Prevalencia de periodontitis apical en dientes no tratados endodónticamente evaluados en CBCT
Introducción El diagnóstico temprano de periodontitis apical se realiza a través de imágenes diagnósticas. La tomografía computarizada de haz cónico (CBCT) actualmente es considerada la técnica radiográfica con mejores capacidades para identificar éste evento. El objetivo de este estudio fue determi...
- Autores:
-
Buitrago Rojas, Sandra Milena
- Tipo de recurso:
- Trabajo de grado de pregrado
- Fecha de publicación:
- 2019
- Institución:
- Universidad Santo Tomás
- Repositorio:
- Repositorio Institucional USTA
- Idioma:
- OAI Identifier:
- oai:repository.usta.edu.co:11634/16565
- Acceso en línea:
- http://hdl.handle.net/11634/16565
- Palabra clave:
- Apical periodontitis
Tooth not treated endodontically
Conventional cone beam tomography
Radiographic technique
Endodoncia
Enfermedades de los dientes
Tomografía computarizada por Rayos X
Dientes - Radiografías
Periodontitis apical
Diente no tratado endodónticamente
Tomografía convencional de haz cónico
Técnica radiográfica
- Rights
- openAccess
- License
- Atribución-NoComercial-SinDerivadas 2.5 Colombia
| id |
SANTOTOMAS_92df14de1a0e71295da9eb1be24ecb69 |
|---|---|
| oai_identifier_str |
oai:repository.usta.edu.co:11634/16565 |
| network_acronym_str |
SANTOTOMAS |
| network_name_str |
Repositorio Institucional USTA |
| repository_id_str |
|
| dc.title.spa.fl_str_mv |
Prevalencia de periodontitis apical en dientes no tratados endodónticamente evaluados en CBCT |
| title |
Prevalencia de periodontitis apical en dientes no tratados endodónticamente evaluados en CBCT |
| spellingShingle |
Prevalencia de periodontitis apical en dientes no tratados endodónticamente evaluados en CBCT Apical periodontitis Tooth not treated endodontically Conventional cone beam tomography Radiographic technique Endodoncia Enfermedades de los dientes Tomografía computarizada por Rayos X Dientes - Radiografías Periodontitis apical Diente no tratado endodónticamente Tomografía convencional de haz cónico Técnica radiográfica |
| title_short |
Prevalencia de periodontitis apical en dientes no tratados endodónticamente evaluados en CBCT |
| title_full |
Prevalencia de periodontitis apical en dientes no tratados endodónticamente evaluados en CBCT |
| title_fullStr |
Prevalencia de periodontitis apical en dientes no tratados endodónticamente evaluados en CBCT |
| title_full_unstemmed |
Prevalencia de periodontitis apical en dientes no tratados endodónticamente evaluados en CBCT |
| title_sort |
Prevalencia de periodontitis apical en dientes no tratados endodónticamente evaluados en CBCT |
| dc.creator.fl_str_mv |
Buitrago Rojas, Sandra Milena |
| dc.contributor.advisor.spa.fl_str_mv |
Castellanos Domínguez, Yeny Zulay Moreno Monsalve, Jaime Omar |
| dc.contributor.author.spa.fl_str_mv |
Buitrago Rojas, Sandra Milena |
| dc.subject.keyword.spa.fl_str_mv |
Apical periodontitis Tooth not treated endodontically Conventional cone beam tomography Radiographic technique |
| topic |
Apical periodontitis Tooth not treated endodontically Conventional cone beam tomography Radiographic technique Endodoncia Enfermedades de los dientes Tomografía computarizada por Rayos X Dientes - Radiografías Periodontitis apical Diente no tratado endodónticamente Tomografía convencional de haz cónico Técnica radiográfica |
| dc.subject.lemb.spa.fl_str_mv |
Endodoncia Enfermedades de los dientes Tomografía computarizada por Rayos X Dientes - Radiografías |
| dc.subject.proposal.spa.fl_str_mv |
Periodontitis apical Diente no tratado endodónticamente Tomografía convencional de haz cónico Técnica radiográfica |
| description |
Introducción El diagnóstico temprano de periodontitis apical se realiza a través de imágenes diagnósticas. La tomografía computarizada de haz cónico (CBCT) actualmente es considerada la técnica radiográfica con mejores capacidades para identificar éste evento. El objetivo de este estudio fue determinar la prevalencia de periodontitis apical en 1858 dientes sin tratamiento endodóntico, evaluados en 152 tomografías computarizadas de haz cónico tomadas a pacientes que asistieron a consulta odontológica en la Universidad Santo Tomás Seccional Bucaramanga. Metodología Mediante un estudio analítico de corte transversal, fueron incluidas las tomografías computarizadas de haz cónico de dientes permanentes de personas de ambos sexos tomadas entre 2016 y 2017. Se evaluó la presencia de periodontitis apical mediante el índice CBCT PAI. La asociación entre el evento y variables como género, edad, diente afectado y cantidad de dientes que presentaron la patología por tomografía evaluada, se realizó mediante prueba de Chi2, valores de p0.05 se consideraron de significancia estadística. Resultados La prevalencia de Periodontitis apical encontrada fue de 19.7%. El 83.6% de estas lesiones (n=306) se ubicaron en el criterio CBCT PAI I ((>0.5 mm–1mm). Los dientes más afectados fueron el 13, 24 y 23 respectivamente. Respecto a la cantidad total de dientes afectados por tomografía evaluada, se evidenció que 19.7% de las tomografías analizadas (n=30) tenían un diente con evidencia de la patología y el 19.1% (n=29) dos dientes afectados. Conclusiones La prevalencia encontrada (19.7%) fue relativamente alta comparada con otros estudios reportados. En una Tomografía axial computarizada es posible observar Periodontitis apical de tamaño incipiente. |
