Uso da termografia por infravermelho como método auxiliar de diagnóstico das lesões periapicais

Abstract

Infrared thermography is a diagnostic method used to identify pain, inflammation and pathologies. The aim of this study was to validate the applicability of the use of infrared thermography as an auxiliary method for the diagnosis of periapical lesions, comparing the initial radiographic images of the periapical lesions with the clinical findings compared to the thermographic images; evaluating the sensitivity and specificity of infrared thermography in detecting periapical lesions and analyzing whether there is a temperature difference (ΔT) in relation to the contralateral side of patients with periapical lesions. A cross-sectional study was carried out, whose project was approved by the Research Ethics Committee (UEPB) under the CAAE: 09203419.0.0000.5187. This study was developed in the Department of Dentistry of the State University of Paraíba (UEPB) Campus I and its sample consisted of 30 patients, who were diagnosed with periapical lesions through pulp sensitivity tests and radiographic examination, were invited to participate the research. Then, after receiving the appropriate guidelines for the realization of the thermographic images in standard frontal, right lateral and left lateral. The regions of interest were the apex regions of the upper and lower teeth, which were analyzed using the Flir Tools software, using the ―circle‖ tool with a standardized dimensions (diameter of 18±3mm). The thermographic images were organized in the Microsoft PowerPoint program, randomly, in which 2 blind examiners analyzed the images, identifying the presence or not of alteration in the thermal pattern that was suggestive of inflammatory process of the periapical lesions. Next, diagnostic tests of sensitivity and specificity were performed. Statistical analysis used Student's t-test for independent samples and Analysis of Variance (ANOVA) with significance level set at p <0.05. The mean temperature of the teeth with periapical lesion was 33.43oC ± 1.12 oC, while the mean tooth temperature of the contralateral region was 33.17 oC ± 1.06 oC, not statistically significant (p = 0.335). A statistically significant difference was observed in the mean temperature of the teeth with periapical lesion according to sex (p = 0.034), where the mean temperature was higher in men. After performing the diagnostic tests we obtained a sensitivity of 17% and a specificity of 79% for the thermographic examination. It was concluded that the applicability of infrared thermography in the diagnosis and identification of periapical lesions was not shown to be an effective method, in the absence of clinical signs.