Rare Incidental Foreign Body in the Maxillary Sinus on Routine Radiographic Examination

Accidental entry of any foreign body into the paranasal sinus could be due to known causes or unknown causes with the patient being either symptomatic or sometimes asymptomatic. Such asymptomatic conditions make it difficult to detect the foreign body for an indefinite period which on a longer duration may lead to various complications later. Routine radiographic examination during dental checkup reports to serve a good purpose in these kinds of cases by accidental detection of such foreign bodies in the maxillofacial region leading to early diagnosis and timely management. The present paper highlights the importance of routine radiographs in detecting a rare type of foreign body (nasal stud) in the maxillary sinus in the asymptomatic patient.

Correlation analysis between imaging classification of varus knee osteoarthritis and axis angle of tibiofemoral and patellofemoral joints / 中国骨伤

OBJECTIVE@#To explore correlation between imaging classification of knee osteoarthritis (KOA) and axis angle of tibiofemoral and patellofemoral joints.@*METHODS@#A retrospective analysis of 739 middle-aged and elderly patients with KOA (1 026 knee joints) who underwent vertical X-ray examination of both lower limbs and lateral knee joints from September 2018 to December 2020. Among them, 63 patients with K-L 0 grade (95 knee joints), 100 patients with K-L 1 grade (130 knee joints), 161 patients with K-L 2 grade (226 knee joints), 187 patients with K-L 3 grade (256 knee joints), and 228 patients of K-L 4 grade (319 knee joints). According to relative position of knee joint center and line between hip joint center and ankle joint center, the affected knee was divided into varus group(844 knees joints) and valgus group (182 knees joints). According to Install-Salvati method, the affected knee was divided into three groups, such as high patella (patella height>1.2 mm, 347 knees joints), median patella (patella height ranged from 0.8 to 1.2 mm, 561 knees joints), and low patella (patella height<0.8 mm, 118 knees joints). Lower femur angle, upper tibia angle, femoral neck shaft angle, femoral tibial angle, joint gap angle, hip-knee-ankle angle, patella-femoral angle and patella height among different groups were observed and compared.@*RESULTS@#(1) In varus KOA group, there were statistical differnces in hip-knee-ankle angle, tibiofemoral angle, lower femoral angle, upper tibial angle, joint space angle, and femoral neck shaft angle of patients with different K-L grades (P<0.05). Hip-knee-ankle angle, tibiofemoral angle, lower femoral angle, upper tibial angle, joint space angle and K-L grade were significantly positively correlated at 0.01(P<0.05);femoral neck shaft angle and K-L grade showed negative correlation at 0.01(P<0.05). (2) In valgus KOA group, hip-knee-ankle angle, there were statistical differences in tibiofemoral angle, inferior femoral angle, superior tibial angle, joint space angle, and femoral neck shaft angle of patients with different K-L grades(P<0.05). Hip-knee-ankle angle, tibiofemoral angle, lower femoral angle, upper tibial angle, and femoral neck shaft angle showed negative correlation with K-L grades at level of 0.01 (P<0.05);joint gap angle and K-L grades showed significantly positive correlation at level of 0.01(P<0.05). (3) In high patella group, there were statistically differences in patellar height and patellar femoral angle of different K-L grades(P<0.05);there were no statistical difference in patella height and patellar femoral angle of different K-L grades in median patella group. There was no significant difference in patella heightin low patella group with different K-L grades(P>0.05), and there was statistical difference in patellofemoral angle(P<0.05). Patellar height and patella-femoral angle of high patella group were significantly positively correlated with K-L grades at the level of 0.01 (P<0.05);patella height and patella-femoral angle were not correlated with K-L grades in median patella group(P>0.05). There was no correlation between height of patella and K-L grade in low patella group (P>0.05). There was significant negative correlation between patella-femoral angle and K-L grade at level of 0.05 (P<0.05).@*CONCLUSION@#Inferior femoral angle, tibiofemoral angle, joint gap angle, hip-knee-ankle angle, femoral neck shaft angle and high patella are related to K-L classification of varus KOA, which could be used for early diagnosis and provide objective data for efficacy analysis of conservative treatment.

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.

Radiographic features of COVID-19 based on an initial cohort of 96 patients in Singapore

INTRODUCTION@#Chest radiographs (CXRs) are widely used for the screening and management of COVID-19. This article describes the radiographic features of COVID-19 based on an initial national cohort of patients.@*METHODS@#This is a retrospective review of swab-positive patients with COVID-19 who were admitted to four different hospitals in Singapore between 22 January and 9 March 2020. Initial and follow-up CXRs were reviewed by three experienced radiologists to identify the predominant pattern and distribution of lung parenchymal abnormalities.@*RESULTS@#In total, 347 CXRs of 96 patients were reviewed. Initial CXRs were abnormal in 41 (42.7%) out of 96 patients. The mean time from onset of symptoms to CXR abnormality was 5.3 ± 4.7 days. The predominant pattern of lung abnormality was ground-glass opacity on initial CXRs (51.2%) and consolidation on follow-up CXRs (51.0%). Multifocal bilateral abnormalities in mixed central and peripheral distribution were observed in 63.4% and 59.2% of abnormal initial and follow-up CXRs, respectively. The lower zones were involved in 90.2% of initial CXRs and 93.9% of follow-up CXRs.@*CONCLUSION@#In a cohort of swab-positive patients, including those identified from contact tracing, we found a lower incidence of CXR abnormalities than was previously reported. The most common pattern was ground-glass opacity or consolidation, but mixed central and peripheral involvement was more common than peripheral involvement alone.