| publishDate |
2019 |
| dc.date.accessioned.spa.fl_str_mv |
2019-05-08T21:25:53Z |
| dc.date.available.spa.fl_str_mv |
2019-05-08T21:25:53Z |
| dc.date.issued.spa.fl_str_mv |
2019-04-29 |
| dc.type.none.fl_str_mv |
bachelor thesis |
| dc.type.local.spa.fl_str_mv |
Tesis de pregrado |
| dc.type.version.none.fl_str_mv |
info:eu-repo/semantics/acceptedVersion |
| dc.type.category.spa.fl_str_mv |
Formación de Recurso Humano para la Ctel: Trabajo de grado de Maestría |
| dc.type.coar.none.fl_str_mv |
http://purl.org/coar/resource_type/c_7a1f |
| dc.type.drive.none.fl_str_mv |
info:eu-repo/semantics/bachelorThesis |
| format |
http://purl.org/coar/resource_type/c_7a1f |
| status_str |
acceptedVersion |
| dc.identifier.citation.spa.fl_str_mv |
Buitrago Rojas, S. M. (2019). Prevalencia de periodontitis apical en dientes no tratados endodónticamente evaluados en CBCT [Tesis de Maestría]. Universidad Santo Tomás, Bucaramanga, Colombia |
| dc.identifier.uri.none.fl_str_mv |
http://hdl.handle.net/11634/16565 |
| dc.identifier.repourl.spa.fl_str_mv |
repourl:https://repository.usta.edu.co |
| identifier_str_mv |
Buitrago Rojas, S. M. (2019). Prevalencia de periodontitis apical en dientes no tratados endodónticamente evaluados en CBCT [Tesis de Maestría]. Universidad Santo Tomás, Bucaramanga, Colombia repourl:https://repository.usta.edu.co |
| url |
http://hdl.handle.net/11634/16565 |
| dc.relation.references.spa.fl_str_mv |
Miller WD. An introduction to the study of the bacterio-pathology of the dental pulp. Dent Cosm. 1894:36,505-28 Andreasen JO, Rud J. Correlation between histology and radiography in the assessment of healing after endodontic surgery. Int J Oral Surg 1972;1(3):161–173 Pak JG, Fayazi S, White SN. Prevalence of periapical radiolucency and root canal treatment: a systematic review of cross-sectional studies. J Endod 2012 38: 1170-1176. Eckerbom M, Andersson JE, Magnusson T. Interobserver variation in radiographic examination of endodontic variables. Endod Dent Traumatology 1986; 2(6):243-246 Berlinck T, Tinoco JMM, Carvalho FF, Sassone LM, Tinoco EMB. Epidemiological evaluation of apical periodontitis prevalence in an urban Brazilian population. Bras. Oral Res. 2015; 29(1): 1-7 Hernández Ríos M, Sorsa T, Obregón F, Tervahartiala T, Valenzuela MA, Pozo P, Dutzan N, Lesaffre E, Molas M, Gamonal J. Proteolytic roles of matrix metalloproteinases (MMP)-13 during progression of chronic periodontitis: initial evidence for MMP-13/MMP-9 activation cascade. J Clin Periodontol 2009; 36:1011–1017 Andreasen JO, Rud J. Correlation between histology and radiography in the assessment of healing after endodontic surgery. Int J Oral Surg 1972;1(3):161–173 Lofthag-Hansen S, Huumonen S, Gröndahl K, Gröndahl H. Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103(1):114-119 Torabinejad M, Rice D, Maktabi O, Oyoyo U, Abramovitch K. Prevalence and size of periapical radiolucencies using cone beam tomography in teeth without apparent intraoral radiographic lesions: A new periapical index with a clinical recomendation. J Endod 2018; 44(3):389-394 Rocas I.N. Siqueira J.F. Root Canal Microbiota of Teeth with Chronic Apical Periodontitis. J. Clin.Microbiol. Nov. 2008; 46 (11): 3599 – 3606 Nair PN. Pathogenesis of apical periodontitis and the causes of endodontic failures. Crit Rev Oral Biol Med. 2004;15: 348-81 Nair PNR. On the causes of persistent apical periodontitis: A review. J Endod 2006;39: 249–281 Abella F, Morales K, Garrido I, et al. Endodontic applications of cone beam computed tomography: case series and literature review. Giornale Italiano di Endodonzia 2015:29,38-50. 53. Al-Salehia S.K, Hornerb K. Impact of cone beam computed tomography (CBCT) on diagnostic thinking in endodontics of posterior teeth: A before- after study. J Den. 2016;53:57–63 Abella F, Patel S, Duran-Sindreu F, Mercadé M, Bueno R, Roig In. Evaluating the periapical status of teeth with irreversible pulpitis by using cone-beam computed tomography scanning and periapical radiographs. J Endod 2012;38(12): 1588–91 Aranda V. Niveles de mieloperoxidasa en fluido gingival crevicular de dientes con periodontitis apical asintomática. Universidad de Chile. Facultad de Odontología. Trabajo de grado. 2011 Bender IB, Seltzer S. Roentgenographic and direct observation of experimental lesions in bone: I. J Endod. 2003; 29(11):702–706 Bender IB, Seltzer S. Roentgenographic and direct observation of experimental lesions in bone: II. 1961. J Endod 2003; 29 (11): 707–712 Bergenholtz G. Textbook of endodontology. Second edition. Edit. Wiley Blackwell. 2012 Brynolf I. Roentgenologic periapical diagnosis. One, two or more roentgenograms? Sven Tandlak Tidsk. 1970; 63(5):345–50 Chapman M, Nadgir MD, Akman AS, Saito N, Sekiya K, Kaneda T, et al. Periapical lucency around the tooth: Radiologic evaluation and differential diagnosis. Radiographics. 