Estimación de la edad por medio del grado de mineralización dental: método de Demirjian

La Odontología Legal constituye una especialidad de real importancia, tanto en el proceso de identificación humana, como en cuestiones relacionadas con el derecho civil, penal o laboral. En este escenario, la estimación de la edad es un factor coadyuvante, al aportar informaciones que orientan dichas acciones. Esta investigación tuvo como objetivo evaluar la posibilidad de aplicar el método radiográfico de estimación de edad de Demirjian et al. (1973), en una muestra uruguaya. Se estudiaron 1013 ortopantomografías digitales, obtenidas del archivo de una institución de asistencia colectivizada, de Montevideo, Uruguay, de las cuales 620 pertenecen a pacientes del sexo femenino y 393 al masculino, con edades comprendidas entre los 5 y 25 años. El algoritmo de Demirjian demostró ser poco efectivo, para la muestra estudiada. Los datos obtenidos para los terceros molares sugieren que este método podría aplicarse para la población uruguaya, aunque se requieran adaptaciones que permitan alcanzar mejores resultados.

A Odontologia Legal é uma especialidade de real importância, tanto no processo de identificação humana, quanto em questões relacionadas ao direito civil, penal ou do trabalho. Nesse cenário, a estimativa de idade é um fator adjuvante, fornecendo informações que norteiam tais ações. O objetivo desta pesquisa foi avaliar a probabilidade de aplicação do método radiográfico de estimativa da idade de Demirjian et al. (1973), em uma amostra populacional uruguaia. Foram estudadas 1013 radiografias panorâmicas digitais obtidas do arquivo de uma instituição de assistência coletivizada, em Montevidéu, Uruguai. 620 radiografias pertenciam ao sexo feminino e 393 ao sexo masculino, com idades entre 5 e 25 anos. O algoritmo Demirjian aplicado à amostra estudada mostrou-se ineficaz. Os dados obtidos para os terceiros molares sugerem que esse método poderia auxiliar no processo de identificação da população uruguaia, embora sejam necessárias adaptações para obter melhores resultados.

Legal Dentistry is a specialty of real importance, either in the process of human identification as well as in questions raised by civil, criminal or labor law. Age estimation is a helpful factor, by providing information that orientates these actions. The aim of this study was to evaluate the applicability of Demirjian et al (1973) radiographic method of age estimation, in a Uruguayan sample. 1013 digital panoramic radiographs were studied, obtained from a private institution, in Montevideo, Uruguay. 620 radiographs belonged to female patients and 393 to male, aged between 5 and 25 years old. The Demirjian algorithm applied to the sample studied proved to be ineffective. The data obtained for third molars, suggest that this method could help in the process of identification of the Uruguayan population, although adaptations are required for better results.

Estimativa de idade pela análise radiográfica de caninos permanentes ­ estudo piloto em uma população do interior da Bahia / Age estimation by radiographic analysis of permanent canines ­ pilot study in a population in the interior of Bahia

A estimativa de idade representa um tipo de perícia com a finalidade de auxiliar na estimativa do perfil biológico de indivíduos vivos e mortos. O presente trabalho teve como objetivo verificar a aplicabilidade do método Cameriere (2004) de estimativa de idade pelos dentes, em indivíduos adultos, a partir do emprego de radiografias panorâmicas, caracterizando a amostra segundo sexo e idade e verificando a relação entre idade real e idade estimada pelo método. Para isso, foram utilizados caninos hígidos para cálculo da área do dente e da polpa, com o Programa Adobe Photoshop, em 50 radiografias panorâmicas. Os valores em pixels foram inseridos em fórmulas propostas pelo método, obtendo-se, assim, a idade estimada. A concordância intraexaminador evidenciou um coeficiente de correlação intraclasse quase perfeito, com valor de p igual a 0,9998. Para a amostra estudada, quando comparadas às médias das idades estimadas e reais para cada indivíduo, observou-se uma tendência de subestimação da idade com o método de Cameriere (2004), em todas as formas de análises, apresentando resultados de médias mais discrepantes, quando utilizado os caninos inferiores. Conclui-se que o método de Cameriere (2004) não se mostrou aplicável considerando a amostra, a faixa etária e a população analisada, com tendência de subestimação das idades quando comparadas com as idades reais

Age estimation represents a type of expertise with the purpose of helping to estimate the biological profile of living and dead individuals. This study aimed to verify the applicability of the Cameriere (2004) method of age estimating by teeth, in adult individuals, from panoramic radiographs use, characterizing the sample according to sex and age and verifying the relationship between actual age and age estimated by the method. For this, we used healthy canine teeth to calculate the area of the tooth and the pulp, with the Adobe Photoshop Program, in 50 panoramic radiographs, using the healthy canine teeth as a reference for analysis. The pixel values were inserted into formulas proposed by the method, thus obtaining the estimated age. The intra-examiner agreement showed an almost perfect correlation coefficient, with p-value equal to 0.9998. For the sample studied, when comparing the averages of the estimated and actual ages for each individual, there was a tendency to underestimate age with the Cameriere (2004) method, in all forms of analysis, with more discrepant average results when using the lower canines It is concluded that the method of Cameriere (2004) was not applicable considering the sample, the age group and the population analyzed, with a tendency of underestimation of the ages when compared with the real ages

Radiografía panorámica: una herramienta invaluable para el estudio del componente óseo y dental del territorio maxilofacial / Panoramic radiographs: an invaluable tool for the study of bone and teeth components in the maxillofacial region

RESUMEN: La radiografía panorámica es probablemente el examen de rutina más solicitado por los dentistas en el mundo. Entre sus ventajas están su bajo costo, rapidez y mayor seguridad debido a que los formatos digitales han permitido disminuir las dosis y tiempos de exposición a la radiación. Su potencial como herramienta diagnóstica radica en la posibilidad que tiene el clínico de observar el territorio maxilofacial casi en su totalidad, pudiendo realizar un estudio anatómico y morfológico acabado de diferentes regiones. En esta revisión se quiere ofrecer una mirada general de la amplia gama de usos que se le pueden dar a la radiografía panorámica, tanto en la clínica como en el ámbito de la investigación, destacando su potencial como herramienta de diagnóstico y su importancia para algunas áreas de especialidad en odontología.

