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Alzahrani O, Komo H, Howait M. Healing and Spontaneous Realignment of Displaced Roots With Periapical Granuloma After Microsurgical Endodontic Treatment (Three Years' Follow-up): A Case Report. Cureus 2024; 16:e52020. [PMID: 38205085 PMCID: PMC10777889 DOI: 10.7759/cureus.52020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2024] [Indexed: 01/12/2024] Open
Abstract
Endodontic therapy aims to treat or prevent apical periodontitis, a condition characterized by inflammation of the periapical tissues at the apex of the tooth root. This case study demonstrates the successful nonsurgical and surgical management of a large periapical lesion involving the lower central incisors with root displacement induced by a periapical granuloma. A patient was referred from the maxillofacial department for endodontic treatment due to persistent pain and swelling in the lower anterior region started two months ago. Upon arrival, a clinical examination and radiographic assessment were performed using cone-beam computed tomography (CBCT). The CBCT scan revealed a significant radiolucent area measuring (10x8) mm extending from the lower left lateral incisor to the right central incisor. The lower left central incisor was necrotic and tender to palpation and percussion. A nonsurgical root canal was performed followed by an apicectomy using mineral trioxide aggregate (MTA) to facilitate healing of the periapical lesion. Histopathological examination of the lesion confirmed the diagnosis of periapical granuloma. At follow-up 1, 2, and 3 years' visits, the periodontal assessment was performed and found to be free of pain upon percussion or palpation. No other clinical or radiological signs or symptoms were identified except for a small radiolucent area mesially adjacent to the root of the lower left central incisor. The development of materials such as MTA has significantly improved the prognosis of cases with large periapical lesions. In this case, healing and spontaneous realignment of the root were observed after three years.
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Affiliation(s)
- Omar Alzahrani
- Department of Advanced General Dentistry, Faculty of Dentistry, King Abdulaziz University Dental Hospital, Jeddah, SAU
| | - Hisham Komo
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, King Abdulaziz University Dental Hospital, Jeddah, SAU
| | - Mohammed Howait
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
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Sabeti M, Ihsan MS, Kharat P, Azarpazhooh A. The effect of hard tissue defects on the clinical outcome of endodontic microsurgery: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:7079-7089. [PMID: 37932638 PMCID: PMC10713757 DOI: 10.1007/s00784-023-05341-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/14/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES The purpose of this systematic review was to appraise the existing literature on the effect of hard tissue defects on the clinical outcome of endodontic microsurgery (EMS). METHODS MEDLINE (PubMed), Embase, Web of Science, Cochrane Library and grey literature were searched from January 2000 to May 2023. Study selection and data extraction were performed in duplicate. Eligible studies were critically appraised for the risk of bias using the Cochrane Risk of bias tool. The quality of evidence was assessed using GRADE. Review Manager (RevMan Computer program Version 5.4, The Cochrane Collaboration, 2020) was utilized and the Mantel Haenszel fixed or random effects model was applied, depending on the heterogeneity of the studies. Meta-analysis was performed to estimate the Risk ratio (RR) and 95% Confidence Interval (CIs) to correlate the effects of these factors on treatment outcomes. RESULTS Nineteen studies were included. The EMS overall pooled success rate was 84.5%. Five characteristics of hard tissue were identified. The size of the lesion (Small ≤ 5 mm: 78.4% vs. Large > 5 mm: 63.3%, RR = 1.12, 95% CI 1.00-1.26, P ≤ .05), significantly affected the outcomes of EMS. Endodontic lesions exhibited slightly better outcomes than endodontic-periodontal lesions (81.4% vs. 68.2%, RR = 1.14 95% CI 0.98-1.33, P > .05). Cases with the height of the buccal bone > 3 mm also exhibited slightly better outcomes (91.5% vs. 71.4%, RR = 1.20, 95% CI 0.88-1.62, P > .05). Additionally, through and through lesions exhibited better outcomes when grafting was completed during the EMS procedure both in 2D (RR = 1.12 95% CI 0.97-1.29, P > .05) and 3D evaluation ((RR = 1.28 95% CI 0.69-2.37 P > .05). The overall quality of evidence was graded as low to high. CONCLUSION With a low to high quality of evidence, the size of the lesion is a key prognostic variable that significantly affects the outcome of EMS, as lesions ≤ 5 mm exhibit better outcomes as compared to larger lesions. CLINICAL SIGNIFICANCE The presence of hard tissue defects can affect the outcome of endodontic microsurgery (EMS). The presented data can aid the clinicians' decision-making process by examining certain pre-operative prognostic variables, when considering EMS as a treatment option. Clinical cases with more favorable hard tissue characteristics lead to a better prognosis in EMS.