2013;(33):15-32 Correa LR, Spin-Neto R, Stavropoulos A, Schropp L, da Silveira HED, Wenzel A. Planning of dental implant size with digital panoramic radiographs, CBCT-generated panoramic images, and CBCT cross-sectional images. Clin Oral Implants Res. 2014; 25(6):690–5 Correia-Sousa J, Madureira A, Fontes M, et al. Apical periodontitis and related risk factors: Cross-sectional study. Revista Portuguesa de Estomatologia, Medicina Dentária e Cirurgia Maxilofacial 2015; 56(4):226-232 CR Stockdale, NP Chandler. The nature of the periapical lesión--a review of 1108 cases. J Dent 1988; 16(3): 123-l 29 De Almeida Filho N. Epidemiología sin números Organización Panamericana de la Salud. 1992; 23 Dutta A, Smith-Jack F, Saunders WP. Prevalence of periradicular periodontitis in a Scottish subpopulation found on CBCT images. Int Endod J 2014;47(9): 854–63 Estrela C, Reis M, Rodrigues C, Azevedo B, Azevedo J. Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. Journal of Endodontics. 2008; 34 (11): 1325-1331 Estrela C, Reis M, Correa B. A new periapical index based on cone beam computed tomography. J Endod 2008: 34 Faitaroni LA, Bueno MR, De Carvalhosa AA, Bruehmueller Ale KA, Estrela C. Ameloblastoma Suggesting Large Apical Periodontitis. J Endod. 2008;34(2): 216–219 Frisk F, Hugoson A, Hakeberg M. Technical quality of root fillings and periapical status in root filled teeth in Jönköping, Sweden. Int Endod J. 2008; 41(11):958–68 Gao Y, Haapasalo M, Shen Y, Wu H, Jiang H, Zhou X. Development of virtual simulation platform for investigation of the radiographic features of periapical bone lesion. J Endod. 2010; 36(8):1404-9 Garg P, Chaman C. Apical periodontitis: is it accountable for cardiovascular diseases? J Clin Diagn Res. 2016; 10(8):ZE08-ZE12 Hernández Ríos M, Sorsa T, Obregón F, Tervahartiala T, Valenzuela MA, Pozo P, Dutzan N, Lesaffre E, Molas M, Gamonal J. Proteolytic roles of matrix metalloproteinases (MMP)-13 during progression of chronic periodontitis: initial evidence for MMP-13/MMP-9 activation cascade. J Clin Periodontol 2009; 36:1011–1017 Haapasalo M, Shen Y, Ricucci D. Reasons for persistent and emerging post-treatment endodontic disease. Endod Top. 2011;18:31–50 Huumonen S, Orstavik D. Radiological aspects of apical periodontitis. Endodontic Topics 2002;1:3–25 IV Estudio Nacional de Salud Bucal ENSAB IV. Situación en Salud Bucal. Ministerio de Salud y Protección Social. 2015 Jiménez-Pinzon A. Segura Egea JJ. Valoración clínica y radiológica del estado periapical: registros e índices periapicales. Endodoncia. 2003; 21(4): 220-228 Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surgery, Oral Med Oral Pathol. 1965; 20:3340–349 Jiménez-Pinzon A. Segura Egea JJ. Valoración clínica y radiológica del estado periapical: registros e índices periapicales. Endodoncia. 2003; 21(4): 220-228 Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surgery, Oral Med Oral Pathol. 1965; 20:3340–349 Kanagasingam S, Lim C, Yong C, Mannocci F, Patel S. Diagnostic accuracy of periapical radiography and cone beam computed tomography in detecting apical periodontitis using histopathological findings as a reference standard. J Endod 2016:50 417–426 Khalighinejad N, Aminoshariae M, Aminoshariae A. Association between Systemic diseases and apical periodontitis. J Endod 2016: 42(10): 1427-1434 Lofthag-Hansen S, Huumonen S, Gröndahl K, Gröndahl H. Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103(1):114-119 López-López J, Jané-Salas E, Estrugo-Devesa A, Velasco-Ortega E, Martín-González J, Segura-Egea JJ. Periapical and endodontic status of type 2 diabetic patients in Catalonia, Spain: a cross-sectional study. J Endod 2011; 37(5):598–601 Miller WD. An introduction to the study of the bacterio-pathology of the dental pulp. Dent Cosm. 1894:36,505-28 Matos E, Filho M, Martins A, et al. Correlation between the periapical index and lesion volume in Cone-beam computed tomography image Iran Endod J. 2018; 13(2): 155-158 Melo L, Ferreira I, Lacet G, Braga AC, Pina-Vaz I. Apical periodontitis and oral status in patients with different systemic conditions and smoking habits in Portuguese population. J Endod. 2017; 35:10-22 m Mol A, Dunn SM, van der Stelt PF. Diagnosing of periapical bone lesions on radiographs by means of texture analysis. Oral Surg Oral Med Oral Pathol. 1992;73(6):746–50 Moreno JO, Alves FR, Goncalves LS, Martinez AM, Rocas IN, Siqueira JF, Jr. Periradicular status and quality of root canal fillings and coronal restorations in an urban Colombian population. J Endod. 2013;39: 600-604 Nair PN. Pathogenesis of apical periodontitis and the causes of endodontic failures. Crit Rev Oral Biol Med. 2004;15: 348-81 Nair PNR. On the causes of persistent apical periodontitis: A review. J Endod 2006;39: 249–281 Nardi C, Calistri L, Grazzini G, et al. Is panoramic radiography an accurate imaging technique for the detection of endodontically treated asymptomatic apical periodontitis. J Endod 2018; 44(10):1500-1508 Nardi C, Calistri L, Pradella S, et al. Accuracy of orthopantomography for apical periodontitis without endodontic treatment. J Endod 2017;43:1640–1646 Nejaim Y. Streamlining the radiation dose. Rev Estomatol Herediana. 2015:25(3): 238-245 Ng Y, Mann V. Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. J Endod. 2011:44. 583–609 Oser D, Henson B, Shiang E, Finkelman MD, Amato RB. Incidental findings in small field of view cone-beam computed tomography scans. J Endod. 