Thiago Lima

Evaluation of cone beam computed tomography and periapical radiography in the diagnosis of root resorption

BACKGROUND This study aimed to evaluate the accuracy of cone beam computed tomography (CBCT) and periapical radiography in diagnosing root resorption and verify the influence of filling material in detecting these lesions. METHODS Digital periapical radiographs and CBCT images of patients with root resorption and a history of dental trauma from a radiology clinic were reviewed retrospectively. The sample comprised 40 teeth with root resorption and 20 normal teeth as controls. Images were analysed by two radiologists and two endodontists. The sensitivity, specificity and accuracy were determined. The kappa coefficient assessed interobserver agreement and the t test determined significant differences between the imaging methods. RESULTS The accuracy of CBCT in diagnosing external (P = 0.0144) and internal (P = 0.0038) inflammatory resorption was significantly higher than for periapical radiography. For replacement resorption, no statistical difference was noted (P > 0.05). In endodontically treated teeth, CBCT was statistically superior in diagnosing root resorption (P = 0.0138). CONCLUSIONS CBCT was superior to digital periapical radiography in diagnosing external and internal inflammatory root resorption after dental trauma and can be considered in the differential diagnosis of resorptive lesions in teeth with endodontic treatment.

Diagnosis and management of root resorption in traumatized teeth: Report of two cases

Internal resorption (IR) is a progressive process initiated within the pulp space with the loss of dentin. Although trauma and pulp inflammation/infection are the major contributory factors in the initiation of IR, all the etiologic factors and the pathogenesis have not yet been completely elucidated. Cervical external resorption is defined as a localized resorptive process that commences on the surface of the root below the epithelial attachment and the coronal aspect of the supporting alveolar process, namely, the zone of the connective tissue attachment. This report is presented two cases of root resorption (external cervical resorption and inflammatory IR) in traumatized teeth where cone beam computed tomography has been used as an important diagnostic tool. Treatment of external cervical resorption involved endodontics and periodontics. In case with inflammatory IR, only endodontic treatment was necessary. The postoperative course was uneventful and a stable clinical outcome was obtained.

Relationship between Initial Attendance after Dental Trauma and Development of External Inflammatory Root Resorption

This clinical study aimed to evaluate the relationship of the delay between dental trauma and the initial attendance to the development of external inflammatory root resorption in permanent teeth affected by severe luxation. Sixty-seven patients, aged between 11 and 56 years, presenting 133 injured teeth with closed apex (56 extrusive luxation, 69 lateral luxation and 8 intrusive luxation) were followed up for a minimum of 24 months. The time elapsed between dental trauma and the initial attendance was recorded. The presence of necrotic pulp and external inflammatory resorption for each type of trauma was verified. Fishers exact test was used to verify the influence of the initial attendance date at the Dental Trauma Center and the development of inflammatory resorption (p<0.05). The odds ratio was used to check the risk of developing external inflammatory resorption due to delay in seeking treatment. Pulp necrosis was observed in 105 teeth (78.9%) and external inflammatory resorption was detected in 17.8% cases of extrusive luxation (10 teeth), 15.9% of lateral luxation (11 teeth) and 25% of intrusive luxation (2 teeth). For lateral luxation, extended delay between the date of injury and initial attendance influenced the occurrence of external inflammatory resorption (p=0.0174). Patients who began treatment 45 days after the injury were 3.4 times more likely to develop external inflammatory resorption than patients who sought treatment after the trauma. Treatment late after the occurrence of dental trauma can impair the prognosis and result in the development of external inflammatory resorption in luxated teeth.

Agricultural Subsidies for Non-farm Interests: An Analysis of the US Agro-industrial Complex

The article argues that the US agricultural subsidies are sustained by a coalition of forces larger than is normally asserted by mainstream analysis. Using the concept of agro-industrial complex, the article sustains that subsidies are a state policy intended to keep farms functional. The subsidies push farmers into a technological treadmill, an economic dynamic by which farmers must keep investing in expensive inputs and expanding scale. All this investment and expansion makes farmers highly indebted and places downward pressure on the price of commodities, creating a tendency that, if it were not for the subsidies, would probably lead to bankruptcy. A generalized farm bankruptcy would be a grave setback for many interests: input suppliers, commodity merchants, food suppliers, landowners, banks and the state itself, among others. Thus, agricultural subsidies should be seen through a broader political economy perspective, not one that traces subsidies only to the connections between farm interest groups and key members of Congress.

Book Review: Leão Walquíria Rego and Alessandro Pinzani (2014), Vozes do Bolsa Família: Autonomia, dinheiro e cidadania

Leão Walquíria Rego and Alessandro Pinzani (2014), Vozes do Bolsa Família: Autonomia, dinheiro e cidadania [Voices of the Family Fund: Autonomy, money and citizenship], Second Edition, São Paulo: Editora Unesp. Paperback, ISBN 9788539305285, pp. 256,

A nonsurgical technique for the removal of overextended gutta-percha.

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