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Affiliation(s)
- Mohammad Sabeti
- Advanced Specialty Program in Endodontics, UCSF School of Dentistry, 707 Parnassus Ave. Room- D 3226, San Francisco, CA, 94143-0758, USA.
| | - Mohammad Saqib Ihsan
- UCSF Advanced Specialty Program in Endodontics, 707 Parnassus Ave. Room- D 3226, San Francisco, CA, 94143-0758, USA
| | - Piyusha Kharat
- UCSF, School of Dentistry, 707 Parnassus Ave, San Francisco, CA, 94143-0758, USA
| | - Amir Azarpazhooh
- University of Toronto, Faculty of Dentistry, 455-124 Edward St, Toronto, ON, M5G1G6, Canada
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Agrawal P, Nikhade P, Patel A, Bhopatkar J, Suryawanshi T. Pioneering Periapical Healing: The Novel Synergy of Mineral Trioxide Aggregate and Injectable Platelet-Rich Fibrin. Cureus 2023; 15:e46341. [PMID: 37920636 PMCID: PMC10618628 DOI: 10.7759/cureus.46341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/01/2023] [Indexed: 11/04/2023] Open
Abstract
This case report presents a novel non-surgical approach for managing a substantial periapical lesion associated with tooth 12 using a combination of injectable platelet-rich fibrin (i-PRF) and mineral trioxide aggregate (MTA). A 28-year-old male patient presented with pus discharge and intermittent swelling following a history of dental trauma. Clinical and radiographic assessments confirmed a large periapical cyst associated with tooth 12. The treatment involved root canal therapy with calcium hydroxide medication, leading to symptom relief. Subsequently, i-PRF combined with MTA was used as a regenerative material for periapical healing. Follow-up examinations at three, six, and nine months showed complete resolution of symptoms and radiographic evidence of lesion healing. This innovative technique demonstrates the potential of i-PRF and MTA synergy in the non-surgical management of periapical lesions, avoiding the risks associated with surgical interventions and promoting effective tissue healing.
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Affiliation(s)
- Paridhi Agrawal
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pradnya Nikhade
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aditya Patel
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Jay Bhopatkar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Tejas Suryawanshi
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Banomyong D, Arayasantiparb R, Sirakulwat K, Kasemsuwan J, Chirarom N, Laopan N, Lapthanasupkul P. Association between Clinical/Radiographic Characteristics and Histopathological Diagnoses of Periapical Granuloma and Cyst. Eur J Dent 2023; 17:1241-1247. [PMID: 36599448 PMCID: PMC10756824 DOI: 10.1055/s-0042-1759489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE The aim of this study was to determine the association between clinical/radiographic characteristics and histopathological diagnoses of periapical granuloma and cyst obtained from the teeth treated with endodontic microsurgery. MATERIALS AND METHODS The clinical, radiographic (periapical and cone-beam computed tomography), and histopathological data were collected from patients' dental records of endodontic microsurgery on the teeth with periapical lesions. These lesions were histopathologically diagnosed as either granuloma or cyst, at the Endodontic Clinic, Faculty of Dentistry, Mahidol University, Bangkok, Thailand, from 2016 to 2021 according to inclusion and exclusion criteria. The data were analyzed using bivariate analysis and a multinomial logistic regression at a significance level of p-value less than 0.05. RESULTS A total of 83 patients (58 females and 25 males) with an average age of 45 to 49.5 years old met the criteria including 68 periapical granulomas (81.9%) and 15 periapical cysts (18.1%). A periapical lesion involving multiple teeth in a periapical radiograph was significantly associated with the histopathological diagnosis of periapical cyst (p < 0.05). Such periapical lesion was six times more likely to be periapical cyst than periapical granuloma. CONCLUSIONS A significant factor for predicting periapical cyst from periapical granuloma was the presence of a periapical lesion with multiple-teeth involvement in a dental radiograph.
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Affiliation(s)
- Danuchit Banomyong
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
- Dental Department, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Raweewan Arayasantiparb
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | | | | | | | - Puangwan Lapthanasupkul
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Li N, Zhang R, Qiao W, Meng L. Conservative endodontic microsurgery to protect critical anatomical structures-selective curettage: a case series. BMC Oral Health 2023; 23:615. [PMID: 37653381 PMCID: PMC10470014 DOI: 10.1186/s12903-023-03287-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/04/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Endodontic microsurgery has yielded highly successful outcomes in preserving teeth with persistent or recurrent cases of periapical periodontitis that could not be successfully treated by nonsurgical endodontic approaches. To avoid complications in conditions in which periapical lesions invade anatomical structures such as the nasopalatine nerve tube and mandibular canal, selective curettage has been proposed as an alternative choice of complete curettage in surgery. CASE PRESENTATION The 8 cases reported herein had undergone root canal treatment and/or retreatment but still presented with symptoms, such as recurring sinus tracts and persistent dull pain. The radiographic examination indicated a large area of radiolucency that was associated with the tooth and had invaded adjacent critical anatomical structures. The patients opted for selective curettage via endodontic microsurgery, and the lesions were histologically confirmed as periapical cysts or granulomas. The follow-up results for one year or more indicated that the affected teeth were clinically asymptomatic and exhibited complete or incomplete healing radiographically. CONCLUSION This case series provides clinical evidence for the feasibility of selective curettage in endodontic microsurgery, which can avoid complications caused by damage to the adjacent critical anatomical structures.