2017;43(6):901-904 Pak JG, Fayazi S, White SN. Prevalence of periapical radiolucency and root canal treatment: a systematic review of cross-sectional studies. J Endod 2012 38: 1170-1176. Paes da Silva LM, Fernandes R, Ordinola-Zapata R, et al. Prevalence of apical periodontitis detected in cone beam CT images of a Brazilian subpopulation. Dentomaxillofacial Radiology, 2013:42(1):80179163 Patel S, Wilson R, Dawood A, Mannocci F. The detection of periapical pathosis using periapical radiography and cone beam computed tomography Part 1: pre-operative status. J Endod 2011;45: 702–710 Paula Silva FWG, Min-Kai W, Leonardo M, et al. Accuracy of periapical radiography and cone-beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard. J Endod 2009: 35(7):1009-12 Persoon I, Özok R. Definitions and Epidemiology of Endodontic Infections. Curr Oral Health Rep. 2017; 4(4): 278–285 Petersson A, Axelsson S, Davidson T, Frisk F, Hakeberg M, Kvist T, Norlund A, Bergenholtz G. Radiological diagnosis of periapical bone tissue lesions in endodontics: a systematic review. Int Endod J. 2012; 45(9):783–801 Rocas I.N. Siqueira J.F. Root Canal Microbiota of Teeth with Chronic Apical Periodontitis. J. Clin.Microbiol. Nov. 2008; 46 (11): 3599 – 3606 Resolución número 8430 de 1993. Por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud. Ministerio de salud y protección social. Rohlin M, Kullendorff B, Ahlquist M, Henrikson CO, Hollender L, Stenstrom B. Comparison between panoramic and periapical radiography in the diagnosis of periapical bone lesions. Dentomax Radiol 1989;18:151–5 Rosenberg PA, Frisbie J, Lee J, Lee K, Frommer H, Kottal S, Phelan J, Lin L, Fisch G. Evaluation of pathologists (histopathology) and radiologists (cone beam computed tomography) differentiating radicular cysts from granulomas. J Endod. 2010;36(3): 423–428 Saad A, Suliman A, Hussan A, et al. Prevalence of apical periodontitis and quality of root canal treatment in an adult Saudi population. Saudi Med J 2017: 38(4):413-421. 39. Bender IB, Bender AB. Diabetes mellitus and the dental pulp. J Endod 2003; 29(6): 383–9 Segura-Egea JJ, Jimenez-Moreno E, Calvo-Monroy C, Rios-Santos JV, Velasco-Ortega E, Sanchez-Dominguez B, et al. Hypertension and Dental Periapical Condition. J Endod. 2010: 36(11):1800-4 Segura-Egea JJ, Jimenez-Pinzon A, Rios-Santos JV, Velasco-Ortega E, Cisneros-Cabello R, Poyato-Ferrera M. High prevalence of apical periodontitis amongst type 2 diabetic patients. Int Endod J. 2005; 38:564-9 Segura-Egea JJ, Martin-Gonzalez J, Cabanillas-Balsera D, Fouad AF, Velasco-Ortega E, Lopez-Lopez J. Association between Diabetes and the prevalence of radiolucent periapical lesions in root-filled teeth: systematic review and meta-analysis. Clin Oral Investig. 2016: 20(6): 1133-1141. Segura-Egea JJ, Martin-Gonzalez J, Castellanos-Cosano L. Endodontic Medicine: Connections between apical periodontitis and systemic diseases. Int Endod J. 2015; 48:933-951 Segura-Egea JJ, Martin-Gonzalez J, Cabanillas-Balsera D, Fouad AF, Velasco-Ortega E, Lopez-Lopez J. Association between Diabetes and the prevalence of radiolucent periapical lesions in root-filled teeth: systematic review and meta-analysis. Clin Oral Investig. 2016: 20(6): 1133-1141. Siqueira JF, Endodontic infections: Concepts, paradigms, and perspectives. Oral Surg Oral Med Oral Pathol Radiol Endod. 2002; 94 (3): p. 281-293 Torabinejad M, Rice D, Maktabi O, Oyoyo U, Abramovitch K. Prevalence and size of periapical radiolucencies using cone beam tomography in teeth without apparent intraoral radiographic lesions: A new periapical index with a clinical recomendation. J Endod 2018; 44(3):389-394 Tapia JA. Incidencia: concepto, terminología y análisis dimensional. Med Clin 1994; 103: 140-142 Ten Cate AR. Histología oral: desarrollo, estructura y función. Editorial Médica Panamericana. Edición 2. 1986 Torabinejad M, Eby WC, Naidorf IJ. Inflammatory and immunological aspects of the pathogenesis of human periapical lesions. J Endod. 1985;11(11):479–488 Uraba S, Ebihara A, Komatsu K, et al. Ability of cone-beam computed tomography to detect periapical lesions that were not detected by periapical: A retrospective assessment according to tooth group. J Endod. 2016;42(8): 1186-1190 Vanderveken D, Curves S, Fieuws S, Lambrechts P. Prevalence of apical periodontitis and root filled teeth in a Belgian subpopulation found on CBCT images. J Endod 2017; 50:317-329 Villoria EM, Francio LA, Cunha CH, Manzi FR. Identification of simulated periapical diseases using five different diagnostic imaging methods. Rev. Port. Estomatol Med Dent Cir Maxilofac. 2016; 57 (3): 125-188 Virtanen E, Nurmi T, Söder P, et al. Apical periodontitis associates with cardiovascular diseases: a cross-sectional study from Sweden. BMC Oral Health. 2017;17(1):107 |
| dc.rights.*.fl_str_mv |
Atribución-NoComercial-SinDerivadas 2.5 Colombia |
| dc.rights.uri.*.fl_str_mv |
http://creativecommons.org/licenses/by-nc-nd/2.5/co/ |
| dc.rights.local.spa.fl_str_mv |
Abierto (Texto Completo) |
| dc.rights.accessrights.none.fl_str_mv |
info:eu-repo/semantics/openAccess |
| dc.rights.coar.none.fl_str_mv |
http://purl.org/coar/access_right/c_abf2 |
| rights_invalid_str_mv |
Atribución-NoComercial-SinDerivadas 2.5 Colombia http://creativecommons.org/licenses/by-nc-nd/2.5/co/ Abierto (Texto Completo) http://purl.org/coar/access_right/c_abf2 |
