Comparative Analysis of the Discrepancy in Conventional Cephalometric Tracing and Digital Cephalometric Tracing with Planmeca Romexis® Software / Análisis comparativo de la discrepancia en trazado cefalométrico convencional y trazado cefalométrico digital con el software Planmeca Romexis®

Abstract The objective of this study was to compare the discrepancy in conventional cephalometric tracing and digital cephalometric tracing in lateral skull radiographs, with 3 angular and 3 linear measurements. We used 24 digital lateral skull radiographs of patients from the Universidad Latina de Costa Rica, taken with the Kodak 8000C Digital Panoramic and Cephalometric System, for the computerized tracing the radiographs were passed directly to the Planmeca Romexis® software, and the same radiographs were printed for the manual tracing. A comparison between the manual tracing and the Planmeca Romexis® software measurements showed statistically significant differences (p<0,05) of 4 measurements between the two systems. It is evident that the cephalometric tracing with the Planmeca Romexis® software is more reliable than the manual tracing due to the data obtained in this research.

Resumen El objetivo de este estudio fue comparar la discrepancia en trazado cefalométrico convencional y trazado cefalométrico digital en radiografías laterales de cráneo, con 3 mediciones angulares y 3 lineales. Se utilizaron 24 radiografías digitales de lateral de cráneo de pacientes de la Universidad Latina de Costa Rica, tomadas con el aparato Kodak 8000C Digital Panoramic and Cephalometric System, para el trazado computarizado se pasó directamente la radiografía al software Planmeca Romexis®, las mismas radiografías fueron impresas para el trazado manual. A la comparación entre el trazado realizado manualmente y las medidas del programa Planmeza Romexis® se encontraron diferencias estadísticamente significativas(p<0,05) de 4 mediciones entre los dos sistemas. Se evidencia que el trazado cefalométrico con el software Planmeca Romexis® es más confiable que el trazado manual por los datos arrojados en esta investigación.

Los estudios por imágenes en la evaluación del niño con estridor / Imaging studies in evaluating children with stridor

El estridor es un síntoma de obstrucción de la vía aérea superior y puede ser resultado de causas congénitas o adquiridas. El diagnóstico suele ser clínico. Si es necesaria una investigación adicional para el diagnóstico diferencial, la endoscopia es el método de elección en la mayoría de los casos. Los estudios por imágenes son complementarios a la endoscopia. Permiten evaluar la patología laríngea y traqueobronquial, las compresiones extrínsecas de la vía aérea por tumores o malformaciones vasculares y definir la localización, extensión y características de una lesión. Son útiles en casos de duda diagnóstica y cuando la endoscopia no está disponible. Es fundamental comprender la anatomía y fisiopatología del tracto respiratorio, y ser conscientes de las indicaciones y limitaciones de los exámenes complementarios para el diagnóstico adecuado. Se describen las diferentes modalidades de imágenes disponibles para evaluar el estridor en pediatría y se discuten sus ventajas.

Stridor is a symptom of upper airway obstruction and may result from congenital or acquired causes. The diagnosis is usually clinical. If further investigation is necessary for differential diagnosis, endoscopy is the method of choice in most cases. Imaging studies are complementary to endoscopy. They allow evaluation of laryngeal and tracheobronchial pathology and extrinsic airway compressions due to tumors or vascular malformations and define a lesion's location, extent, and characteristics. They are helpful in cases of diagnostic doubt and when endoscopy is unavailable. It is essential to understand the anatomy and pathophysiology of the respiratory tract and to be aware of the indications and limitations of complementary examinations for proper diagnosis. The different imaging modalities available to evaluate stridor in pediatrics are described, and their advantages are discussed.