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Affiliation(s)
- Nan Li
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Rui Zhang
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Weiwei Qiao
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Liuyan Meng
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China.
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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Shafi I, Sajad M, Fatima A, Aray DG, Lipari V, Diez IDLT, Ashraf I. Teeth Lesion Detection Using Deep Learning and the Internet of Things Post-COVID-19. SENSORS (BASEL, SWITZERLAND) 2023; 23:6837. [PMID: 37571620 PMCID: PMC10422255 DOI: 10.3390/s23156837] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/26/2023] [Accepted: 07/29/2023] [Indexed: 08/13/2023]
Abstract
With a view of the post-COVID-19 world and probable future pandemics, this paper presents an Internet of Things (IoT)-based automated healthcare diagnosis model that employs a mixed approach using data augmentation, transfer learning, and deep learning techniques and does not require physical interaction between the patient and physician. Through a user-friendly graphic user interface and availability of suitable computing power on smart devices, the embedded artificial intelligence allows the proposed model to be effectively used by a layperson without the need for a dental expert by indicating any issues with the teeth and subsequent treatment options. The proposed method involves multiple processes, including data acquisition using IoT devices, data preprocessing, deep learning-based feature extraction, and classification through an unsupervised neural network. The dataset contains multiple periapical X-rays of five different types of lesions obtained through an IoT device mounted within the mouth guard. A pretrained AlexNet, a fast GPU implementation of a convolutional neural network (CNN), is fine-tuned using data augmentation and transfer learning and employed to extract the suitable feature set. The data augmentation avoids overtraining, whereas accuracy is improved by transfer learning. Later, support vector machine (SVM) and the K-nearest neighbors (KNN) classifiers are trained for lesion classification. It was found that the proposed automated model based on the AlexNet extraction mechanism followed by the SVM classifier achieved an accuracy of 98%, showing the effectiveness of the presented approach.
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Affiliation(s)
- Imran Shafi
- College of Electrical and Mechanical Engineering, National University of Sciences and Technology (NUST), Islamabad 44000, Pakistan; (I.S.); (A.F.)
| | - Muhammad Sajad
- Abasyn University Islamabad Campus, Islamabad 44000, Pakistan;
| | - Anum Fatima
- College of Electrical and Mechanical Engineering, National University of Sciences and Technology (NUST), Islamabad 44000, Pakistan; (I.S.); (A.F.)
| | - Daniel Gavilanes Aray
- Higher Polytechnic School, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (D.G.A.); (V.L.)
- Universidad Internacional Iberoamericana, Campeche 24560, Mexico
- Fundación Universitaria Internacional de Colombia Bogotá, Bogotá 11131, Colombia
| | - Vivían Lipari
- Higher Polytechnic School, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (D.G.A.); (V.L.)
- Universidad Internacional Iberoamericana Arecibo, Puerto Rico, PR 00613, USA
- Universidade Internacional do Cuanza, Cuito EN250, Bié, Angola
| | - Isabel de la Torre Diez
- Department of Signal Theory, Communications and Telematics Engineering, Unviersity of Valladolid, Paseo de Belén, 15, 47011 Valladolid, Spain
| | - Imran Ashraf
- Department of Information and Communication Engineering, Yeungnam University, Gyeongsan 38541, Republic of Korea
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Berne JV, Saadi SB, Politis C, Jacobs R. A deep learning approach for radiological detection and classification of radicular cysts and periapical granulomas. J Dent 2023:104581. [PMID: 37295547 DOI: 10.1016/j.jdent.2023.104581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 05/27/2023] [Accepted: 06/06/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVES Dentists and oral surgeons often face difficulties distinguishing between radicular cysts and periapical granulomas on panoramic imaging. Radicular cysts require surgical removal while root canal treatment is the first-line treatment for periapical granulomas. Therefore, an automated tool to aid clinical decision making is needed. METHODS A deep learning framework was developed using panoramic images of 80 radicular cysts and 72 periapical granulomas located in the mandible. Additionally, 197 normal images and 58 images with other radiolucent lesions were selected to improve model robustness. The images were cropped into global (affected half of the mandible) and local images (only the lesion) and then the dataset was split into 90% training and 10% testing sets. Data augmentation was performed on the training dataset. A two-route convolutional neural network using the global and local images was constructed for lesion classification. These outputs were concatenated into the object detection network for lesion localization. RESULTS The classification network achieved a sensitivity of 1.00 (95% C.I. 0.63 - 1.00), specificity of 0.95 (0.86 - 0.99), and AUC (area under the receiver-operating characteristic curve) of 0.97 for radicular cysts and a sensitivity of 0.77 (0.46 - 0.95), specificity of 1.00 (0.93 - 1.00), and AUC of 0.88 for periapical granulomas. Average precision for the localization network was 0.83 for radicular cysts and 0.74 for periapical granulomas. CONCLUSIONS The proposed model demonstrated reliable diagnostic performance for the detection and differentiation of radicular cysts and periapical granulomas. Using deep learning, diagnostic efficacy can be enhanced leading to a more efficient referral strategy and subsequent treatment efficacy. CLINICAL SIGNIFICANCE A two-route deep learning approach using global and local images can reliably differentiate between radicular cysts and periapical granulomas on panoramic imaging. Concatenating its output to a localizing network creates a clinically usable workflow for classifying and localizing these lesions, enhancing treatment and referral practices.