| eu_rights_str_mv |
openAccess |
| dc.format.mimetype.spa.fl_str_mv |
application/pdf |
| dc.coverage.campus.spa.fl_str_mv |
CRAI-USTA Bucaramanga |
| dc.publisher.program.spa.fl_str_mv |
Maestria en Odontología |
| institution |
Universidad Santo Tomás |
| bitstream.url.fl_str_mv |
https://repository.usta.edu.co/bitstream/11634/16565/4/2019sandrabuitrago.pdf https://repository.usta.edu.co/bitstream/11634/16565/5/2019sandrabuitrago1.pdf https://repository.usta.edu.co/bitstream/11634/16565/2/2019sandrabuitrago2.pdf https://repository.usta.edu.co/bitstream/11634/16565/6/license.txt https://repository.usta.edu.co/bitstream/11634/16565/7/2019sandrabuitrago.pdf.jpg https://repository.usta.edu.co/bitstream/11634/16565/8/2019sandrabuitrago1.pdf.jpg https://repository.usta.edu.co/bitstream/11634/16565/9/2019sandrabuitrago2.pdf.jpg |
| bitstream.checksum.fl_str_mv |
0dfdd1d732c4fc2199048bc63f3b3a25 df3d3b1e5f4809827c6ab016bf2e3369 ade62592f2618cd6934ba814ec050d7b f6b8c5608fa6b2f649b2d63e10c5fa73 1a214408d2d25737784ce5b00ee4eb5c bddb73e9b21e3ca497176b51c806b15d d2a0894092c21df519ddb3da28b62e89 |
| bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 MD5 MD5 MD5 MD5 |
| repository.name.fl_str_mv |
Repositorio Universidad Santo Tomás |
| repository.mail.fl_str_mv |
noreply@usta.edu.co |
| _version_ |
1860882280005763072 |
| spelling |
Castellanos Domínguez, Yeny ZulayMoreno Monsalve, Jaime OmarBuitrago Rojas, Sandra Milena2019-05-08T21:25:53Z2019-05-08T21:25:53Z2019-04-29Buitrago Rojas, S. M. (2019). Prevalencia de periodontitis apical en dientes no tratados endodónticamente evaluados en CBCT [Tesis de Maestría]. Universidad Santo Tomás, Bucaramanga, Colombiahttp://hdl.handle.net/11634/16565repourl:https://repository.usta.edu.coIntroducción El diagnóstico temprano de periodontitis apical se realiza a través de imágenes diagnósticas. La tomografía computarizada de haz cónico (CBCT) actualmente es considerada la técnica radiográfica con mejores capacidades para identificar éste evento. El objetivo de este estudio fue determinar la prevalencia de periodontitis apical en 1858 dientes sin tratamiento endodóntico, evaluados en 152 tomografías computarizadas de haz cónico tomadas a pacientes que asistieron a consulta odontológica en la Universidad Santo Tomás Seccional Bucaramanga. Metodología Mediante un estudio analítico de corte transversal, fueron incluidas las tomografías computarizadas de haz cónico de dientes permanentes de personas de ambos sexos tomadas entre 2016 y 2017. Se evaluó la presencia de periodontitis apical mediante el índice CBCT PAI. La asociación entre el evento y variables como género, edad, diente afectado y cantidad de dientes que presentaron la patología por tomografía evaluada, se realizó mediante prueba de Chi2, valores de p0.05 se consideraron de significancia estadística. Resultados La prevalencia de Periodontitis apical encontrada fue de 19.7%. El 83.6% de estas lesiones (n=306) se ubicaron en el criterio CBCT PAI I ((>0.5 mm–1mm). Los dientes más afectados fueron el 13, 24 y 23 respectivamente. Respecto a la cantidad total de dientes afectados por tomografía evaluada, se evidenció que 19.7% de las tomografías analizadas (n=30) tenían un diente con evidencia de la patología y el 19.1% (n=29) dos dientes afectados. Conclusiones La prevalencia encontrada (19.7%) fue relativamente alta comparada con otros estudios reportados. En una Tomografía axial computarizada es posible observar Periodontitis apical de tamaño incipiente.Introduction The early diagnosis of apical periodontitis is made through diagnostic images. Cone beam computed tomography (CBCT) is currently considered the radiographic technique with the best capabilities to identify this event. The objective of this study was to determine the prevalence of apical periodontitis in 1858 teeth without endodontic treatment, evaluated in 152 CBCT taken from patients who attended a dental practice in a region of Colombia. Methodology Through a cross-sectional analytical study, CBCT of permanent teeth of people of both sexes taken between 2016 and 2017 were included. The presence of apical periodontitis was evaluated using the CBCT PAI index. The association between the event and variables such as gender, age, affected tooth and number of teeth that presented the pathology by assessed tomography, was performed by Chi2 test, p de 0.05 values were considered of statistical significance. Results The prevalence of apical Periodontitis was 19.7%. 83.6% of these lesions (n = 306) were located in the CBCT PAI I ((> 0.5 mm-1mm) .The most affected teeth were 13, 24 and 23 respectively. With respect to the total number of affected teeth in evaluated tomography, it was evidenced that 19.7% of the CBCT analyzed (n = 30) had one tooth with evidence of the pathology and 19.1% (n = 29) two affected teeth. Conclusions The prevalence found (19.7%) was relatively high compared with other studies reported. In a CBCT it is possible to observe apical Periodontitis of incipient size.Magíster en Odontologíahttps://www.ustabuca.edu.co/Maestríaapplication/pdfAtribución-NoComercial-SinDerivadas 2.5 Colombiahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Prevalencia de periodontitis apical en dientes no tratados endodónticamente evaluados en CBCTbachelor