Imaging diagnosis of compound - complex odontoma and impacted dental elements: a case report

O odontoma é o mais comum tumor odontogênico, definido como malformação benigna, geralmente descoberto na segunda década de vida, durante a investigação de erupção tardia de dentes adjacentes ou retenção prolongada de dentes decíduos. O odontoma é subdividido em composto e complexo. O Odontoma classificado como Composto é constituído por um conjunto de estruturas similares a dentes, de formas e tamanhos diversos, cercados por uma área delgada radiolúcida. Já o Odontoma Complexo se assemelha a uma massa calcificada que apresenta a mesma radiopacidade do tecido dentário, também cercado por uma área delgada radiolúcida. Ocasionalmente, esses dois aspectos podem ser vistos em uma mesma lesão. Frequentemente os odontomas podem provocar um aumento de volume ósseo local devido ao seu desenvolvimento. O diagnóstico é feito através de exames radiográficos de rotina e quando necessário pode-se também lançar mão de Radiografias Panorâmicas e Tomografia Computadorizada Cone Beam com o intuito de verificar sua extensão, as malformações e alterações de erupção causadas aos dentes adjacentes, assim como a classificação do tumor. Este relato de caso apresenta um Odontoma Composto-Complexo em um paciente de 13 anos, do sexo masculino, atendido em 2016 na Clínica de Diagnóstico Bucal II da Universidade Federal Fluminense, que apresentou elementos dentários 22 e 23 impactados, retenção prolongada do elemento 63 e aumento de volume na região anterior do lado esquerdo da maxila. Para obtenção do diagnóstico foram realizadas: Radiografias Periapicais, Radiografia Panorâmica e Tomografia Computadorizada Cone Beam. O objetivo deste trabalho foi elucidar as formas de diagnóstico por imagem que foram utilizadas neste caso clínico e quais as vantagens de cada exame.

Odontomas are the most common type of odontogenic tumors, defined as a benign malformation, usually diagnosed in the second decade of life, during the investigation of late adjacent teeth eruption or a delay in exfoliation of deciduous teeth. They are divided into two types: compound and complex. The odontoma classified as compound is composed of multiple small tooth-like structures, in several shapes and sizes, surrounded by a thin radiolucent rim. On the other hand, complex odontomas resemble a mass of calcified tissue that presents the same dental tissue radiopacity, also surrounded by a thin radiolucent rim. Occasionally, both aspects can be seen in the same lesion. Often, odontomas can cause a local increase in bone volume due to their development. The diagnosis is made through routine radiographic examination and, when it is necessary, it is possible to make use of panoramic radiographies and cone beam computed tomography with the purpose of verifying its extension, malformations and erupted alterations caused to the adjacent teeth, as well as the tumor classification. This case report presents a Compound-Complex Odontoma in a 13-year-old male patient, treated in 2016 at the Oral Diagnosis Clinic II of the Federal Fluminense University. He presented impacted teeth 22 and 23, delayed eruption of tooth 63 and volume increase in the left anterior maxilla site. Aiming the patient's diagnosis, the following exams were necessary: periapical radiographies, panoramic radiography, cone beam computed tomography. The aim of this paper is to explain the different image diagnostic tools which were used in this clinical study and what are the advantages of each exam.

Potential of artificial intelligence to generate health research reports of decayed, missed and restored teeth / Potencial de la inteligencia artificial para generar informes de investigación sanitaria sobre dientes cariados, perdidos y restaurados

Abstract This study aims to indicate the potential of artificial intelligence (AI) in epidemiological reports of decayed, missed and restored teeth. As a proof of concept our study model used panoramic x-ray images and an AI algorithm for tooth numbering, detection of the caries and restorations with accuracy over 80% for such diagnostic tasks. The output came as the number of decayed, missed and restored teeth according to patient's age and the DMFT index (number of decayed, missing, and filled teeth) which varied from 3.6 (up to 20 years old) to 20.4 (+60 years old). Thus, it is suggested that AI is a promising method to automate health data collection through the analysis of x-rays.

Resumen Este estudio tiene como objetivo indicar el potencial de la inteligencia artificial (IA) en los informes epidemiológicos de dientes cariados, perdidos y restaurados. Como prueba de concepto, nuestro modelo de estudio utilizó imágenes panorámicas de rayos X y un algoritmo de inteligencia artificial para la numeración de dientes, la detección de caries y las restauraciones con una precisión superior al 80 % para dichas tareas de diagnóstico. El resultado fue el número de dientes cariados, perdidos y restaurados según la edad del paciente y el índice CPOD (número de dientes cariados, perdidos y obturados) que varió de 3,6 (hasta 20 años) a 20,4 (+60 años). Por tanto, se sugiere que la IA es un método prometedor para automatizar la recopilación de datos de salud mediante el análisis de rayos X.