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Affiliation(s)
- Jonas Ver Berne
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS-IMPATH Research Group, Department of Imaging and Pathology, Catholic University Leuven, Belgium.
| | - Soroush Baseri Saadi
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Catholic University Leuven, Belgium
| | - Constantinus Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS-IMPATH Research Group, Department of Imaging and Pathology, Catholic University Leuven, Belgium
| | - Reinhilde Jacobs
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS-IMPATH Research Group, Department of Imaging and Pathology, Catholic University Leuven, Belgium; Department of Dentistry, Karolinska Institutet, Stockholm, Sweden
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Chan F, Brown LF, Parashos P. CBCT in contemporary endodontics. Aust Dent J 2023; 68 Suppl 1:S39-S55. [PMID: 37975281 DOI: 10.1111/adj.12995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
Cone-beam computed tomography (CBCT) is a three-dimensional imaging modality which can aid endodontic diagnosis and treatment planning. While there are guidelines available describing the indications, there are divergent philosophies on when this technology should be applied in clinical practice. This paper reviews the applications of CBCT including the clinical relevance of parameters which can be assessed, highlights the limitations of this technology, and provides guidance on how to maximise its clinical utility.
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Affiliation(s)
- F Chan
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - L F Brown
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - P Parashos
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
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Mackiewicz E, Bonsmann T, Kaczor-Wiankowska K, Nowicka A. Volumetric Assessment of Apical Periodontitis Using Cone-Beam Computed Tomography-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2940. [PMID: 36833634 PMCID: PMC9966796 DOI: 10.3390/ijerph20042940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/28/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
This systematic review aimed to investigate the scientific literature on volumetric studies concerning the diagnosis and treatment of apical periodontitis using CBCT. A systematic review protocol was written following the preferred reporting items for the systematic reviews and meta-analyses (PRISMA) checklist. Four electronic databases were searched for relevant publications in English, which were published up to 21 January 2023. The inclusion criteria and corresponding search keys were applied. The risk of bias was assessed using the Joanna Briggs Institute Meta-Analysis of Statistic Assessment and Review Instrument. The search strategy identified 202 studies, with 123 studies excluded during the title and abstract screening and 47 studies left for full text screening. A total of 17 studies met the inclusion criteria. The lesion volume was measured and classified according to different indices which compared the effectiveness of their diagnostics. Moreover, the volume of AP lesions increased with the thickness of the maxillary sinus mucosa in primary and secondary infections and decreased due to endodontic treatment. Volumetric measurements using CBCT are useful in the correct definition of periapical tissue pathosis using a CBCT periapical volume index and assessment of the dynamics of the treatment of apical lesions.
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Affiliation(s)
- Ewa Mackiewicz
- Student Scientific Circle at the Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Tobias Bonsmann
- Student Scientific Circle at the Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Kinga Kaczor-Wiankowska
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Alicja Nowicka
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
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Zamaliauskiene R, Veberiene R. Successful treatment of cystic lesion combining Cystectomy, Nonsurgical Endodontics and Vital Pulp Therapy of Mature Permanent Mandibular Molars: a Case Report with 19 Months Follow-Up. J Oral Maxillofac Res 2023; 14:e4. [PMID: 37180405 PMCID: PMC10170662 DOI: 10.5037/jomr.2023.14104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 03/31/2023] [Indexed: 05/16/2023]
Abstract
Background Clinical examination revealed large periapical lesion. Patient was referred for endodontic treatment of right mandibular first and second molars before planed cystectomy. The aim of this case report is to present the clinical approach to preserve healthy pulp tissue by combining nonsurgical root canal treatment and vital pulp therapy for mature mandibular molar. Methods A minimally invasive endodontic therapy treatment with combination of nonsurgical root canal treatment and vital pulp therapy was performed. Osteotomies around wisdom teeth were performed, wisdom teeth extracted, and cyst was removed. Results At the 19 months follow-up appointment patient had no complaints, radiographically full regeneration of periapical bone was observed. Conclusions A minimally invasive endodontic therapy treatment with combination of nonsurgical root canal treatment and vital pulp therapy for mature mandibular molar before a planned cystectomy could be considered as a treatment option showing good long-term results.