thesisTesis de pregradoinfo:eu-repo/semantics/acceptedVersionFormación de Recurso Humano para la Ctel: Trabajo de grado de Maestríahttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesisMaestria en OdontologíaApical periodontitisTooth not treated endodonticallyConventional cone beam tomographyRadiographic techniqueEndodonciaEnfermedades de los dientesTomografía computarizada por Rayos XDientes - RadiografíasPeriodontitis apicalDiente no tratado endodónticamenteTomografía convencional de haz cónicoTécnica radiográficaCRAI-USTA BucaramangaMiller WD. An introduction to the study of the bacterio-pathology of the dental pulp. Dent Cosm. 1894:36,505-28Andreasen JO, Rud J. Correlation between histology and radiography in the assessment of healing after endodontic surgery. Int J Oral Surg 1972;1(3):161–173Pak JG, Fayazi S, White SN. Prevalence of periapical radiolucency and root canal treatment: a systematic review of cross-sectional studies. J Endod 2012 38: 1170-1176.Eckerbom M, Andersson JE, Magnusson T. Interobserver variation in radiographic examination of endodontic variables. Endod Dent Traumatology 1986; 2(6):243-246Berlinck T, Tinoco JMM, Carvalho FF, Sassone LM, Tinoco EMB. Epidemiological evaluation of apical periodontitis prevalence in an urban Brazilian population. Bras. Oral Res. 2015; 29(1): 1-7Hernández Ríos M, Sorsa T, Obregón F, Tervahartiala T, Valenzuela MA, Pozo P, Dutzan N, Lesaffre E, Molas M, Gamonal J. Proteolytic roles of matrix metalloproteinases (MMP)-13 during progression of chronic periodontitis: initial evidence for MMP-13/MMP-9 activation cascade. J Clin Periodontol 2009; 36:1011–1017Andreasen JO, Rud J. Correlation between histology and radiography in the assessment of healing after endodontic surgery. Int J Oral Surg 1972;1(3):161–173Lofthag-Hansen S, Huumonen S, Gröndahl K, Gröndahl H. Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103(1):114-119Torabinejad M, Rice D, Maktabi O, Oyoyo U, Abramovitch K. Prevalence and size of periapical radiolucencies using cone beam tomography in teeth without apparent intraoral radiographic lesions: A new periapical index with a clinical recomendation. J Endod 2018; 44(3):389-394Rocas I.N. Siqueira J.F. Root Canal Microbiota of Teeth with Chronic Apical Periodontitis. J. Clin.Microbiol. Nov. 2008; 46 (11): 3599 – 3606Nair PN. Pathogenesis of apical periodontitis and the causes of endodontic failures. Crit Rev Oral Biol Med. 2004;15: 348-81Nair PNR. On the causes of persistent apical periodontitis: A review. J Endod 2006;39: 249–281Abella F, Morales K, Garrido I, et al. Endodontic applications of cone beam computed tomography: case series and literature review. Giornale Italiano di Endodonzia 2015:29,38-50. 53. Al-Salehia S.K, Hornerb K. Impact of cone beam computed tomography (CBCT) on diagnostic thinking in endodontics of posterior teeth: A before- after study. J Den. 2016;53:57–63Abella F, Patel S, Duran-Sindreu F, Mercadé M, Bueno R, Roig In. Evaluating the periapical status of teeth with irreversible pulpitis by using cone-beam computed tomography scanning and periapical radiographs. J Endod 2012;38(12): 1588–91Aranda V. Niveles de mieloperoxidasa en fluido gingival crevicular de dientes con periodontitis apical asintomática. Universidad de Chile. Facultad de Odontología. Trabajo de grado. 2011Bender IB, Seltzer S. Roentgenographic and direct observation of experimental lesions in bone: I. J Endod. 2003; 29(11):702–706Bender IB, Seltzer S. Roentgenographic and direct observation of experimental lesions in bone: II. 1961. J Endod 2003; 29 (11): 707–712Bergenholtz G. Textbook of endodontology. Second edition. Edit. Wiley Blackwell. 2012Brynolf I. Roentgenologic periapical diagnosis. One, two or more roentgenograms? Sven Tandlak Tidsk. 1970; 63(5):345–50Chapman M, Nadgir MD, Akman AS, Saito N, Sekiya K, Kaneda T, et al. Periapical lucency around the tooth: Radiologic evaluation and differential diagnosis. Radiographics. 2013;(33):15-32Correa LR, Spin-Neto R, Stavropoulos A, Schropp L, da Silveira HED, Wenzel A. Planning of dental implant size with digital panoramic radiographs, CBCT-generated panoramic images, and CBCT cross-sectional images. Clin Oral Implants Res. 2014; 25(6):690–5Correia-Sousa J, Madureira A, Fontes M, et al. Apical periodontitis and related risk factors: Cross-sectional study. Revista Portuguesa de Estomatologia, Medicina Dentária e Cirurgia Maxilofacial 2015; 56(4):226-232CR Stockdale, NP Chandler. The nature of the periapical lesión--a review of 1108 cases. J Dent 1988; 16(3): 123-l 29De Almeida Filho N. Epidemiología sin números Organización Panamericana de la Salud. 1992; 23Dutta A, Smith-Jack F, Saunders WP. Prevalence of periradicular periodontitis in a Scottish subpopulation found on CBCT images. Int Endod J 2014;47(9): 854–63Estrela C, Reis M, Rodrigues C, Azevedo B, Azevedo J. Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. Journal of Endodontics. 2008; 34 (11): 1325-1331Estrela C, Reis M, Correa B. A new periapical index based on cone beam computed tomography. J Endod 2008: 34Faitaroni LA, Bueno MR, De Carvalhosa AA, Bruehmueller Ale KA, Estrela C. Ameloblastoma Suggesting Large Apical Periodontitis. J Endod. 