Avaliação qualitativa e quantitativa de reabsorções cervicais invasivas: estudo em tomografia computadorizada de feixe cônico

Abstract

The objective of this study was to quantitatively quantitatively and qualitatively evaluate invasive cervical resorption lesions (ICR) and analyze their density patterns to determine their predominant phase (active or reparative), using cone beam computed tomography (CBCT). Exams of 70 participants obtained from the collection belonging to the Dental Radiology discipline, from the Department of Dentistry of the Federal University of Juiz de Fora, Campus Governador Valadares –UFJF/GV, were evaluated. For each examination, ICR cases were selected and data collection included information regarding: demographic data such as patient's sex and age, affected tooth, presence of endodontic treatment, assessment of the quality of endodontic treatment and associated periapical changes. The three-dimensional classification of the lesions was carried out in accordance with the proposition of Patel and collaborators (2018), which considers the coronoapical extension of the lesion, circumferential extension and proximity to the root canal. The face and root third where the entrance door was located were identified, as well as measuring its largest diameter and identifying its periodontal location (intraosseous, at the level of the bone crest and supraosseous). To confirm this location, a measurement of the distance between the cemento-enamel junction and the most cervical part of the RCI, and the distance between the cemento-enamel junction and the bone crest was applied. Finally, to evaluate the density pattern in the images, using gray tones, 3 areas of interest were selected (lesion, healthy dentin and root canal lumen) in order to collect data regarding the mean and standard deviation of each region. All images were evaluated by two Endodontists using the OnDemand3D program using multiplanar reconstructions. Statistical analyzes were conducted using the JAMOVI software version 2.3.17, adopting a significance level of 95% (p < 0.05). The teeth most affected by RCI were the upper central incisors. It was not possible to determine a significant difference in the distribution of injuries according to gender. The most obtained 3D classification (Patel et al., 2018a) was 3 (coronoapical extension to the middle third), D (circumferential extension >207º) and p (probable pulp involvement). The entry point was found most frequently on the lingual/palatal surface, cervical third and with a suprabony periodontal location. The density pattern with repair was greater for anterior teeth. When the lesions were confined to dentin, the images showed a more hypodense character and when there was pulp involvement, a hyperdense characteristic, indicating a resorptive and reparative phase, respectively. This study provided a comprehensive analysis of RCI. The findings can contributes to a better understanding of RCI and assist in therapeutic planning for affected patients.