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Affiliation(s)
| | - Rita Veberiene
- Department of Dental and Oral Pathology, Lithuanian University of Health Sciences, KaunasLithuania
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Patil S, Alkahtani A, Bhandi S, Mashyakhy M, Alvarez M, Alroomy R, Hendi A, Varadarajan S, Reda R, Raj AT, Testarelli L. Ultrasound Imaging versus Radiographs in Differentiating Periapical Lesions: A Systematic Review. Diagnostics (Basel) 2021; 11:1208. [PMID: 34359291 PMCID: PMC8303698 DOI: 10.3390/diagnostics11071208] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Ultrasonography is a non-invasive method of diagnosing periapical lesions while radiologic methods are more common. Periapical lesions due to endodontic infection are one of the most common causes of periapical radiolucency that need to be distinguished to help determine the course of treatment. This review aimed to examine the accuracy of ultrasound and compare it to radiographs in distinguishing these lesions in vivo. METHODS This review process followed the PRISMA guidelines. A literature search of databases (PubMed, Scopus, Embase, and Web of Science) was conducted without any restrictions on time. Articles available in English were included. The selection was done according to the inclusion and exclusion criteria. The QUADAS-2 tool was used to assess the quality of the studies. RESULTS The search provided a total of 87 articles, out of which, five were selected for the final review. In all the studies, ultrasound had higher accuracy in distinguishing periapical lesions. All the studies indicated a risk of bias, especially in patient selection. CONCLUSION Within limitations, the study indicates that ultrasound is a better diagnostic tool to distinguish periapical lesions compared to radiographs but further studies with well-designed, rigorous protocols and low risk of bias are needed to provide stronger evidence.
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Affiliation(s)
- Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Ahmed Alkahtani
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Shilpa Bhandi
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (S.B.); (M.M.)
| | - Mohammed Mashyakhy
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (S.B.); (M.M.)
| | - Mario Alvarez
- Division of Endodontics and Orthodontics, University of Southern California, Los Angeles, CA 90007, USA;
| | - Riyadh Alroomy
- Department of Restorative Dental Sciences, College of Dentistry, Majmaah University, AlMajmaah 11952, Saudi Arabia;
| | - Ali Hendi
- Department of Radiology, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia;
| | - Saranya Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India; (S.V.); (A.T.R.)
| | - Rodolfo Reda
- Department of Oral and Maxillofacial Sciences, Sapienza University, University of Rome, 00161 Rome, Italy;
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India; (S.V.); (A.T.R.)
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University, University of Rome, 00161 Rome, Italy;
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Umer F, Javed F. Decompression strategy for critical-sized lesions: A case series and literature review. AUST ENDOD J 2021; 47:731-740. [PMID: 34145932 DOI: 10.1111/aej.12536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/23/2021] [Accepted: 05/12/2021] [Indexed: 11/29/2022]
Abstract
Critical-sized lesions are defined as the smallest sized intraosseous wound in a particular bone that will not heal spontaneously during the lifetime of that animal. These critical-sized entities pose a unique challenge in endodontics, where these lesions are most likely cystic, with dimensions extending over 10 mm. This paper describes a structured methodology to treat such cases whilst also highlighting inconsistencies and variability between practitioners regarding management of critical-sized lesions. The case series demonstrates that non-surgical root canal therapy followed by surgical decompression may be the treatment of choice for such pathosis. A 16 gauge nasogastric tube was used as a decompression device and sutured to surrounding mucosa. Healing was evaluated using both two- and three-dimensional radiographs. Decompression of critical-sized lesions would appear to be a reliable, conservative and an altogether complete procedure that may not warrant second-stage surgery.