2008;34(2): 216–219Frisk F, Hugoson A, Hakeberg M. Technical quality of root fillings and periapical status in root filled teeth in Jönköping, Sweden. Int Endod J. 2008; 41(11):958–68Gao Y, Haapasalo M, Shen Y, Wu H, Jiang H, Zhou X. Development of virtual simulation platform for investigation of the radiographic features of periapical bone lesion. J Endod. 2010; 36(8):1404-9Garg P, Chaman C. Apical periodontitis: is it accountable for cardiovascular diseases? J Clin Diagn Res. 2016; 10(8):ZE08-ZE12Hernández Ríos M, Sorsa T, Obregón F, Tervahartiala T, Valenzuela MA, Pozo P, Dutzan N, Lesaffre E, Molas M, Gamonal J. Proteolytic roles of matrix metalloproteinases (MMP)-13 during progression of chronic periodontitis: initial evidence for MMP-13/MMP-9 activation cascade. J Clin Periodontol 2009; 36:1011–1017Haapasalo M, Shen Y, Ricucci D. Reasons for persistent and emerging post-treatment endodontic disease. Endod Top. 2011;18:31–50Huumonen S, Orstavik D. Radiological aspects of apical periodontitis. Endodontic Topics 2002;1:3–25IV Estudio Nacional de Salud Bucal ENSAB IV. Situación en Salud Bucal. Ministerio de Salud y Protección Social. 2015Jiménez-Pinzon A. Segura Egea JJ. Valoración clínica y radiológica del estado periapical: registros e índices periapicales. Endodoncia. 2003; 21(4): 220-228Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surgery, Oral Med Oral Pathol. 1965; 20:3340–349Jiménez-Pinzon A. Segura Egea JJ. Valoración clínica y radiológica del estado periapical: registros e índices periapicales. Endodoncia. 2003; 21(4): 220-228Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surgery, Oral Med Oral Pathol. 1965; 20:3340–349Kanagasingam S, Lim C, Yong C, Mannocci F, Patel S. Diagnostic accuracy of periapical radiography and cone beam computed tomography in detecting apical periodontitis using histopathological findings as a reference standard. J Endod 2016:50 417–426Khalighinejad N, Aminoshariae M, Aminoshariae A. Association between Systemic diseases and apical periodontitis. J Endod 2016: 42(10): 1427-1434Lofthag-Hansen S, Huumonen S, Gröndahl K, Gröndahl H. Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103(1):114-119López-López J, Jané-Salas E, Estrugo-Devesa A, Velasco-Ortega E, Martín-González J, Segura-Egea JJ. Periapical and endodontic status of type 2 diabetic patients in Catalonia, Spain: a cross-sectional study. J Endod 2011; 37(5):598–601Miller WD. An introduction to the study of the bacterio-pathology of the dental pulp. Dent Cosm. 1894:36,505-28Matos E, Filho M, Martins A, et al. Correlation between the periapical index and lesion volume in Cone-beam computed tomography image Iran Endod J. 2018; 13(2): 155-158Melo L, Ferreira I, Lacet G, Braga AC, Pina-Vaz I. Apical periodontitis and oral status in patients with different systemic conditions and smoking habits in Portuguese population. J Endod. 2017; 35:10-22mMol A, Dunn SM, van der Stelt PF. Diagnosing of periapical bone lesions on radiographs by means of texture analysis. Oral Surg Oral Med Oral Pathol. 1992;73(6):746–50Moreno JO, Alves FR, Goncalves LS, Martinez AM, Rocas IN, Siqueira JF, Jr. Periradicular status and quality of root canal fillings and coronal restorations in an urban Colombian population. J Endod. 2013;39: 600-604Nair PN. Pathogenesis of apical periodontitis and the causes of endodontic failures. Crit Rev Oral Biol Med. 2004;15: 348-81Nair PNR. On the causes of persistent apical periodontitis: A review. J Endod 2006;39: 249–281Nardi C, Calistri L, Grazzini G, et al. Is panoramic radiography an accurate imaging technique for the detection of endodontically treated asymptomatic apical periodontitis. J Endod 2018; 44(10):1500-1508Nardi C, Calistri L, Pradella S, et al. Accuracy of orthopantomography for apical periodontitis without endodontic treatment. J Endod 2017;43:1640–1646Nejaim Y. Streamlining the radiation dose. Rev Estomatol Herediana. 2015:25(3): 238-245Ng Y, Mann V. Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. J Endod. 2011:44. 583–609Oser D, Henson B, Shiang E, Finkelman MD, Amato RB. Incidental findings in small field of view cone-beam computed tomography scans. J Endod. 2017;43(6):901-904Pak JG, Fayazi S, White SN. Prevalence of periapical radiolucency and root canal treatment: a systematic review of cross-sectional studies. J Endod 2012 38: 1170-1176.Paes da Silva LM, Fernandes R, Ordinola-Zapata R, et al. Prevalence of apical periodontitis detected in cone beam CT images of a Brazilian subpopulation. Dentomaxillofacial Radiology, 2013:42(1):80179163Patel S, Wilson R, Dawood A, Mannocci F. The detection of periapical pathosis using periapical radiography and cone beam computed tomography Part 1: pre-operative status. J Endod 2011;45: 702–710Paula Silva FWG, Min-Kai W, Leonardo M, et al. Accuracy of periapical radiography and cone-beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard. J Endod 2009: 35(7):1009-12Persoon I, Özok R. Definitions and Epidemiology of Endodontic Infections. Curr Oral Health Rep. 2017; 4(4): 278–285Petersson A, Axelsson S, Davidson T, Frisk F, Hakeberg M, Kvist T, Norlund A, Bergenholtz G. Radiological diagnosis of periapical bone tissue lesions in endodontics: a systematic review. Int Endod J. 2012; 45(9):783–801Rocas I.N. Siqueira J.F. Root Canal Microbiota of Teeth with Chronic Apical Periodontitis. J. Clin.Microbiol. Nov. 2008; 46 (11): 3599 – 3606Resolución número 8430 de 1993. Por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud. Ministerio de salud y protección social.Rohlin M, Kullendorff B, Ahlquist M, Henrikson CO, Hollender L, Stenstrom B. Comparison between panoramic and periapical radiography in the diagnosis of periapical bone lesions. Dentomax Radiol 1989;18:151–5Rosenberg PA, Frisbie J, Lee J, Lee K, Frommer H, Kottal S, Phelan J, Lin L, Fisch G. Evaluation of pathologists (histopathology) and radiologists (cone beam computed tomography) differentiating radicular cysts from granulomas. J Endod. 