: Results comparing pre-op and post-op TFA 3D cephalometry, were then evaluated considering reference values reported in literature. The CBCT, carried out pre- and post-surgery, were subsequently analyzed employing the superimposition method using cranial base as reference. The aim of this study is to evaluate the advantages and disadvantages of the two methods in orthognathic surgery. Conclusions: Multiplane 3D TFA allows the clinician to locate where major or minor skeletal discrepancies are found with respect to ideal parameters and is also useful in classifying skeletal intermaxillary relation. The superimposition method is highly intuitive but does not provide information on the quantity and location of osteotomic movement.

Evaluation of cone beam computed tomography imaging in placed dental implants: comparison between multiplanar reconstruction and parasagittal images / Avaliação de imagens de tomografia computadorizada de feixe cônico em implantes instalados: comparação entre reconstrução multiplanar e imagens parassagitais

This study aimed to compare multiplanar reconstruction (MPR) to parasagittal images of cone-beam computed tomography (CBCT) for localizing placed dental implants concerning adjacent anatomical structures (nasal fossa floor, maxillary sinus, inferior alveolar canal and nasopalatine canal).The CBCT exams of 164 placed implants were analyzed. All tomographic images were imported to Imaging Studio software to create parasagittal image templates. The images were randomized and analyzed by two oral and maxillofacial radiologists who classified whether or not there was perforation of the anatomical structure in question.According to Kappa coefficient of agreement, the results including, all anatomical structures for inter-observer assessment was 0.81 and for intra-observer assessment, 0.79 for observer one and 0.89 for observer two. For each anatomical structure, the agreement ranged from 'substantial' to 'almost perfect' (nasal fossa floor 0.72, nasopalatine canal 0.92, maxillary sinus 0.81, and inferior alveolar canal 0.81). Based on our findings, there was substantial to almost perfect agreement when comparing MPR and parasagittal images of CBCT regarding of implant position relationship with anatomical structures. Since both modalities did not differ in implant position, and the MPR represents the complete and original volume that enables analysis in three dimensions, they can be the first-choice imaging modality to analyze placed dental implants.

Facial soft tissue depth measurements in cone-beam computed tomography: A study of a Brazilian sample.

Forensic facial reconstruction (approximation) (FFR) is an aid to human identification when no presumed identity is available. It is based on average soft tissue thickness (STT) applied onto a skull. These averages vary at each landmark according to sex, ancestry, and Facial Growth Patterns (FGP). To obtain the reference, there are different protocols and conditions, such as needles in cadavers, ultrasound, magnetic resonance, and computer tomography. Using cone-beam computed tomography (CBCT), landmark placement and direction of measurement are critical. The purpose of this article is to detailly describe a method for STT measurement in CBCT DICOM files and to test it in the analysis of a multi-ancestral Brazilian sample, subdivided into sex, age and FGP. A sample of 100 (50 male and 50 female) CBCT exams were selected and the volume was primarily been repositioned to cephalometric standards. A detailed description of the location and measurement direction of 32 landmarks was provided and granted good reproducibility of the measurements. The averages were assessed by sex, age, and FGP. There were significant differences between males and females. The CBCT measuring protocol provided standardization of measurements and is a method to be used in future researches. Advantages of CBCT, such as the subject's upright position and adjustable volume positioning, also justify its usage. Limited differences of STT were related to age and FGP. The updated Brazilian soft tissue thickness chart is a reliable source of data for forensic and clinical purposes.

Cone-beam computed tomography in Endodontics: an exploratory research of the main clinical applications

This study revisited three oral radiology centers (ORC) and screened the main clinical indications that justified the request for cone-beam computed tomography (CBCT) examination in Endodontics. The databases of three ORCs were searched for requests of CBCT exams taken for Endodontic purposes over the last two years. The extracted data consisted of the total number of CBCT exams, the clinical indication in the endodontic field that justified the CBCT exam, the outcome of each exam (from the report of Oral Radiologists), and demographic data of the patients. From the total CBCT exams (n = 4,583), nearly 13% (n = 611) were taken for Endodontic purposes. Most of the clinical indications were related to root fractures (65%) and periapical lesions/disease (24.1%). Radiologists’ reports hypothesized more often toward periapical lesion/disease (70.5%), root fracture (51.4%) and accidents/complications (25.2%). Some clinical indications significantly varied based on age. In particular, post-traumatic imaging and the investigation of root resorption were more common in young patients, while the prevalence of exams for the investigation of pulpal calcifications and root fractures increased with age. More interestingly, there was a significant disagreement between the clinical indication that justified the CBCT examinations and the outcomes retrieved from radiologists’ reports (p &lt; 0.005). This study illustrates the broad spectrum of CBCT applications for the diagnosis, treatment planning and follow-up in Endodontics. Attention is necessary to the disagreements between clinical indications and imaging outcomes, especially because certain conditions in the routine Endodontics are only visible with the aid of advanced tools.

Dentin Thickness of Pulp Chamber Floor in Primary Molars: Evaluation by Cone-Beam Computed Tomography

Objective: Use cone-beam computed tomography (CBCT) images to evaluate the dentin thickness of the pulp chamber floor in primary molars . Material and Methods: Cross-sectional study, conducted with CBCT images of teeth of children. Primary molars with preserved pulp chamber floor were included. The dentin thickness of the pulp chamber floor in the primary molars was measured linearly in CBCT cross-sections. Data were descriptively analyzed and the Mann-Whitney test was applied (p<0.05). Results: 27 CBCT exams and 123 primary molars of children aged 4 to 13 years were analyzed; the majority was female (52.0%). In maxillary molars, the median dentin thickness was 1.50 (0.6–2.2) mm in the first and 1.65 (0.6–2.3) mm in the second (p=0.049) molars. In mandibular molars, the median was 1.20 (0.3–1.7) mm in the first and 1.60 (1.0–2.2) mm in the second (p<0.001) molars. Children aged 4 to 8 years showed less dentin thickness (p<0.001) . Conclusion: The median dentin thickness of the pulp chamber floor in primary molars was 1.50 mm, ranging from 0.3 to 2.3 mm. Less dentin thickness was associated with younger children, teeth in the mandibular arch, and first molars.