Two methods of treatment for skeletal Class Ⅲ malocclusion on airway changes before and after clinical research / 口腔疾病防治

Objective @# To investigate the changes in the sagittal diameter of the upper airway before and after the treatment of skeletal Class Ⅲ malocclusion in adults with microimplant anchorage and class Ⅲ intermaxillary elastics and to provide a reference for clinical treatment. @*Methods @#A total of 35 adult patients with skeletal Class Ⅲ malocclusion were selected to be treated with the straight-wire technique. Microimplant group, 15 cases (group A): patients with severe skeletal Class Ⅲ malocclusion (vertical high angle) were treated with the straight-wire technique combined with microimplant anchorage; class Ⅲ intermaxillary elastics group, 20 cases (group B): Patients with mild or moderate skeletal Class Ⅲ malocclusion (vertical low angle and average angle) were treated with the straight-wire technique combined with class Ⅲ intermaxillary elastics, and cephalometric radiographs obtained before and after treatment in the upper airway in the two groups were measured and analyzed.@*Results @#Changes in cranial and maxillofacial measurements after correction: in group A, (sella-nasion-supramental angle) the SNB angle decreased significantly (P < 0.05), and (subspinale-nasion-supramental angle) the ANB angle increased significantly (P < 0.05). In group B, the SNB angle decreased significantly (P < 0.05), while (subspinale-nasion-subspinale angle) the SNA angle、ANB angle and anterior skull base plane-mandibular plane angle (Sn-MP) angle increased significantly (P < 0.05). Changes in sagittal diameter of the upper airway measurements after corrections: In group A, the width of the glossopharyngeal segment of the upper airway (TB-TPPW) decreased significantly (P < 0.05). In group B, first segment width of the upper airway behind the hard palate (PNS-R) increased significantly (P < 0.05). After correction, the decreased SNB and increased ANB in group A was higher than that in group B, and the difference was statistically significant （P < 0.05）. The decreased of TB-TPPW in upper airway of group A was greater than that of group B, and the difference was statistically significant （P < 0.05）.@* Conclusions @#In the treatment of skeletal class Ⅲ malocclusion with microimplant anchorage, the sagittal diameter of the glossopharyngeal segment of the upper airway has a negative impact.

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.

Variaciones anatómicas de los senos frontales en radiografías de cráneo de pacientes con cráneos braquicéfalos / Anatomical variations of frontal sinuses in skull radiographs of patients with brachycephalic skulls

Introducción: La anatomía ósea de las cavidades paranasales presenta múltiples variantes, que pueden ser causa o factor predisponente de enfermedad rinosinusal, entre las que se encuentran las asimetrías y las agenesias. Éstas pueden ser reparos de gran importancia en la cirugía endoscópica nasal y demandan atención médica con frecuencia. Objetivo: Determinar las variaciones anatómicas de los senos frontales en los pacientes con cráneos braquicéfalos y que no presentaron diagnóstico de enfermedad rinosinusal. Métodos: Se realizó un estudio observacional, descriptivo y transversal, donde fueron estudiados los diámetros transversales y longitudinales de los senos frontales a través de radiografías de cráneo AP en 28 pacientes con cráneos braquicéfalos, en el servicio de imagenología del Hospital Juan Bruno Zayas Alfonso en los meses de enero y febrero de 2019. Resultado: Se identificaron las principales variaciones de los senos frontales a través de radiografías de cráneo y su comportamiento según variables epidemiológicas. Conclusiones: Predominó los enfermos (9) en el rango etáreo de 19-29 años, lo que representa un 32,1 por ciento, hubo un ligero predominio de los hombres con respecto a las mujeres, 10 (35,7 por ciento) pacientes presentaron agenesia bilateral y 3 (10,7 por ciento) agenesia unilateral izquierda. Las magnitudes de las cavidades derechas fueron mayores que las izquierdas y los senos frontales estudiados son asimétricos por su tamaño y posición(AU)

Introduction: The bone anatomy of paranasal cavities presents a large number of variants which may be the cause of or predisposing factor for rhinosinus disease, among which are asymmetry and agenesis. These may be very important hurdles in nasal endoscopic surgery and often require medical care. Objective: Determine the anatomical variations in the frontal sinuses of patients with brachycephalic skulls not diagnosed with rhinosinus disease. Methods: A cross-sectional observational descriptive study was conducted of frontal sinus longitudinal and transverse diameters of frontal sinuses based on AP skull radiographs of 28 patients with brachycephalic skulls attending the imaging service of Juan Bruno Zayas Alfonso Hospital from January to February 2019. Result: Identification was made of the main frontal sinus variations in skull radiographs and their behavior according to epidemiological variables. Conclusions: The 19-29 years age group prevailed, with 9 patients (32.1 percent). There was a slight predominance of men versus women. Ten (35.7 percent) patients had bilateral agenesis and 3 (10.7 percent) had unilateral left agenesis. The magnitudes for right cavities were greater than those for left cavities. The frontal sinuses studied were asymmetrical in terms of size and position(AU)

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.