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Affiliation(s)
- Fahad Umer
- Operative Dentistry, Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Faizan Javed
- Operative Dentistry, Department of Surgery, Aga Khan University, Karachi, Pakistan
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Conservative Approach in the Management of Large Periapical Cyst-Like Lesions. A Report of Two Cases. ACTA ACUST UNITED AC 2021; 57:medicina57050497. [PMID: 34068934 PMCID: PMC8156608 DOI: 10.3390/medicina57050497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/28/2021] [Accepted: 05/13/2021] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Periapical cystic lesions are a pathology frequently addressed to endodontic specialists. Although their therapy is still not standardized, the treatment should be as conservative as possible and by endodontic means, as they are lesions of endodontic origin. The present case report describes two cases of upper central incisors with large cyst-like periapical lesions, and their one-year follow up. Materials and Methods: Endodontic orthograde treatment was performed under copious irrigation with sodium hypochlorite, in association with calcium hydroxide as an intra-canal medication for both teeth. Root canal filling was achieved in a separate appointment using the continuous wave of condensation technique. A decompression procedure was used in association with endodontic therapy in the second case to reduce the pressure inside the cystic lesion and to allow its drainage, and only because the root canal could not be dried three weeks after medication. Initial cone beam computed tomography (CBCT) investigations, as well as at the one-year follow up, were used to compare the evolution of the lesion. Results: Both cases had a favorable outcome. New bone formation in the periapical region and complete resolution of the lesion was observed at the one-year control in the first case. In the second case, although the lesion was still not completely healed at 12 months, a significant reduction in its size could be observed, showing active signs of healing. Conclusions: Endodontic treatment is the first choice option in the management of teeth with pulpal necrosis and large periapical cystic-like lesions. Decompression is the only surgical procedure recommended when the canals cannot be dried and obturated. Large surgical interventions are unnecessary in cases where endodontic treatment can be performed.
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孟 圆, 张 丽, 赵 雅, 柳 登, 张 祖, 高 岩. [Three-dimentional radiographic features of 67 maxillary radicular cysts]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2021; 53:396-401. [PMID: 33879917 PMCID: PMC8072440 DOI: 10.19723/j.issn.1671-167x.2021.02.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To analyze the three-dimensional radiographic characteristics of maxillary radi-cular cysts using cone-beam computed tomography (CBCT) and spiral CT. METHODS Clinical records, histopathological reports, and CBCT or non-enhanced spiral CT images of 67 consecutive patients with maxillary radicular cysts were retrospectively acquired, and radiographic features, including size, shape, expansion, internal structure and relationship with the surrounding tissues, were analyzed. The lesions were divided into three types according to the involved tooth number, as follows: type Ⅰ (single tooth), the epicenter of the cyst was located at the apex of a nonvital tooth, without involvement of the neighbo-ring tooth; type Ⅱ (adjacent tooth involvement), the cyst was located at the apex of a nonvital tooth with involvement of the mesial and/or distal tooth root; and type Ⅲ (multi-teeth), the cyst involved the apexes of ≥4 teeth. Besides, these cysts were classified as another three types on sagittal views, as follows: centripetal, the root apex was oriented centripetally to the center of the cyst; palatal, the cyst was located mainly at the palatal side of the apex; and labial/buccal, the cyst was located mainly at the labial/buccal side of the apex. RESULTS Totally, 67 patients with maxillary radicular cysts were acquired, including 38 males and 29 females, and their ages ranged from 13 to 77 years. Among them, 46 lesions (68.7%) were located in the anterior maxilla and 65 (97.0%) were round or oval. Labial/buccal cortex expansion was present in 43 cases (64.2%) and palatal cortex expansion in 37 cases (55.2%). The nasal floor was invaded in 27 cases (40.3%), the maxillary sinus was invaginated in 26 cases (38.8%), and root resorption was present in 9 cases (13.4%). The average diameter of lesions was (20.89±8.11) mm mesio-distally and (16.70±5.88) mm bucco-palatally. In spite of the 4 residual cysts, the remaining 63 lesions included 14 type Ⅰ, 26 type Ⅱ and 23 type Ⅲ cysts according to the involved tooth number. Besides, the 63 lesions included 46 centripetal, 15 palatal and 2 buccal cysts on sagittal views. CONCLUSION The maxillary radicular cysts were frequently well-circumscribed round or oval radiolucency, with significantly different sizes. According to the involved tooth number, it can be divided into single tooth, adjacent tooth involvement and multi-teeth types. On sagittal views, the root-cyst relationship was centripetal in most cases, while a minority of cysts expanded palatally or buccally.