Dientes supernumerarios tipo mesiodens evaluados a través de radiografías panorámicas digitales en un centro radiológico privado en Manizales, Colombia / Mesiodens-type supernumerary teeth evaluated through digital panoramic radiographs in a private radiology center in Manizales, Colombia / Dentes supranumerários do tipo mesiodens avaliados através de radiografias panorâmicas digitais em um centro de radiologia privado em Manizales, Colômbia

RESUMEN Objetivo: Evaluar los dientes supernumerarios tipo mesiodens en radiografías panorámicas digitales tomadas entre los años 2019-2020 en un centro radiológico privado de Manizales, Colombia. Materiales y métodos: Estudio retrospectivo, descriptivo, transversal y observacional. La población estuvo constituida por 1000 radiografías panorámicas del centro radiológico en la ciudad Manizales, Colombia, entre los años 2019-2020. Se accedió a la base de datos virtual. Las variables evaluadas fueron edad, sexo, presencia o ausencia de mesiodens, número de dientes con anomalía, forma del diente, posición, localización y evolución. Se realizó un análisis estadístico según frecuencia y porcentajes. Resultados: La frecuencia de diente supernumerario (DS) mesiodens fue de 3,8 % (n = 40) con una predilección por el sexo masculino. Predominó la presencia de 1 mesiodens (n = 38) y el mayor número de casos se encontró en grupos de 6 a 11 (n = 13) y 12 a 17 (n = 21) años, según el tipo rudimentario y la evolución intraósea. Conclusión: Los DS tipo mesiodens son una condición que no es muy frecuente encontrarla en la población estudiada; sin embargo, este estudio permitió realizar una caracterización para Colombia, en donde no se posee mucha evidencia científica al respecto, y contrastarlo con otros estudios realizados a nivel nacional e internacional.

ABSTRACT Objective: To evaluate mesiodens supernumerary teeth in digital panoramic radiographs taken between 2019 and 2020 at a private radiological center in Manizales, Colombia. Materials and Methods: A retrospective, descriptive, cross-sectional, observational study was conducted. The study population consisted of 1,000 panoramic radiographs from the radiological center in Manizales, Colombia, from 2019-2020. A virtual database was accessed for this purpose. The evaluated variables included age, sex, presence or absence of mesiodens, number of teeth with anomalies, tooth shape, position, location, and evolution. Statistical analysis was performed using frequencies and percentages. Results: The frequency of mesiodens supernumerary teeth was 3.8% (n=40), with a higher occurrence in males. Most cases involved a single mesiodens (n=38), with the highest number of cases in the age groups of 6 to 11 years (n=13) and 12 to 17 years (n=21), characterized by a rudimentary type and intraosseous evolution. Conclusion: Mesiodens type DS is a condition not very frequently found in the population studied; however, this study allowed us to carry out a characterization for Colombia, where there is not much scientific evidence in this regard, in order to have the possibility of contrasting it with other studies carried out nationally and internationally.

