Impact of cone-beam computed tomography on implant planning and on prediction of implant size

The aim was to investigate the impact of cone-beam computed tomography (CBCT) on implant planning and on prediction of final implant size. Consecutive patients referred for implant treatment were submitted to clinical examination, panoramic (PAN) radiography and a CBCT exam. Initial planning of implant length and width was assessed based on clinical and PAN exams, and final planning, on CBCT exam to complement diagnosis. The actual dimensions of the implants placed during surgery were compared with those obtained during initial and final planning, using the McNemmar test (p < 0.05). The final sample comprised 95 implants in 27 patients, distributed over the maxilla and mandible. Agreement in implant length was 50.5% between initial and final planning, and correct prediction of the actual implant length was 40.0% and 69.5%, using PAN and CBCT exams, respectively. Agreement in implant width assessment ranged from 69.5% to 73.7%. A paired comparison of the frequency of changes between initial or final planning and implant placement (McNemmar test) showed greater frequency of changes in initial planning for implant length (p < 0.001), but not for implant width (p = 0.850). The frequency of changes was not influenced by implant location at any stage of implant planning (chi-square test, p > 0.05). It was concluded that CBCT improves the ability of predicting the actual implant length and reduces inaccuracy in surgical dental implant planning.

Perfil epidemiológico de portadores de líquen plano oral atendidos no centro goiano de doenças da boca (CGDB)- 12 Anos de experiência / Epidemiologic profile of patients with oral lichen planus of goiano center for disease mouth - 12 years experience

O líquen plano é uma enfermidade mucocutânea crônica, de caráter inflamatório, etiologia desconhecida e natureza autoimune, em que é produzida uma agressão do linfócito T dirigido ás células basais do epitélio da mucosa oral. Objetivo: O objetivo deste estudo foi avaliar o perfil epidemiológico dos pacientes portadores de líquen plano, atendidos no período de 1998 a 2010 no Centro Goiano de Doenças da Boca (CGDB). Material e método: Os dados foram obtidos através da avaliação do prontuário médico do CGDB e do exame clínico das condições de saúde bucal, sendo inclusos todos os pacientes com presença de líquen plano, atendidos neste período, exceto aqueles cuja documentação ou contato estavam incompletos ou inacessíveis ou que não consentiram em participar deste estudo. Resultados: Dos prontuários do CGDB, foram encontrados 141 prontuários de pacientes com o diagnóstico inicial de líquen plano, destes, 52 (65,82%) tiveram diagnóstico confirmado atravésde exame clínico e/ou biópsia de LPO e foram incluídos na pesquisa. 80% eram do gênero feminino e 79% possuíam entre 41 a 63 anos. Quanto ao tipo de líquen plano, foi observado 75% do tipo reticular, 5,76% erosivo e 3,84% em placa. Em 7,69% dos casos não foi possível identificar o tipo de líquen plano. O local mais acometido foi a mucosa jugal, com 40,38% , seguido da genviva, com 19,23%, e na língua a porcentagem foi 3,84%. Em 15% dos casos havia acometimento simultâneo em mucosa jugal e língua. Conclusão: Em nenhum paciente foi encontrada transformação maligna nesses 12 anos de acompanhamento.

Lichen planus is a mucocutaneous, chronic inflammatory, autoimmune disease of unknown etiology, which is produced in a T-lymphocyte-directed aggression in the basal cells of oral mucosa epithelium. Objective: The aim of this study was to evaluate the epidemiological profile of patients with lichen planus, treated between 1998-2010 at the Center of Oral Disease in Goiás- Brazil (CGDB). Methods: The data were obtained through review of medical records of CGDB and clinical examination of oral health conditions, which included all patients with presenceof lichen planus treated during this period, except those whose contact or documentation were incomplete or inaccessible. Results: Of the 8030 records of CGDB, there were 141 records of patients with initial diagnosis of lichen planus, 80% were female and 79% were between 41-63 years. It was observed that 75% was the reticular type, 5.76% erosive/ulcerative and 3.84% plaque type. At 7.69% it was not possible to identify the type of lichen planus. The most common sites were the buccal mucosa (40.38%), gum (19.23%) and tongue (3.84%). Simultaneous involvement in the buccal mucosa and tongue were observed in 15% of the cases. No patient showed malignant transformation in 12 years of monitoring. The prevalence of oral lichen planus in CGDB is considerable when compared with other oral lesions. Conclusions: The epidemiological profile of affected patients can contribute to a decisive therapeutic approach and patient follow-up.

Protocolo de atendimento e acompanhamento do paciente com líquen plano oral (LPO) / Protocol of care and patient follow-up monitoring with oral lichen planus (OLP)

O Líquen Plano é uma doença mucocutânea crônica com prevalênciarelativamente elevada, acometendo entre 0,02% e 1,2%da população mundial. A complicação mais importante é suadiscutida possibilidade de transformação maligna, razão pelaqual tem sido considerada uma condição cancerizável. Objetivo:O objetivo deste estudo foi a criação de um protocolo de atendimentoe acompanhamento dos pacientes com LPO. Material emétodo: O protocolo foi criado pela revisão da literatura e peloestudo obtido por meio do exame detalhado de 52 pacientes comdiagnóstico de LPO, que procuraram o Centro Goiano de Doençasda Boca (CGDB) da FO/UFG, durante o período de agosto de1998 a abril de 2010. Resultados: Dos 52 pacientes diagnosticadoscom LPO e incluídos na pesquisa, 55,76% já fizeram uso de corticóides,outros 44,23% nunca foram submetidos à terapêuticamedicamentosa. A dexametasona tópica foi utilizada em 89,65%dos casos. Nenhum caso apresentava características clínicas ouhistopatológicas de transformação maligna, entretanto apenas26,92% dos pacientes possuíam acompanhamento profissionalde suas lesões e 48,07% tiveram o diagnóstico confirmado porexame histopatológico. Conclusões: Embora remota, a possibilidadeda transformação maligna deve ser considerada. Dessaforma, torna-se imprescindível a implementação de padrões rígidosde acompanhamento destes pacientes com cuidado e emlongo prazo. Espera-se que este protocolo possa ser validadoem estudos futuros e utilizado de forma rotineira no controleclínico do paciente com diagnóstico de LPO.

Lichen planus is a chronic mucocutaneous disease with relativelyhigh prevalence, affecting between 0.02% and 1.2% ofthe population. The most important complication is discussedtheir possible malignant transformation, which is why a conditionhas been considered carcinogenic. Objective: The objectiveof this study was to establish a protocol for treatment ormonitoring of patients with OLP. Methods: The protocol wasestablished by literature review and the study obtained throughdetailed examinations of 52 patients diagnosed with OLP, whosought the Centre Goiano Mouth Disease (CGDB) of FO / UFG,during the period August of 1998 to April of 2010. Results: 52patients was diagnosed with OLP and included in the survey,55.76% have already made use of corticosteroids, other 44.23%have never been subjected to drug therapy. The topical dexamethasonewas used in 89.65% of cases. No case had clinical orhistopathologic features of malignant transformation, howeveronly 26.92% of patients had professional monitoring of theirinjuries and only 48.07% had the diagnosis confirmed by histopathology.Conclusions: Although remote, the possibility ofmalignancy should be considered. Thus, it is essential to implementstrong standards for monitoring these patients carefullyand long term. It is hoped that this protocol can be validated infurther studies and used routinely in patient care with a diagnosisof OLP.