SUMMARY: The panoramic radiograph is in all likelihood, the routine exam most required by dentists in the clinic worldwide. Among the advantages of using this type of radiograph, is that it is inexpensive, quick and also safer in digital format since it reduces the radiation dose and time of exposure. Its potential as a diagnostic tool is based on the possibility to explore almost all of the maxillofacial area, allowing a proper anatomic and morphological study of different areas at the same time. In this review, we aimed to provide an overview of the multiple uses of panoramic radiographs, highlighting its potential as a diagnostic tool and also its importance in some specialized areas of dentistry.

Relationship Between the Initial Position of Palatally Displaced Canines and Treatment Duration / Relación entre la posición incial de caninos desplazados palatalmente y la duración del tratamiento

Abstract This prospective study aimed to assess the positional features of palatally displaced maxillary canines (PDCs), their relationship with both cephalometric and dental cast measurements and treatment duration. Pretreatment panoramic and lateral cephalometric radiographs and dental casts of 46 patients (23 patients with uni/bilateral PDC and 23 patients with Class I malocclusion) were collected. The mesial inclination of the permanent canine to the midline (α angle), the distance from the cusp tip of the permanent canine to the occlusal line (d distance), and the mesial position of the crown of the displaced canine (sector) were measured on the panoramic radiographs. SNA°, SNB°, ANB°, SN-GoGn°, SN-PP°, and PP-MP° angles and sagittal inclinations of the PDCs' (C-PP°) were measured on cephalometric radiographs. Arch length discrepancies and transversal arch measurements were also performed. The Student's t-test, Mann-Whitney U test and Kruskal-Wallis test were used to compare variables that were not normally distributed while ANOVA was used for the normally distributed data. The arch widths were similar between the groups while crowding was significantly greater in the PDC group. A negative correlation was found between the α angle and vertical plane angle (SN-GoGn°). Treatment duration was positively correlated with α angle and d distance but there was no relationship with the sagittal angulation of the PDC to the palatal plane (C-PP°) and the treatment duration. Treatment duration can be expected to be longer with every increase in the angle of the PDC to the midline and distance from the occlusal plane.

Resumen El objetivo de este estudio prospectivo fue evaluar las características de los caninos mailares desplazados palatalmente (CDPs), su relación con las radiografías cefalométricas, las medidas en los modelos de yeso y el tiempo de duración del tratamiento. Se recolectaron radiografías panorámicas, laterales cefalométricas y modelos dentales de 46 pacientes (23 pacientes con CDPs uni/bi laterales y 23 pacientes con maloclusión de Clase I). Se midieron la inclinación mesial de los caninos permanentes con respecto a la línea media (ángulo α), la distancia de la punta de la cúspide del canino permanente a la línea oclusal (distancia d) y la posición mesial de la corona del canino desplazado (sector) en la radiografía panorámica. En las radiografías cefalométricas se midieron los ángulos SNA°, SNB°, ANB°, SN-GoGn°, SN-PP° y PP-MP° y las inclinaciones sagitales de los CDPs (C-PP°). También se realizaron las medidas de las discrepancias de la longitud de arco y las medidas de arco transversal. La prueba de t de student, prueba Mann-Whitney U y la prueba Kruskal-Wallis se usaron para comparar las variables que no se comportaron con una distribución normal, mientras que se utilizó la ANOVA para los datos de distribución normal. El ancho de los arcos fue similar entre grupos mientras el apiñamiento fue significativamente mayor en el grupo de CDPs. Se encontró una correlación negativa entre el ángulo α y el ángulo del plano vertical (SN-GoGn°). La duración del tratamiento fue positivamente correlacionado con el ángulo α y la distancia d peron o se encontró relación entre la angulación sagital del CDP con el plano palatal (C-PP°) y la duración del tratamiento. Se puede esperar que la duración del tratamiento sea mayor con el aumento del ángulo entre el CDP a la línea media y la distancia desde el plano oclusal.

Factores sistémicos asociados con el edentulismo, según edad y género, mediante las radiografías panorámicas y expedientes digitales / Systemic factors associated with edentulism according to age and gender by panoramic radiographs and digital records

Resumen Esta investigación se realizó con el objetivo de determinar los principales factores sistémicos que provocan edentulismo en los pacientes que asisten a la Clínica de Odontología, con el fin de educar y concientizarlos sobre la relación entre la pérdida de piezas dentales y la salud en general, así como las causas y consecuencias del edentulismo. Para el estudio se tomó una muestra de 954 expedientes del último cuatrimestre de 2017. Estos registros se evaluaron para obtener un número de 108 pacientes edéntulos con factores sistémicos, total utilizado para este trabajo.

Abstract This research was carried out with the aim to determine the main systemic factors that cause edentulism in patients attending the Dental Clinic, in order to enhance patient education concerning the relationship between toothloss and with general health, as well as the causes and consequences of edentulism. For this study, a sample of 954 records was acquired from the last four months of the year 2017. These records were evaluated to obtain a number of 108 patients with systemic factors, the overall participants for this study.