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Affiliation(s)
- 圆 孟
- 北京大学口腔医学院·口腔医院,口腔颌面医学影像科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 丽琪 张
- 北京大学口腔医学院·口腔医院,口腔颌面医学影像科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 雅宁 赵
- 北京大学口腔医学院·口腔医院,口腔颌面医学影像科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 登高 柳
- 北京大学口腔医学院·口腔医院,口腔颌面医学影像科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 祖燕 张
- 北京大学口腔医学院·口腔医院,口腔颌面医学影像科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 岩 高
- 北京大学口腔医学院·口腔医院,口腔病理科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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AlMadi DM, Al-Hadlaq MA, AlOtaibi O, Alshagroud RS, Al-Ekrish AA. Accuracy of mean grey density values obtained with small field of view cone beam computed tomography in differentiation between periapical cystic and solid lesions. Int Endod J 2020; 53:1318-1326. [PMID: 32614972 DOI: 10.1111/iej.13355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 11/29/2022]
Abstract
AIM To determine if small and medium field of view (FOV) cone beam computed tomography (CBCT) adjusted grey density values can be used to distinguish between periapical cystic and solid lesions. METHODOLOGY Fifty-seven patients with periapical lesions having retrievable small or medium FOV CBCT images and biopsy samples were included. Two oral and maxillofacial pathologists examined the biopsy samples to provide the gold standard diagnosis of cystic or solid lesion. From the CBCT images, two independent examiners recorded the minimum adjusted grey density value of each lesion twice. Intra-examiner and inter-examiner reliability of the measurements were analysed, and sensitivity, specificity and accuracy of the minimum grey values in distinguishing a solid from cystic lesion were calculated. A receiver operating curve for diagnostic ability of adjusted grey density values to differentiate between periapical cystic and solid lesions was obtained, and the area under the curve (AUC) was calculated. RESULTS The intra- and inter-examiner reliability of the grey density values of the lesions and dentine were excellent. The AUC was 0.44 (P-value = 0.45). The adjusted grey density value with the greatest accuracy for differentiating between cystic and solid lesions had an accuracy, sensitivity and specificity of 0.54, 1.00 and 0.075, respectively. CONCLUSIONS Small FOV CBCT adjusted grey density values obtained by the device used in the study could not distinguish between periapical cystic and solid lesions. Further developments in CBCT devices are needed to improve the accuracy of grey density measurements.
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Affiliation(s)
- D M AlMadi
- King Saud University, College of Dentistry, Riyadh, Saudi Arabia
| | - M A Al-Hadlaq
- Department of Oral Medicine and Diagnostic Sciences, Division of Oral Medicine, King Saud University, College of Dentistry, Riyadh, Saudi Arabia
| | - O AlOtaibi
- Department of Oral Medicine and Diagnostic Sciences, Division of Oral Biology/Microbiology/Pathology, King Saud University, College of Dentistry, Riyadh, Saudi Arabia
| | - R S Alshagroud
- Department of Oral Medicine and Diagnostic Sciences, Division of Oral Biology/Microbiology/Pathology, King Saud University, College of Dentistry, Riyadh, Saudi Arabia
| | - A A Al-Ekrish
- King Saud University, College of Dentistry, Riyadh, Saudi Arabia
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Karamifar K, Tondari A, Saghiri MA. Endodontic Periapical Lesion: An Overview on the Etiology, Diagnosis and Current Treatment Modalities. Eur Endod J 2020; 5:54-67. [PMID: 32766513 PMCID: PMC7398993 DOI: 10.14744/eej.2020.42714] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 07/09/2020] [Indexed: 12/16/2022] Open
Abstract
Nonsurgical and surgical endodontic treatments have a high success rate in the treatment and prevention of apical periodontitis when carried out according to standard and accepted clinical principles. Nevertheless, endodontic periapical lesions remain in some cases, and further treatment should be considered when apical periodontitis persists. Although several treatment modalities have been proposed for endodontically treated teeth with persistent apical periodontitis, there is a need for less invasive methods with more predictable outcomes. The advantages and shortcomings of existing approaches for the diagnosis and treatment of endodontic periradicular lesions are discussed in this review.
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Affiliation(s)
- Kasra Karamifar
- From the Department of Restorative Dentistry, Rutgers School of Dental Medicine, New Jersey, USA
| | - Afsoon Tondari
- Department of Restorative Dentistry, Dental Branch, Shiraz Azad University, Shiraz, Iran
| | - Mohammad Ali Saghiri
- From the Department of Restorative Dentistry, Rutgers School of Dental Medicine, New Jersey, USA
- Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, USA
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Etöz M, Amuk M, Avcı F, Yabacı A. Investigation of the effectiveness of CBCT and gray scale values in the differential diagnosis of apical cysts and granulomas. Oral Radiol 2020; 37:109-117. [PMID: 32613300 DOI: 10.1007/s11282-020-00459-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/20/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE The aim of this study was to investigate the effectiveness of cone-beam CT (CBCT) findings and gray scale values (GSV) in the differential diagnosis of apical cysts and granulomas. METHODS Two independent researchers retrospectively analyzed the CBCT images of 21 teeth and histopathologically diagnosed them as having radicular cysts or apical granulomas. In the CBCT images, apical lesions were evaluated and categorized according to 7 criteria. These criteria were determined as relationship of lesions with dental roots, periphery of the lesion, shape, darker focus in the center, root resorption, displacement in related teeth, and cortical bone perforation. In addition, the minimum and maximum gray scale values of the lesions were measured and compared. RESULTS There was a statistically significant relationship between histopathological (HP) diagnosis and well-defined cortical border and lesion shape (p = 0.003, p = 0.014, respectively). According to the HP diagnosis, no statistically significant difference was found among other variables (p > 0.05) CONCLUSION: The presence of a well-defined cortical border or partial cortical border is a distinctive criterion for cysts. Additionally, the shape of the lesion was found to be a significant criterion for the separation of the two lesions. The shape of cystic lesions was circular and apical granulomas had a more curved shape. There was no relationship between the histopathological diagnosis of lesions and CBCT gray scale values.
