Marius Bud

Cam la asta ma gandeam eu cand cei din Leuven, unde eram cu o bursa, m-au intrebat de ce-am batut eu atat cale de la Cluj! Curiozitatea mea era cat de mare trebuie sa fie un gol din obturatie astfel incat sa-l putem observa pe radiografii si, respectiv, de la ce dimensiuni in jos el nu mai este vizibil.

Stabilirea protocolului de cercetare a fost o adevarata hernie cerebrala la care toti cinci din echipa incercam sa gasim cea mai simpla cale de crea in obturatia endo goluri de marime cunoscuta astfel incat sa stim care este marimea maxima vizibila pe radiografii! atunci mi-am amintit ce m-a invatat un unchi de-al meu electrician: mereu o litza de sarma salveaza situatia!  Asa ca acest studiu l-am realizat inserand in obturatia endo diferite diametre de sarme pe care le-am scos dupa priza sigilantului pentru a crea golurile. 

Articolul a aparut in numarul din august  2009 al International Endodontic Journal si se numste “Void detection in root fillings using intraoral analogue, intraoral digital and cone beam CT images”

http://www3.interscience.wiley.com/journal/122504554/abstract 

 

Aim To compare void detection in root fillings using different radiographic imaging techniques: intraoral analogue, intraoral digital and cone beam CT (CBCT) images and to assess factors influencing small void detection.

Methodology Two straight root canals in canine teeth were prepared. Calibrated steel wires of five different diameters (200, 300, 350, 500, 800 μm) were inserted respectively in the canal after the injection of a sealer. To simulate filling voids of known dimensions, the wires were removed after the sealer had set. Each sample was imaged, using a Minray X-ray tube (Soredex, Helsinki, Finland) at optimal clinical settings combined with Vistascan PSP (Dürr Dental, Bietigheim-Bissingen, Germany), Digora Optime PSP (Soredex), Sigma CCD (Instrumentarium, Tuusula, Finland) and E-speed films (Agfa-Gevaert, Mortsel, Belgium). The teeth were also imaged using CBCT (3D Accuitomo, Morita, Japan). A generalized mixed model and anova analysis were used on the acquired data (Tukey–Kramer correction).

Results There was no evidence that the factor ‘root level’ affected void detection in root fillings. ‘Void size’ was a main determining factor as all voids larger than 300 μm were determined with all techniques. For the smaller voids, there were significant differences between the 5 imaging techniques at different void sizes and different root levels.

Conclusions Void size and imaging technique were main determining factors. Voids larger than 300 μm were determined with all imaging techniques. For small void detection, all digital intraoral techniques performed better than intraoral analogue and CBCT images.

Nici nu s-a incheiat bine vacanta si concediul ca stiinta ne bate la usa, defapt noi batem la usa ei! Am trimis si eu un articol spre publicare in urma cu ceva vreme la Clinical Oral Investigations! Este una dintre cercetarile facute in Leuven  la care eu tin foarte mult deoarece face parte din teza mea de doctorat iar la momentul realizarii ei a fost singurul studiu care analiza vizibilitatea acelor K de marimi  ISO #6 #8 si #10 pe mai multe tipuri de imagini digitale (PSI, CCD!)

o singura problema insa!  Nu stim scrie articole! Este intr-un fel ca si la proiectele UE, trebuie sa stii sa scrii! Abia atunci am inteles de ce din Romania nu se prea vad articole in reviste internationale serioase de Stomatologie (radiologie orala sau endodontie…..aici cunosc mai bine literatura). NU stim …..dar stim sa invatam! Coautorii mei Bart Vandenberghe si Prof. Reinhilde Jacobs m-au incurajat foarte mult sa nu lasam totul balta ci  sa exprimam aceasta cercetare in cuvinte, adica sa construim articolul astfel incat sa fie acceptat de Clinical Oral Investigations. Si a fost….

Articolul se numeste ” The use of high-resolution digital imaging technology for small diameter K-file length determination in endodontics” si il puteti accesa aici:

http://www.springerlink.com/content/702782592qm63m63/

Abstract

To assess the reliability of high resolution intra-oral photostimulable storage phosphor (PSP) and complementary metal-oxide semiconductor (CMOS) imaging systems for working length (WL) assessment of small K-files in narrow and curved root canals. Eleven narrow and curved canals from extracted molars were used as pre-test for sample-size calculation. Nineteen canals from four cadavers were used for endodontic length assessment in the final study. Small K-files (ISO size 6, 8, and 10) were introduced into the canals at prepared length. Digital intra-oral radiographs were obtained using high-resolution Vistascan^® PSP plates and Sigma M CMOS active pixel sensor with a DC X-ray tube at 70 kV, 7 mA, and 0.16 s. Both image series were assessed with and without use of a dedicated endodontic filter. Three observers measured WLs for comparison to the gold standards of a digital millimeter ruler. Multiple regression analysis of the dependent measurements revealed no significant influence of imaging sensor (PSP or CMOS, p = 0.34) and image processing (p = 0.97). For ISO file size, however, there was a significant difference (p = 0.08) at a level of 10%. Observers mostly underestimated lengths using PSP but overestimated them on CMOS. Almost all radiographic measurements (96–98%) were within 2-mm deviation, while 71% to 82% deviated within 1 mm. Dedicated filtering and sensor type did not influence the outcome of WL determination of small file sizes when using high-resolution imaging sensors. WL determination with ISO file 6 did show a significant difference compared to ISO 8 and 10 but mostly for deviations <1.5 mm.

Keywords Photostimulable storage phosphor (PSP) plates - CMOS - Endodontics - Working length - Small K-files - Intra-oral radiography