Osteometric and radiological study of the mandibular notch / Estudio osteométrico y radiológico de la incisura mandibular

The mandibular notch is located on the superior margin, between two prominent processes of the mandibular ramus, the coronoid and condylar processes. The mandibular notch permits the entry of the masseteric artery, vein and nerve to the deep surface the masseteric muscle. Literary reports documented variations in both, the shape and size of the mandibular notch. Therefore, this study aimed to document the morphology and morphometry of the mandibular notch in the South African Black and Indian population groups and to determine their relationship to sex, age and race (if any). The morphometric and morphological parameters of the mandibular notch were measured and assessed in 149 digital panoramic radiographs and 51 dry mandible specimens (n=400) belonging to the South African Black African and Indian population groups. A combination of classification schemes by Mohammad et al. (2012) and Shakya et al. (2013) were adopted to assess the morphology of the mandibular notch. The morphometric parameter was measured using the Dicom x-ray viewer and a digital vernier caliper. Each of the morphometric and morphological parameters were statistically analyzed using SPSS, to determine if a relationship existed between the afore-mentioned parameters and sex, age and race. This study recorded the round shaped mandibular notch to be the most prevalent type in both sexes with a combined incidence of 44.2 %. The length of the mandibular notch was reported to be greater in males than females and concurred with previous studies. However, the selected South African group displayed a smaller mandibular notch than the Japanese and Chinese population groups. Furthermore, this study documented population differences among the South African population group, as the Black African population group showed a wider mandibular notch than the Indian population group. This suggests that population-specific differences may exist for both the morphological and morphometric parameters of the mandibular notch. However, only a statistically significant relationship between the length of the mandibular notch with age and race was documented. The mandibular notch may be of clinical significance to maxillofacial surgeons for surgical and reconstructive procedures, in addition it may also aid forensic anthropologists in the identification of unknown remains.

La incisura mandibular se encuentra en el margen superior, entre dos procesos importantes de la rama mandibular, el proceso coronoides y el proceso condilar. La incisura mandibular permite la entrada de la arteria, la vena y el nervio masetérico en la superficie profunda del músculo masetero. En la literatura se han documentado variaciones tanto en la forma como en el tamaño de la incisura mandibular. Este estudio tuvo como objetivo documentar la morfología y la morfometría de la incisura mandibular en los grupos de población de negros e indios sudafricanos y determinar su relación con el sexo, la edad y la raza. Los parámetros morfométricos y morfológicos de la incisura mandibular se midieron y evaluaron en 149 radiografías panorámicas digitales y 51 especímenes de mandíbula seca (n = 400) pertenecientes a los grupos de población sudafricana negra e india. Una combinación de esquemas de clasificación de Mohammad et al. (2012) y Shakya et al. (2013) fueron adoptados para evaluar la morfología de la incisura mandibular. El parámetro morfométrico se midió utilizando el visor de rayos X Dicom y un calibrador Vernier digital. Cada uno de los parámetros morfométricos y morfológicos se analizaron estadísticamente utilizando el software SPSS, para determinar si existía una relación entre los parámetros mencionados anteriormente y el sexo, la edad y la raza. Este estudio registró la incisura mandibular de forma redonda como el tipo más prevalente en ambos sexos, con una incidencia de un 44,2 %. Se informó que la longitud de la incisura mandibular es mayor en hombres que en mujeres y coincidió con estudios anteriores. Sin embargo, el grupo sudafricano seleccionado mostró una incisura mandibular más pequeña que los grupos de población japoneses y chinos. Además, se documentó las diferencias de población entre el grupo de Sudáfrica, ya que el grupo de población negra de África mostró una incisura mandibular más amplia que el grupo de la población India. Esto sugiere que pueden existir diferencias específicas de la población para los parámetros morfológicos y morfométricos de la incisura mandibular. Sin embargo, solo se documentó una relación estadísticamente significativa entre la longitud de la incisura mandibular con la edad y la raza. La incisura mandibular puede ser de importancia clínica para los cirujanos maxilofaciales en procedimientos quirúrgicos y reconstructivos; además, también puede ayudar a los antropólogos forenses en la identificación de restos desconocidos.

A Radiographic Study to Evaluate the Course and Visibility of the Mandibular Canal in Darbhanga Population: An Original Research

Introduction: Mandibular canal or inferior alveolar canal isan important anatomical landmark in mandible which containsneurovascular bundles. Mandibular canal is considered asreference anatomical landmark in maxillofacial surgeries.The aim of this study was to evaluate the course and visibilityof the mandibular canal in Darbhanga (Bihar) populationon digital panoramic radiographs, and the objective was toassess the normal variation of mandibular canal on panoramicradiographsMaterial and Methods: A total of 500 panoramic radiographswere selected from the archives of our department as softcopies. The course of mandibular canal was evaluated onpanoramic radiographs. The collected data were subsequentlyprocessed and analyzed using SPSS statistical package version17.Results: We found that elliptic curve is most common curve.Visibility of mandibular canal is more in the third molarregion compared to first molar region. Conclusion: In thepresent study, most common curve was elliptic curve (64.8%)followed by linear curve (22.2%). Visibility of mandibularcanal in third molar region was 98.1%. In both gender, ellipticcurve was most common curve.

Accuracy of Demirjian’s Method to Estimate Chronological Age in 5‒17-Year-Old Iranian Population

Introduction:To detect physiological maturity of a child, use of dental and skeletal development can be helpful. The Demirjian’s Method is one of the commonly used methods to estimate dental age. The aim of the present study was to evaluate the validity of Demirjian method in Iranian population with different races.Materials and Methods:The present cross-sectional study was performed on a randomly selected sample of panoramic radiographs of 3073 patients aged 5‒17 years. The chronological age (CA) was calculated by subtracting the date of birth from the date on which the radiographs were taken. Estimated age (EA) was performed by Demirjian method using seven left mandibular teeth. Paired t-test was used to compare differences between chronological and estimated age.Results:The mean of CA was 11.14±2.61 years whereas the mean EA was 11.35±2.62; Original Research Article therefore, EA was calculated 2.5 months more than CA. According to paired t-test the difference between CA & EA was significant (P≤ 0.001). Pearson’s correlation coefficient showed a strong linear correlation between CA and EA in total (r=0.891, P≤0.001), in girls (r=0.895, P≤ 0.001) and in boys (r=0.876, P≤ 0.001). The new regression line equation based on Iranian standards would be CA=1.08±0.89EA in total, CA=1.09±0.89EA in girls and CA=1.12+0.88EA in boys. Conclusion:Using Demirjian’sMethod overestimated dental age in the Iranian population. A new regression line equation based on Iranian standards was obtained according to the results of the present study