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Affiliation(s)
- Meryem Etöz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Turkey.
| | - Mehmet Amuk
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Turkey
| | - Fatma Avcı
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Turkey
| | - Ayşegül Yabacı
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
- Department of Biostatistics, Faculty of Medicine, Uludag University, Bursa, Turkey
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18
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Hawkins TK, Wealleans JA, Pratt AM, Ray JJ. Targeted endodontic microsurgery and endodontic microsurgery: a surgical simulation comparison. Int Endod J 2020; 53:715-722. [DOI: 10.1111/iej.13243] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/30/2019] [Indexed: 12/12/2022]
Affiliation(s)
- T. K. Hawkins
- Department of Endodontics US Air Force Postgraduate Dental School Uniformed Services University JBSA‐Lackland TX USA
| | - J. A. Wealleans
- Department of Endodontics US Air Force Postgraduate Dental School Uniformed Services University JBSA‐Lackland TX USA
| | - A. M. Pratt
- Department of Endodontics US Air Force Postgraduate Dental School Uniformed Services University JBSA‐Lackland TX USA
| | - J. J. Ray
- Department of Endodontics US Air Force Postgraduate Dental School Uniformed Services University JBSA‐Lackland TX USA
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Du M, Haag D, Song Y, Lynch J, Mittinty M. Examining Bias and Reporting in Oral Health Prediction Modeling Studies. J Dent Res 2020; 99:374-387. [DOI: 10.1177/0022034520903725] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Recent efforts to improve the reliability and efficiency of scientific research have caught the attention of researchers conducting prediction modeling studies (PMSs). Use of prediction models in oral health has become more common over the past decades for predicting the risk of diseases and treatment outcomes. Risk of bias and insufficient reporting present challenges to the reproducibility and implementation of these models. A recent tool for bias assessment and a reporting guideline—PROBAST (Prediction Model Risk of Bias Assessment Tool) and TRIPOD (Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis)—have been proposed to guide researchers in the development and reporting of PMSs, but their application has been limited. Following the standards proposed in these tools and a systematic review approach, a literature search was carried out in PubMed to identify oral health PMSs published in dental, epidemiologic, and biostatistical journals. Risk of bias and transparency of reporting were assessed with PROBAST and TRIPOD. Among 2,881 papers identified, 34 studies containing 58 models were included. The most investigated outcomes were periodontal diseases (42%) and oral cancers (30%). Seventy-five percent of the studies were susceptible to at least 4 of 20 sources of bias, including measurement error in predictors ( n = 12) and/or outcome ( n = 7), omitting samples with missing data ( n = 10), selecting variables based on univariate analyses ( n = 9), overfitting ( n = 13), and lack of model performance assessment ( n = 24). Based on TRIPOD, at least 5 of 31 items were inadequately reported in 95% of the studies. These items included sampling approaches ( n = 15), participant eligibility criteria ( n = 6), and model-building procedures ( n = 16). There was a general lack of transparent reporting and identification of bias across the studies. Application of the recommendations proposed in PROBAST and TRIPOD can benefit future research and improve the reproducibility and applicability of prediction models in oral health.
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Affiliation(s)
- M. Du
- School of Public Health, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - D. Haag
- School of Public Health, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Y. Song
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - J. Lynch
- School of Public Health, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Population Health Sciences, University of Bristol, Bristol, UK
| | - M. Mittinty
- School of Public Health, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
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Dembinskaite A, Veberiene R, Machiulskiene V. Successful treatment of dens invaginatus type 3 with infected invagination, vital pulp, and cystic lession: A case report. Clin Case Rep 2018; 6:1565-1570. [PMID: 30147906 PMCID: PMC6099029 DOI: 10.1002/ccr3.1647] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/07/2018] [Accepted: 05/23/2018] [Indexed: 12/14/2022] Open
Abstract
All efforts should be aimed to safe permanent tooth for adolescents. Presented rare case confirms a possibility to save a tooth with Oehlers Type 3 anomaly with peri-invaginated periodontitis and to preserve vitality of the tooth pulp, even when surgical cyst removal is performed.
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Affiliation(s)
- Ausra Dembinskaite
- Clinic of Dental and Oral PathologyFaculty of OdontologyLithuanian University of Health SciencesKaunasLithuania
| | - Rita Veberiene
- Clinic of Dental and Oral PathologyFaculty of OdontologyLithuanian University of Health SciencesKaunasLithuania
| | - Vita Machiulskiene
- Clinic of Dental and Oral PathologyFaculty of OdontologyLithuanian University of Health SciencesKaunasLithuania
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