2010;36(3): 423–428Saad A, Suliman A, Hussan A, et al. Prevalence of apical periodontitis and quality of root canal treatment in an adult Saudi population. Saudi Med J 2017: 38(4):413-421. 39. Bender IB, Bender AB. Diabetes mellitus and the dental pulp. J Endod 2003; 29(6): 383–9Segura-Egea JJ, Jimenez-Moreno E, Calvo-Monroy C, Rios-Santos JV, Velasco-Ortega E, Sanchez-Dominguez B, et al. Hypertension and Dental Periapical Condition. J Endod. 2010: 36(11):1800-4Segura-Egea JJ, Jimenez-Pinzon A, Rios-Santos JV, Velasco-Ortega E, Cisneros-Cabello R, Poyato-Ferrera M. High prevalence of apical periodontitis amongst type 2 diabetic patients. Int Endod J. 2005; 38:564-9Segura-Egea JJ, Martin-Gonzalez J, Cabanillas-Balsera D, Fouad AF, Velasco-Ortega E, Lopez-Lopez J. Association between Diabetes and the prevalence of radiolucent periapical lesions in root-filled teeth: systematic review and meta-analysis. Clin Oral Investig. 2016: 20(6): 1133-1141.Segura-Egea JJ, Martin-Gonzalez J, Castellanos-Cosano L. Endodontic Medicine: Connections between apical periodontitis and systemic diseases. Int Endod J. 2015; 48:933-951Segura-Egea JJ, Martin-Gonzalez J, Cabanillas-Balsera D, Fouad AF, Velasco-Ortega E, Lopez-Lopez J. Association between Diabetes and the prevalence of radiolucent periapical lesions in root-filled teeth: systematic review and meta-analysis. Clin Oral Investig. 2016: 20(6): 1133-1141.Siqueira JF, Endodontic infections: Concepts, paradigms, and perspectives. Oral Surg Oral Med Oral Pathol Radiol Endod. 2002; 94 (3): p. 281-293Torabinejad M, Rice D, Maktabi O, Oyoyo U, Abramovitch K. Prevalence and size of periapical radiolucencies using cone beam tomography in teeth without apparent intraoral radiographic lesions: A new periapical index with a clinical recomendation. J Endod 2018; 44(3):389-394Tapia JA. Incidencia: concepto, terminología y análisis dimensional. Med Clin 1994; 103: 140-142Ten Cate AR. Histología oral: desarrollo, estructura y función. Editorial Médica Panamericana. Edición 2. 1986Torabinejad M, Eby WC, Naidorf IJ. Inflammatory and immunological aspects of the pathogenesis of human periapical lesions. J Endod. 1985;11(11):479–488Uraba S, Ebihara A, Komatsu K, et al. Ability of cone-beam computed tomography to detect periapical lesions that were not detected by periapical: A retrospective assessment according to tooth group. J Endod. 2016;42(8): 1186-1190Vanderveken D, Curves S, Fieuws S, Lambrechts P. Prevalence of apical periodontitis and root filled teeth in a Belgian subpopulation found on CBCT images. J Endod 2017; 50:317-329Villoria EM, Francio LA, Cunha CH, Manzi FR. Identification of simulated periapical diseases using five different diagnostic imaging methods. Rev. Port. Estomatol Med Dent Cir Maxilofac. 2016; 57 (3): 125-188Virtanen E, Nurmi T, Söder P, et al. Apical periodontitis associates with cardiovascular diseases: a cross-sectional study from Sweden. BMC Oral Health. 2017;17(1):107ORIGINAL2019sandrabuitrago.pdf2019sandrabuitrago.pdfDocumento de trabajo de gradoapplication/pdf1206374https://repository.usta.edu.co/bitstream/11634/16565/4/2019sandrabuitrago.pdf0dfdd1d732c4fc2199048bc63f3b3a25MD54metadata only access2019sandrabuitrago1.pdf2019sandrabuitrago1.pdfActa de aprobaciónapplication/pdf72436https://repository.usta.edu.co/bitstream/11634/16565/5/2019sandrabuitrago1.pdfdf3d3b1e5f4809827c6ab016bf2e3369MD55metadata only access2019sandrabuitrago2.pdf2019sandrabuitrago2.pdfAcuerdo de confidencialidadapplication/pdf48695https://repository.usta.edu.co/bitstream/11634/16565/2/2019sandrabuitrago2.pdfade62592f2618cd6934ba814ec050d7bMD52metadata only accessLICENSElicense.txtlicense.txttext/plain; charset=utf-8807https://repository.usta.edu.co/bitstream/11634/16565/6/license.txtf6b8c5608fa6b2f649b2d63e10c5fa73MD56open accessTHUMBNAIL2019sandrabuitrago.pdf.jpg2019sandrabuitrago.pdf.jpgIM Thumbnailimage/jpeg5045https://repository.usta.edu.co/bitstream/11634/16565/7/2019sandrabuitrago.pdf.jpg1a214408d2d25737784ce5b00ee4eb5cMD57open access2019sandrabuitrago1.pdf.jpg2019sandrabuitrago1.pdf.jpgIM Thumbnailimage/jpeg7655https://repository.usta.edu.co/bitstream/11634/16565/8/2019sandrabuitrago1.pdf.jpgbddb73e9b21e3ca497176b51c806b15dMD58open access2019sandrabuitrago2.pdf.jpg2019sandrabuitrago2.pdf.jpgIM Thumbnailimage/jpeg8926https://repository.usta.edu.co/bitstream/11634/16565/9/2019sandrabuitrago2.pdf.jpgd2a0894092c21df519ddb3da28b62e89MD59open access11634/16565oai:repository.usta.edu.co:11634/165652024-02-08 15:09:30.895metadata only accessRepositorio Universidad Santo Tomásnoreply@usta.edu.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 |