Índices de simetría condilar y mandibular a través de radiografías panorámicas digitales en una muestra de pacientes chilenos / Condylar and mandibular symmetry indexes through digital panoramic radiographs in a sample of Chileans patients

La simetría mandibular puede alterarse por diversos motivos. Variados estudios buscan definir parámetros de "normalidad" y para ello se han descrito técnicas que utilizan la radiografía panorámica (RPN). El objetivo de este estudio fue determinar índices de simetría mandibular/condilar en una muestra de pacientes chilenos. Se realizó un estudio descriptivo de corte trasversal en RPN digitales obtenidas de la Clínica Odontológica de la Universidad de La Frontera. Se aplicaron criterios de inclusión: pacientes mayores de 18 años, dentición permanente completa hasta el primer molar; y de exclusión: signos radiográficos de alteraciones óseas y/ o cirugía mandibular, cóndilos no visibles, ortodoncia. Se utilizó el software ImageJ para dibujar rectas y medir la altura de la rama y cóndilo mandibular del lado derecho e izquierdo de acuerdo a la técnica propuesta por Kjellberg et al. (1994). Con estas medidas se calculó el índice de simetría entre altura condilar y rama (S1); y entre altura condilar y mandibular (S2). 235 RPN digitales fueron analizadas (95 hombres; 140 mujeres) con edad promedio de 24,98±7,32 años. El promedio de S1 fue de 93,74 % (±3,85) en hombres y 93,41 % (±5,77) en mujeres, mientras que para S2 fue de 90,50 % (±6,51) en hombres y 90,27 % (±7,80) en mujeres, sin diferencias significativas para ninguno de ambos índices (p=0,347 y p=0,233, respectivamente). En cuanto a la edad, tampoco se encontraron diferencias significativas en el promedio de los índices S1 y S2 para cada rango etario (p=0,594 y p=0,669, respectivamente). Mediante este estudio se concluye que hay un alto porcentaje de pacientes con simetría mandibular/condilar en ambos sexos y en diferentes rangos etarios, esto sin considerar el estado de salud o presencia de alteraciones morfológicas y/o funcionales.

Mandibular symmetry may be modified by various conditions. A number of studies have attempted to define parameters of "normality" and several techniques have been described using digital orthopantomography (OPG). The aim of this study was to determine mandibular/condylar symmetry indexes in a sample of Chilean patients. A cross sectional descriptive study in digital OPG obtained from the Dental Clinic of Universidad de La Frontera was performed. Inclusion criteria applied were: Patients older than 18 years, complete permanent dentition up to the first molar. Exclusion criteria were also applied: Radiographic signs of bone disease and/or mandibular surgery, not visible condyles, orthodontics. ImageJ software was used to draw lines and measure the height of the ramus and mandibular condyle on the right and left side with the technique postulated by Kjellberg (1994). With these measurements, the symmetry index between condylar height and ramus (S1) and between condylar and mandibular height (S2) were calculated. The study analyzed 235 digital OPG (95 men, 140 women) with an average age of 24.98 ± 7.32 years. The S1 average was 93.74 % (± 3.85) for men and 93.41 % (± 5.77) for women, and for S2 it was 90.50 % (± 6.51) for men and 90.27 % (± 7.80) for women, without significant differences for either index (p=0.347 and p=0.233, respectively). No significant differences were found in reference to age, for indexes S1 and S2 (p=0.594 and p=0.669, respectively). Therefore, it is concluded that there is presence of condylar/mandibular symmetry in both sexes and in age ranges, when measuring digital OPGs without considering health status or presence of any morphological or functional alteration.

Prevalencia y caracterización de hallazgos asociados con implantes en radiografías panorámicas / Prevalence and characterization of findings associated with implants in panoramic radiographs

Introducción: en Colombia, el último estudio de salud bucal evidenció que cerca del 70 por ciento de la población presenta edentulismo parcial mientras que el 5,2 por ciento habrá perdido todos los dientes entre los 65 y 79 años. La rehabilitación con implantes es una opción cada vez más utilizada, que requiere seguimiento clínico y radiográfico, siendo la radiografía panorámica una opción de bajo costo, en la que es posible observar zonas de pérdida ósea, angulación mesodistal del implante, relación con estructuras anatómicas y lesiones sugerentes de periimplantitis. Se requieren reportes y análisis de datos relevantes sobre los hallazgos en radiografías asociados a implantes dentales para determinar los factores de riesgo para su éxito, en los pacientes que los usan. Objetivo: determinar la prevalencia y caracterizar los hallazgos asociados a los implantes de oseointegración en radiografías panorámicas. Métodos: se realizó un estudio observacional descriptivo de corte transversal, con 10 000 radiografías panorámicas digitales seleccionadas por conveniencia de centros radiológicos en la ciudad de Bogotá, Colombia, de las cuales 543 correspondieron a la muestra analizada por la presencia de implantes. Se evaluó para cada implante: localización, posición, angulación y distancias con las estructuras adyacentes, utilizando el programa Clínicalview® (Orthopantomograph OP200D, Instrumentarium, USA). Resultados: La frecuencia de radiografías con implantes fue del 5,43 por ciento con un total de 1 791 implantes, con un promedio 3,2 por radiografía. Se encontraron en mayor proporción en el maxilar superior con una localización supracrestal y una angulación de 10,3 grados. El 32 por ciento presentaba distancias implante/diente o implante/implante inferiores a las óptimas. El 40,9 por ciento estaban restaurados y 1,2 por ciento mostraban lesiones compatibles con periimplantitis. Conclusiones: un alto porcentaje de los implantes revisados tiene un factor de riesgo que afecta su viabilidad a largo plazo ya sea por angulación, posición supracrestal o crestal, vecindad con dientes u otros implantes o bien por no ser restaurable(AU)