RESUMO Objetivo: Avaliar dentes supranumerários do tipo mesiodens em radiografias panorâmicas digitais obtidas entre 2019 e 2020 em um centro de radiologia privado em Manizales, Colômbia. Materiais e métodos: Estudo retrospectivo, descritivo, transversal e observacional. A população consistiu em 1000 radiografias panorâmicas do centro radiológico na Manizales, Colômbia, entre os anos de 2019 e 2020. O banco de dados virtual foi acessado. As variáveis avaliadas foram idade, sexo, presença ou ausência de mesiodens, número de dentes com anomalia, forma do dente, posição, localização e evolução. A análise estatística foi realizada de acordo com a frequência e as porcentagens. Resultados: A frequência de dente supranumerário (DS) mesiodens foi de 3.8% (n = 40), com predileção pelo sexo masculino. A presença de 1 mesiodens foi predominante (n = 38) e o maior número de casos foi encontrado nas faixas etárias de 6 a 11 (n = 13) e 12 a 17 (n = 21) anos, de acordo com a caracterização do tipo rudimentar e da evolução intraóssea. Conclusões: O DS do tipo mesiodens é uma condição não muito frequente na população estudada; no entanto, esse estudo permitiu que fosse feita uma caracterização para a Colômbia, onde não há muitas evidências científicas sobre o assunto, a fim de ter a possibilidade de contrastá-la com outros estudos realizados nacional e internacionalmente.

Hallazgos radiográficos asociados a la alteración nerviosa posquirúrgica en la cirugía de los terceros molares inferiores / Radiographic findings associated with postsurgical nerve alteration in lower third molar surgery / Achados radiográficos associados à alterações nervosas pós-cirúrgica na cirurgia dos terceiro molar inferior

RESUMEN Objetivo: Identificar los hallazgos radiográficos asociados a una alteración nerviosa posquirúrgica en la cirugía de los terceros molares inferiores de pacientes atendidos en el quirófano de la Facultad de Odontología durante el período 2015-2019. Materiales y métodos: Estudio transversal con una población de estudio compuesta por historias clínicas y radiografías panorámicas de pacientes que se extrajeron los terceros molares inferiores en la FOUCE (Facultad de Odontología de la Universidad Central del Ecuador) durante el período 2015-2019. La muestra se seleccionó con criterios de inclusión y exclusión. Se observó en las radiografías los signos predictores y en las notas de evolución la presencia o ausencia de una alteración nerviosa. Los datos fueron registrados en una ficha de Excel y el análisis estadístico se realizó en el programa SPSS 25.0. Se ejecutó una estadística descriptiva para frecuencias absolutas y relativas, y para la relación entre variables chi-cuadrado con un nivel de confianza del 95 %. Resultados: La frecuencia de la alteración nerviosa fue de 3,8 % (n = 16), para mayores de 25 años se presentó en un 9,7 % (n = 7), y para la clasificación Pell y Gregory tipo C y clase II en un 4,4 % (n = 6) y 2,4 % (n = 13), respectivamente. Adicionalmente, el signo raíz oscura y bífida se presentó en un 8,7 % (n = 2) de las alteraciones nerviosas. Conclusiones: Los signos radiográficos raíz oscura y bífida, pérdida de la línea blanca y desviación del canal están asociados a la alteración nerviosa posquirúrgica en la cirugía de los terceros molares inferiores.

ABSTRACT Objective: To identify the radiographic findings associated with postsurgical nerve alteration in lower third molar surgery in patients treated in the Faculty of Odontology operating room from 2015 to 2019. Materials and methods: This cross-sectional study included a population composed of medical records and panoramic radiographs of patients who underwent lower third molar extraction at the Faculty of Odontology, Universidad Central del Ecuador (FOUCE), from 2015 to 2019. The sample was selected based on inclusion and exclusion criteria. Radiographic predictor signs were observed, and the presence or absence of nerve alteration was assessed from the evolution notes. Data were recorded in an Excel file, and statistical analysis was conducted using SPSS version 25.0. Descriptive statistics for absolute and relative frequencies, as well as the relationship between variables, were analyzed using the Chi-square test with a confidence level of 95%. Results: The frequency of nerve alteration was 3.8% (n = 16); for patients older than 25 years, it was 9.7% (n = 7). For the Pell and Gregory classification, type C and class II had frequencies of 4.4% (n = 6) and 2.4% (n = 13), respectively. The dark and bifid root sign was found in 8.7% (n = 2) of the cases with nerve alteration. Conclusions: In third molar surgery, radiographic signs such as dark and bifid roots, loss of the white line, and canal deviation are associated with postsurgical nerve alteration.

