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.
Ideea articolului tau mi s-a parut chiar foarte interesanta si culmea ca am si inteles ce ai facut desi inafara de “anova analysis” totul mi-e cam strain :). Ma gandesc insa ca important e si ce faci dupa ce gasesti “void-urile” astea…ca din ce ziceai si tu si din ce mai citeam si eu pe internet microorganismele se cam plimba in voie prin golurile astea. Cel mai “tare” ar fi sa existe o solutie – mai pasnica decat aceea a deschiderii canalului – pentru rezolvarea problemei…cine stie…poate iarasi o “litza de sarma” :))
Oricum astept continuarea ca pe mine sigur ma va salva de la o gramada de experiente stomatologice…ca eu am o inclinatie inspre asa ceva. :))
merci pentru comentariul tau! da, ai dreptate ar fi tare de tot daca dupa ce am identificat problema, adica golul existent, sa o si rezolvam mai pasnic nu prin refacere, dar cred ca sunt lucruri in viata care e mai bine de tratat prin inlocuirea lor…….Ar fi totusi o solutie: inchiderea coronara extrem de buna! nu?