Introduction: the most recent survey about oral health conducted in Colombia revealed that nearly 70 percent of the population is partially edentulous, whereas 5.2 percent will have lost all their teeth by the time they are 65-79 years old. Implant rehabilitation is an ever more common alternative which requires clinical and radiographic follow-up, panoramic radiography being a low-cost option to observe areas of bone loss, mesiodistal angulation of the implant, relationship to anatomical structures and lesions suggesting peri-implantitis. Relevant data analyses and reports are needed about radiographic findings associated with dental implants to determine the risk factors for their success in patients wearing them. Objective: determine the prevalence of and characterize the findings associated to osseointegration implants in panoramic radiographs. Methods: a cross-sectional observational descriptive study was conducted of 10 000 digital panoramic radiographs chosen by convenience sampling at radiology centers from the city of Bogotá, Colombia, of which 543 made up the study sample, due to the presence of implants. Each implant was evaluated for location, position, angulation and distance from adjacent structures, using the software Clínicalview® (Orthopantomograph OP200D, Instrumentarium, USA). Results: the frequency of radiographs with implants was 5.43 percent with a total 1 791 implants and an average 3.2 per radiograph. Implants were more common on the upper maxilla with a supracrestal location and an angulation of 10.3 degrees. In 32 percent implant-tooth or implant-implant distances were below optimum values. 40.9 percent had been restored and 1.2 percent showed lesions compatible with peri-implantitis. Conclusions: a large proportion of the implants examined exhibit a risk factor affecting their long-term viability, namely angulation, supracrestal or crestal position, proximity to teeth or other implants, or not being restorable(AU)

Quest for haller cells: A digital orthopantomography study

Aims: Haller Cells refer to the ethmoidal pneumatization and are the extensions of anterior ethmoid sinus into the floor of the orbit and superior aspect of the maxillary sinus, basically an anatomic variation. They may be associated with orofacial pain, sinusitis, nasal obstruction, impaired nasal breathing, headache, chronic cough, and mucocele. The aim of the present study was to identify, determine the prevalence and characteristics of Haller's cells on Digital orthopantomographs in patient's reporting to a dental institution in Chennai. Settings and Design: This was a retrospective, cross-sectional study. Subjects and Methods: The study group comprised 600 radiographs inclusive of both genders (379 females and 221 males) with an age range of 20–80 years. Retrospectively panoramic radiograph for each of the patients was viewed and interpreted for the presence of Haller's cells. The data collected was subjected to statistical analysis: frequencies/percentages, descriptive statistics to obtain the results. Statistical Analysis Used: Frequencies/percentages, descriptive statistics using SPSS for Windows Version 20 (SPSS Inc., Chicago, IL, USA), to obtain the results. Results: Haller's cells were noted in patients, accounting for a prevalence of 23.61%. The majority of the cells were circular, ovoid, and irregular in shape. Conclusions: This study has attempted to explore the characteristics of Haller's cells on panoramic radiographs. A description of Haller's cells on these radiographs may prove vital in enumerating the differential diagnosis for patients afflicted with intractable orofacial pain and reduce the risk of untoward intraoperative complications during endonasal procedures.

Localization of the mental foramen through digital panoramic radiographs in a Chilean population / Localización del foramen mental a través de radiografías panorámicas digitales en una población chilena

SUMMARY: The purpose of the current research was to describe the location of mental foramen (MF) through digital panoramic radiographs in a Chilean population sample. A cross sectional study was carried out in which 500 radiographs taken at a university clinic in Temuco, Chile, were analyzed. Exclusion criteria were applied and the radiographs were analyzed by two previously calibrated examiners. The antero-posterior and supero-inferior positions of the MF were established in relation to longitudinal axes of premolars and the height of their apices, respectively. The distances from the center of the MF to the inferior margin of the mandible, the midline and the height of the dental apices were measured. In total, 163 radiographs were analyzed (93 female, 70 male). On both left and right sides, the MF was most commonly found between the longitudinal axes of premolars (58.49 % and 65.43 %) and below of the apices (94.34 % and 95.68 %), with no significant differences for sex and age. On the right side the mean distance to the inferior margin of the mandible (D1) was 11.87±1.46 mm; to the midline (D2) it was 24.46±2.99 mm and to the height of the apices (D3) it was 5.03±8.44 mm. On the left side the same distances were 11.98±1.62 mm, 25.85±2.87 mm and 4.09±2.21 mm respectively. In conclusions, the distances measured from the MF to anatomical landmarks are smaller in women, however significant differences were only found for D1 (right and left sides) and D3 (left side). D2 was the only distance found to diminish with age (left side).

RESUMEN: El objetivo de este estudio fue describir la localización del foramen mental (FM) a través de radiografías panorámicas digitales en una población chilena. Se realizó un estudio de corte transversal en el cual se analizaron 500 radiografías tomadas en una clínica universitaria de la ciudad de Temuco. Se aplicaron criterios de exclusión y las radiografías incluidas fueron analizadas por dos examinadores previamente calibrados. La posición antero-posterior y supero-inferior del FM se estableció de acuerdo a los ejes longitudinales de los premolares y la altura de sus ápices respectivamente. También se midió la distancia desde el centro del FM hasta el borde inferior de la mandíbula, hasta la línea media y hasta la altura de los ápices dentarios. En total, 163 radiografías fueron analizadas (93 mujeres, 70 hombres). Tanto para el lado derecho como izquierdo, la ubicación más frecuente del FM fue entre los ejes longitudinales de los premolares (58,49 % y 65,43 %) y debajo de los ápices (94,34 % y 96,68 %), sin diferencias significativas por sexo y edad. En el lado derecho la distancia promedio desde el FM hasta el borde inferior de la mandíbula (o D1) fue 11,87±1,46 mm; a la línea media (o D2) fue 24,46±2,99 mm y a la altura de los ápices fue de 5,03±8,44 mm. En el lado izquierdo el promedio de las mismas distancias fueron 11,98±1,62 mm, 25,85±2,87 mm y 4,09±2,21 mm respectivamente. En conclusión, las distancias medidas desde el centro del FM hacia referencias anatómicas son menores en mujeres, sin embargo solo se encontraron diferencias significativas para D1 (en el lado derecho e izquierdo) y D3 (en el lado izquierdo). D2 fue la única distancia encontrada que disminuye con la edad (lado izquierdo).