Permanent Maxillary Premolars With Three Canals- A Case Report

Maxillary first premolar is a bi-rooted tooth with several variations in the root canal morphology. Usually it has 2 canals, however at times there could be an additional third canal present which could easily be missed by the clinician owing to lack of awareness and knowledge about the canal variations. Awareness of internal and external anatomy of tooth and also about its variations are essential for successful endodontic therapy. Prevalence of three canals in maxillary premolar is very low. This case report describes the endodontic management of permanent maxillary premolars with three root canals.

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

Role of bone status in anterolateral portion of femoral head in the progression of osteonecrosis of the femoral head / 中国组织工程研究

BACKGROUND:Mechanical stress plays an important role in the progressive collapse in osteonecrosis of the femoral head.Therefore,the bone structure of weight-bearing area may be the risk factor for collapse.OBJECTIVE:To investigate the relationship between the bone preservation of weight-bearing area and collapse progression in necrotic femoral head.METHODS:Eighty-seven patients (102 hips) with ARCO stage Ⅱ osteonecrosis of the femoral head,diagnosed by MRI,were enrolled.All patients underwent a natural progression.Collapse and bone involvement of the weight-bearing area were viewed by anteroposterior and frog-leg lateral radiographs.According to the location of the necrotic lesion on the anterolateral portion of the femoral head,the necrosis was divided into three types:type 1,the posteromedial and central portions;type 2,part of the anterolateral portion;type 3,the entire anterolateral portion.The collapse rate and the time to collapse in different types were assessed.RESULTS AND CONCLUSION:(1) All patients were followed up for 3-58 months.(2) Of the 60 hips with collapse,46 (76.7％) hip collapse was identified on anteroposterior radiograph.On frog-leg lateral radiograph showing collapsed femoral head could be identified in 57 (95.0％) hips,which was significantly different (P ＜ 0.01).(3) In all 102 hips,the collapse rate in type 3 osteonecrosis of the femoral head was significantly higher than that of type 2 osteonecrosis of the femoral head (P ＜ 0.001),and the time to collapse was markedly shortened.None collapse occurred in all six hips with type Ⅰ osteonecrosis of the femoral head during follow-up.(4) In summary,preservation of anterolateral portion is associated with potential collapse progression in necrotic femoral head.

Segmentation of lung fields from chest radiographs-a radiomic feature-based approach

Precisely segmented lung fields restrict the region-of-interest from which radiological patterns are searched, and is thus an indispensable prerequisite step in any chest radiographic CADx system. Recently, a number of deep learning-based approaches have been proposed to implement this step. However, deep learning has its own limitations and cannot be used in resource-constrained settings. Medical systems generally have limited RAM, computational power, storage, and no GPUs. They are thus not always suited for running deep learning-based models. Shallow learning-based models with appropriately selected features give comparable performance but with modest resources. The present paper thus proposes a shallow learning-based method that makes use of 40 radiomic features to segment lung fields from chest radiographs. A distance regularized level set evolution (DRLSE) method along with other post-processing steps are used to refine its output. The proposed method is trained and tested using publicly available JSRT dataset. The testing results indicate that the performance of the proposed method is comparable to the state-of-the-art deep learning-based lung field segmentation (LFS) methods and better than other LFS methods.

Robust pulmonary segmentation for chest radiography, combining enhancement, adaptive morphology and innovative active contours

Abstract Introduction Statistical data reveal that approximately 140 million radiological exams are performed annually in Brazil. These exams are designed to detect and to analyze fractures, caused by different types of trauma; as well as, to diagnose pathologies such as pulmonary diseases. For better visualization of those lesions or abnormalities, methods of image segmentation can be implemented. Such methods lead to the separation of the region of interest, which allows extracting the characteristics and anomalies of the desired tissue. However, the methods developed by researchers in this area still have restrictions. Consequently, we present an automatic pulmonary segmentation approach that overcomes these constraints. Methods This method is composed of a combination of Discrete Wavelet Packet Frame (DWPF), morphological operations and Gradient Vector Flow (GVF). The methodology is divided into four steps: Pre-processing - the original image is enhanced by discrete wavelet; Processing - where occurs a combination of the Otsu threshold with a series of morphological operations in order to identify the pulmonary object; Post-processing - an innovative form of using GVF improves the binary information of pulmonary tissue, and; Evaluation - the segmented images were evaluated for accuracy of detection the pulmonary region and border. Results The evaluation was carried out by segmenting 247 digital X-ray challenging images of the thorax human. The results show high for values of Overlap (97,63% ± 3.34%), and Average Contour Distance (0.69mm ± 0.95mm). Conclusion The results allow verifying that the proposed technique is robust and more accurate than other methods of lung segmentation, besides being a fully automatic method of lung segmentation.

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.