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Tomografia computadorizada de feixe cônico como instrumento complementar de diagnóstico e planejamento cirúrgico de cisto radicular: relato de um caso clínico

ABSTRACT The aim of this study was to highlight, through a clinical case, the importance of using cone beam computed tomography as a complementary tool in the diagnosis and surgical planning of radicular cyst. This is the most common cyst of the jaws, originated from a granuloma at the apex of a necrotic tooth. It’s asymptomatic and may suffer from acute cases, where pain and swelling are present. The endodontic surgery for enucleation of the lesion is the therapy of choice when the conventional endodontic treatment isn’t well succeeded. For a correct surgical planning is important to conduct complementary exams to allow detailed visualization of the region involved. The cone beam computed tomography allows three-dimensional view of structures, overcoming the inherent limitations of periapical radiographs. In the case presented, a 51 years old patient was submitted to a surgery for enucleation of periapical lesion, radiolucent and unilocular, related to the root apex of 31, 32 and 41 teeth. For surgical planning was requested cone beam computed tomography, which allowed to view the details of the lesion and the root
apex. After enucleation and flattening of the apex, the lesion was sent to hystopathological exam and the surgical cavity was filled with graft and bovine collagen membrane. The diagnosis was radicular cyst. The patient is under proservation after eight months. It was concluded that CBCT is an important omplementary tool in diagnosis and surgical planning of radicular cyst.

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    ABSTRACT: The development of periapical lesions in teeth that are close to the maxillary sinus (MS) may cause inflammatory changes in the sinus mucosa, and consequently the development of sinusitis. Image exams showing MS and adjacent anatomical structures, like teeth and nasal cavity, are essential to an accurate diagnosis of different situations that can lead to the development of sinusitis. Cone beam computed tomography (CBCT) shows maxillofacial structures in three planes of space, without overlapping ontralateral structures, representing an important tool in diagnosis. The aim of the present study was to highlight, thorough a clinical case, the importance of CBCT in diagnosis of odontogenic sinusitis. Female patient, 51 years old, presented with signs and symptoms unresponsive to conventional treatment for sinusitis. The CBCT exam allowed confirming the etiology of odontogenic sinusitis. After the realization of the appropriate treatment, it was found complete remission of signs and symptoms. CBCT is an important complementary method in diagnosis of odontogenic sinusitis, and should be the exam of choice, since it allows the visualization of three-dimensional region of interest, detailing the anatomical structures involved. KEYWORDS: cone beam computed tomography, diagnosis, odontogenic sinusitis.
    Revista da ABRO. 01/2014; 13(2):87-94.

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Jun 2, 2014