Early diagnosis of atherosclerosis with panoramic radiographs: a review / O diagnóstico precoce de aterosclerose através de radiografias panorâmicas: uma revisão

Abstract Carotid artery disease has been linked with cerebral vascular accident, also known as stroke, cerebral hemorrhage, or cerebral ischemia. It is caused by narrowing or obstruction of arteries in the neck (the carotid arteries) that are responsible for transporting blood from the aorta to the brain. Panoramic radiographs are used in dentistry to show both dental arches as a supplement to the clinical dental examination. The objective of this study is to highlight the importance of panoramic radiographs for diagnosis of arterial disease, by means of a bibliographic review. The PubMed database was searched using the keywords “atherosclerosis” and “panoramic”, with the filters “last 5 years” and “humans”. Twenty articles were identified, six of which were chosen for this study because they were open access. The review concluded that panoramic radiographs enable early diagnosis of carotid artery calcification, resulting in earlier interventions, and offer an accessible cost.

Resumo Doenças das artérias carótidas estão associadas a casos de acidente vascular cerebral, também chamados de derrame ou isquemia cerebral. Ocorrem devido ao estreitamento ou obstrução das artérias do pescoço, ou artérias carótidas, responsáveis por levar o sangue da aorta para o cérebro. A radiografia panorâmica é um exame de ambos os arcos dentários que ajuda no exame clínico odontológico. Destacar a importância da radiografia panorâmica no diagnóstico de doença arterial é o objetivo deste trabalho, que foi realizado através de pesquisa bibliográfica na PubMed, com as palavras-chave “atherosclerosis” e “panoramic”, e os filtros: últimos 5 anos e humanos. Vinte artigos foram elencados, dos quais seis formaram a base para este estudo, graças ao acesso livre ao seu conteúdo. Conclui-se que a radiografia panorâmica permite o diagnóstico precoce de calcificação da artéria carótida, levando a uma intervenção precoce a um custo acessível.

The mental foramen II: radiographic study of the superior-inferior position, appearance and accessory foramina in Iraqi population / El foramen mental II: estudio radiográfico de la posición superior-inferior, aspecto y forámenes accesorios de una población Iraquí

Accurate information regarding the vertical location and appearance of the mental foramen, and the presence of accessory foramina, can have clinical significance, such as reducing complications that may occur during many oral surgical procedures involving the mental area. Geographic variations were reported in these variables. The aim was to evaluate the above-mentioned variables in an Iraqi sample. Five hundred eighteen panoramic radiographs of a random Iraqi sample (257 males, 261 females, average age= 46.5 years) were evaluated with regard to the above-mentioned variables, as well as the symmetry of the foramen regarding these variables. The area below the apices of mandibular premolars, and the continuous type were the most frequent vertical location and appearance of the mental foramen, respectively. Age advancement was found to be associated with an increase in the frequency of more inferior positioning and continuous appearance. The vertical position and appearance were asymmetrical in 16.2 % and 20.1 % of cases, respectively. Symmetry in the vertical location was statistically significant between sexes (P= 0.035), and young and old ages (P= 0.000). Symmetry in the appearance was found statistically significant (P= 0.025) only between the two age groups. Accessory foramina were recorded in 7.3 % of cases. The most common vertical location and appearance of the mental foramen on panoramic radiographs in this group are below the apices of mandibular premolars, and continuous type, respectively. This is in consistence with the findings of previous studies on other populations. The mental foramen usually has symmetrical vertical location and appearance. Accessory foramina are recorded in a percentage lower than that recently reported in some regional countries.

La información precisa acerca de la localización vertical, apariencia del foramen mental y la presencia de forámenes accesorios, puede tener importancia clínica, como la reducción de las complicaciones que pueden ocurrir durante muchos procedimientos quirúrgicos orales relacionados con el mentón. Las variaciones geográficas fueron reportadas en estas variables. El objetivo fue evaluar las variables anteriormente mencionadas en una muestra iraquí. Fueron evaluadas 518 radiografías panorámicas de una muestra aleatoria de Irak (257 varones, 261 mujeres, edad media = 46,5 años) con respecto a las variables antes mencionadas, así como la simetría del foramen con respecto a estas variables. El área por debajo de los ápices de los premolares mandibulares y el tipo continuo, fueron la localización vertical y apariencia del foramen mental más frecuentes, respectivamente. La edad avanzada se asoció con un aumento en la frecuencia de posicionamiento más inferior y de apariencia continua. La localización vertical y la apariencia fueron asimétricas en 16,2 % y 20,1 % de los casos, respectivamente. La simetría en la localización vertical fue estadísticamente significativa entre sexos (p= 0,035), y entre jóvenes y viejos (P= 0,000). La simetría en apariencia sólo fue estadísticamente significativa (p= 0,025) entre los dos grupos de edad. Se registró presencia de forámenes accesorios en un 7,3 % de los casos. La localización vertical del foramen mental más común en las radiografías panorámicas de este grupo están por debajo de los ápices de los premolares mandibulares, y respecto a la apariencia, el tipo continuo fue el más común. Esto está en coherencia con los resultados de estudios anteriores en otras poblaciones. Los forámenes mentales tienen una localización vertical y apariencia que suelen ser simétricas. Los forámenes accesorios se registran en un porcentaje inferior al informado recientemente en algunos países de la región.

Panoramic mandibular index: Effect of age and gender related variations in the North-Indian population.

Background: Panoramic Mandibular Index (PMI) is a quantitative radiomorphometric index of the mandible. It is an important indicator of mandibular bone mineral density. Objectives: To examine the age and gender related variations associated with the panoramic mandibular index and their effect in a group of North-Indian population of Haryana. Methods: 60 adult human orthopantomographs were evaluated and divided into six age groups (35-65 years) with equal number of males and females. Panoramic mandibular index was measured bilaterally on every radiograph. The measurements were analyzed for interactions with age and sex, using SPSS (Stastistical Package for Social Studies) software version no. 18. The tests employed were Kruskal-Wallis, Mann-Whitney and the unpaired T-test. Results: The male mean panoramic mandibular index values ranged from 0.3 ± 0.025 to 0.381 ± 0.019, whereas the female mean panoramic mandibular values ranged from 0.286 ± 0.306 to 0.36 ± 0.007. Panoramic mandibular index showed significant negative correlation with age in both the sexes. Inter-age group comparisons showed statistically significant differences between the youngest and eldest age-groups in both the genders. Female values were lower than male values in all age groups, but sexual dimorphism was not observed. Conclusion: Panoramic mandibular index was influenced significantly by the variations in age but minimally by the gender related variations.

Morfometría de premolares mandibulares en radiografías panorámicas digitales: análisis de curvaturas radiculares / Morphometric study of mandibular premolars in panoramic digital radiographs: analysis of root curvatures

El objetivo de este trabajo fue describir el grado y orientación de la curvatura radicular en premolares mandibulares, e identificar el tercio radicular en el que la curvatura se origina, mediante el uso de radiografías panorámicas y morfometría lineal. También se detectó la prevalencia de curvaturas radiculares excesivas o dilaceraciones. Se desarrolló un estudio de corte transversal y la muestra consistió en 477 radiografías panorámicas digitales tomadas durante el año 2014 en un centro radiográfico universitario. Se aplicaron criterios de exclusión tanto para radiografías como para los dientes y de esta manera se incorporaron al estudio 118 radiografías (76 mujeres y 42 hombres) y un total de 294 premolares. A partir del análisis de las muestras, se registró el grado y orientación de curvaturas (mesial o distal), el tercio radicular en el que la curvatura se originó y la prevalencia de dilaceraciones. De los dientes curvados, el ángulo promedio de la curvatura fue de 19,68°. Se encontró que 12,24% de los premolares tienen curvatura con orientación mesial, 58,84% tienen orientación distal y 28,92% son rectos. Del total de curvaturas, el 0,48% se originaron en el tercio cervical, 27,27% en el tercio medio y 72,25% en el tercio apical. Una asociación estadísticamente significativa fue encontrada entre el tipo de diente y la orientación de la curvatura (p= 0,025) y entre el tercio del diente en que se originó la curvatura y la orientación de ésta (p= 0,000). Respecto a los premolares mandibulares, tienen curvaturas radiculares en el 72,09% (ángulo promedio: 13,9°). La mayoría de las curvaturas se originaron en el tercio apical (72,25%). La prevalencia de las dilaceraciones fue de 0% o 30,27%, según distintos criterios. A partir de los resultados obtenidos en nuestra investigación consideramos que el conocimiento de la anatomía radicular de los dientes es de importancia antes de la ejecución de procedimientos en endodoncia, ortodoncia y otras áreas, para realizar una planificación adecuada de estas prácticas odontológicas.

The aim of this study was to describe the degree and orientation of root curvature in mandibular premolars and to identify the radicular third in which the curvature originates, using digital panoramic radiographs and linear morphometry. We also aimed to detect the prevalence of excessive root curvatures or dilacerations. A cross-sectional study was developed and were included 477 digital panoramic radiographs taken during 2014 at a university radiologic center. Exclusion criteria were applied to both radiographs and teeth, so that, 118 radiographs (76 women, 42 men) and a total of 294 premolars were included in the study. From the analysis of the samples, we registered the degree of curvature, the curvature orientation (distal or mesial), the part of the root in which the curvature originates, and the prevalence of dilacerations. In curved teeth, the average angle of the curvature was 19.68°. It was found that 12.24% of the premolars have mesial orientation curves, 58.84% have distal orientation curves, and 28.92% were straight. Of the total number of curvatures, 0.48% originated in the radicular cervical third, 27.27% in the middle third, and 72.25% in the apical third. A statistically significant association was found between tooth type and orientation of the curvature (p= 0.025) and between the tooth third in which the curvature originates and the orientation of the curvature (p= 0.000). In respect to mandibular premolars, 72.09% have root curvatures (average angle: 13.9°). Most curvatures originate in the apical third (72.25%). The prevalence of dilacerations was 0% to 30.27% according to different criteria. From the results of our research we believe that knowledge of the anatomy of the tooth root is important before performing procedures in endodontics, orthodontics and other areas, for a proper planning of these dental practices.

The mental foramen I: radiographic study of the anterior-posterior position and shape in Iraqi population / Foramen mental I: estudio radiográfico de su posición antero-posterior y forma en población iraquí

Accurate information regarding the horizontal location and shape of the mental foramen can have clinical significance, such as reducing complications that may occur during maxillofacial surgical procedures involving the mental area. Geographic variations were reported in these variables. The aim was to study the horizontal position and shape of the mental foramen, as seen on panoramic radiographs of an Iraqi sample, to assess difference in these variables between sexes and age groups, and to assess symmetry of the mental foramen. 518 panoramic radiographs of a random Iraqi sample (257 males, 261 females, average age=46.5 years) were evaluated with regard to the horizontal location, shape and symmetry of the mental foramina. The area between the long axes of the two mandibular premolars, and the round type were the most frequent horizontal location and shape of mental foramen, respectively. Age advancement was found to be associated with an increase in the frequency of more posterior positioning and irregular shape. The horizontal position and shape were asymmetrical in 21.6% and 31.6% of cases, respectively. The Symmetry in horizontal location and shape of mental foramina were found statistically significant between sexes (P=0.041), and between young and old age groups (P=0.001), respectively. The most common horizontal location and shape of the mental foramen on panoramic radiographs in this group are between the two premolars, and the round type, respectively. This is in consistence with the findings of previous studies on other populations. The mental foramina have usually symmetrical horizontal locations and shapes.

Información precisa sobre la ubicación horizontal y forma del foramen mental puede tener importancia clínica en la reducción de complicaciones durante procedimientos quirúrgicos maxilofaciales que involucran el área mental. Fueron reportadas variaciones geográficas en relación a estas variables. El objetivo fue estudiar la posición horizontal y forma del foramen mental, a partir de 518 radiografías panorámicas de una muestra aleatoria en sujetos de Irak (257 varones, 261 mujeres; edad media= 46,5 años), quienes fueron evaluados con respecto a la posición horizontal, forma y la simetría de los forámenes mentales. En individuos de edad avanzada se encontró una asociación con un aumento en la frecuencia de un posicionamiento posterior y con forma irregular. La posición horizontal y forma del foramen fueron asimétricos en 21,6% y 31,6% de los casos, respectivamente. La diferencia hallada en relación a la simetría en posición horizontal y forma de los forámenes mentales fue estadísticamente significativa entre sexos (p=0,041), y entre los grupos de edad jóvenes y mayores (P=0,001), respectivamente. Se encontró con mayor frecuencia la posición horizontal entre los ejes longitudinales de los dos premolares mandibulares, y la forma circular, en relación a la posición antero-posterior y forma del foramen, respectivamente. Estos fueron resultados similares a estudios anteriores sobre otras poblaciones. Los forámenes mentales son simétricos, respecto a su ubicación horizontal y su forma.

Influence of age on the radiomorphometric indices of the gonial region of mandible in North- Indian population.

Background: The gonial region of mandible plays a significant role in the determination of mandibular basal bone morphology. Gonial Angle is important for maintenance of a harmonius facial profile whereas Gonial Index is an indicator of the bone quality of the mandibular gonial region. Objectives: To examine the influence of age on two quantitative radiomorphometric indices of mandible, Gonial Angle (GA) and Gonial Index (GI) in a group of North-Indian population. Material and Methods: 60 adult human orthopantomographs were evaluated and divided into six age groups (35-65 years) with equal number of cases. Gonial Angle and Gonial Index were measured bilaterally on each radiograph. The measurements were analyzed for interactions with age and other interrelationships between the indices. The data obtained was subjected to statistical analysis using SPSS (Statistical Package for Social Studies) software version No. 18 and Mann- Whitney tests were used for various comparisons. Results: Gonial angle showed a significant positive correlation with age as the mean gonial angle values showed an increase with increasing age. Whereas in sharp contrast to this, gonial index showed no correlation with age as the mean gonial index values showed no pattern of either increase or decrease with increase in age. The correlation between gonial angle and gonial index was statistically insignificant (p>0.05). Conclusion: Age had a significant influence on the angular radiomorphometric index i.e. gonial angle but the linear radiomorphometric index i.e. gonial index remained independent of age.

Ateromas de carótida nas panorâmicas: como o clínico pode identificar? / Carotid atheromas in panoramic radiographs: how can the general practioner identify?

A presença de ateromas de carótida é associada ao desenvolvimento de acidente vascular encefálico, angina, enfarto do miocárdio e morte. Como a radiografia panorâmica é um dos exames mais utilizados na rotina odontológica, é fundamental evidenciar ateromas calcificados na artéria carótida de pacientes em acompanhamento odontológico a fim de encaminhá-los a avaliação médica na qual outros exames serão feitos para confirmação de diagnóstico e tratamento adequado. Foram avaliadas fichas de pacientes inativos da Faculdade de Odontologia da Universidade Estácio de Sá (RJ). Dos 29 pacientes examinados, seis (20,68%) apresentaram ateromas de carótida. Estes pacientes tinham idade compreendida entre 52 e 73 anos. O objetivo deste trabalho é elucidar como os ateromas de carótida podem ser vistos nas radiografias panorâmicas pelo clínico geral.

The presence of carotid atheroma is associated with the development of stroke, angina, myocardial infarction and death. As long as panoramic radiography is one of the most used exams in routine dental care, is very important for the general dentist to evidence calcified carotid artery atheromas of the patients, in order to direct them to the medical evaluation in which other procedures will be done to confirm the diagnosis and appropriated treatment. We evaluated inactive patient records from the College of Dentistry of Estácio de Sá University (RJ, Brazil). From the total of 29 patients examined, 6 (20.68%) had carotid atheroma. These patients were aged between 52 and 73 years. The objective of this paper is to elucidate how the carotid atheroma can be seen on panoramic radiographs by the general dentist.

Presencia de quistes de retención mucoso del seno maxilar detectados por radiografías panorámicas en pacientes de la ciudad de Temuco, Chile / Presence of mucus retention cysts in maxillary sinus detected by panoramic radiographs on patients of Temuco, Chile

Los quistes de retención mucoso son una patología muy poco frecuente en el seno maxilar, pero de fácil detección en radiografías panorámicas. El propósito de este estudio fue cuantificar los casos de mucoceles en senos maxilares durante un periodo de 5 meses, observando su frecuencia por edad y sexo. Se encontró una prevalencia de 2.06 por ciento en 339 radiografías revisadas, observándose mayor frecuencia en el género masculino y a una edad promedio de 30 años. Todos los casos no manifestaron sintomatología alguna.

Mucus retention cyst are a pathology with very low frequency in maxillary sinus, but easy to detect in panoramic radiographs. The aim of this study was quantify mucocele cases in maxillary sinus along five months, detecting their frequency by age and sex. It was found a prevalence of 2.06 percent, noting more frequently in male sex and with an average age of 30. All cases were presented without previous symptomatology.