RESUMO Objetivo: Identificar os achados radiográficos associados a alterações nervosas pós-cirúrgicas na cirurgia dos terceiros molares inferiores em pacientes tratados na Sala de Operações da Faculdade de Odontologia durante o período de 2015 a 2019. Materiais e métodos: Este estudo transversal incluiu uma população composta por prontuários e radiografias panorâmicas de pacientes que se submeteram à extração do terceiro molar inferior na Faculdade de Odontologia da Universidad Central del Ecuador (FOUCE) entre 2015 e 2019. A amostra foi selecionada usando critérios de inclusão e exclusão. Os sinais preditores foram observados nas radiografias e a presença ou ausência de uma alteração nervosa foi registrada nas notas de evolução. Os dados foram registrados em um arquivo do Excel, e a análise estatística foi conduzida utilizando o SPSS versão 25.0. Estatísticas descritivas para frequências absolutas e relativas, bem como a relação entre variáveis, foram analisadas utilizando o teste Qui-quadrado com um nível de confiança de 95%. Resultados: A frequência de alteração nervosa foi de 3.8% (n = 16), para aqueles com mais de 25 anos de idade foi de 9.7% (n = 7), e para a classificação de Pell e Gregory tipo C e classe II foi de 4.4% (n = 6) e 2.4% (n = 13), respectivamente. Além disso, o sinal de raiz escura e bífida estava presente em 8.7% (n = 2) das alterações nervosas. Conclusões: Os sinais radiográficos de raiz escura e bífida, perda da linha branca e desvio do canal estão associados à alteração nervosa pós- cirúrgica na cirurgia de terceiros molares inferiores.

Dental Radiographic Alterations in Patients Undergoing Antineoplastic Therapy in Childhood: A Case Series

Introduction: Antineoplastic therapy (AT) can cause unwanted effects, including dental alterations. However, many of the studies are case control or cohort studies, use a big number of patients, and may make it difficult to discuss the individual sequels. Objective: Therefore, this article aims to describe five cases of patients who had done AT in childhood or adolescence and discuss the radiography alterations. The side effects related were agenesis (five patients), root anomalies (two patients) and microdontia (two patients). This individual case analysis enabled to discuss chemotherapeutic agents and radiation parameters individually and the age of dental formation when the patient did the AT. Conclusion: In these cases, only when the therapy was perform in the age of teeth formation it was consider a direct effect of AT, so the cases presents root malformations, microdontia and premolars agenesis and third molars agenesis. On the other hand, another cases of root malformations, microdontia and third molars agenesis may be an indirect effect of AT or caused by other external factors, because the AT was not performed at the age of formation of these teeth.

Association between pulp stones and systemic diseases: a case-control study / Associação entre nódulos pulpares e doenças sistêmicas: um estudo caso-controle

INTRODUCTION: Pulp stones (PS) are calcifications commonly found in the pulp tissue that may be associated with systemic diseases. OBJECTIVE: To evaluate the association between PS and systemic diseases. METHODS: A case-control study with the inclusion of individuals from 18 to 65 years of age, of both sexes. Analysis was made of 1047 digital panoramic radiographs. The controls could not have any teeth with PS; the cases were the contrary. A questionnaire comprising demographic, habit, and general health (diabetes, problems with blood vessels, altered cholesterol level, heart attack, kidney or gallbladder stone, arthritis, or autoimmune disease, and for women, endometriosis, and ovarian cyst). Data were submitted to the Student's t-test to identify differences between groups about sex and age. The Chi-square test was applied to the cross-tabulation. The analyses were performed using SPSS®, version 25.0, with a 5% significance level. RESULTS: 490 patients participated (242 cases and 248 controls). There was no difference between groups for the sex (p=0.966) and age (p=0.186). Only "kidney stone" was associated with the case group (p=0.001), being almost three times higher when compared to the control group. No significant differences were found in females about the presence or absence of PS (p>0.05). CONCLUSÃO: In this research, it is suggested the existence of an association between kidney stones and the presence of pulp stones.

INTRODUÇÃO: Nódulos pulpares (NP) são calcificações comumente encontradas no tecido pulpar que podem estar associadas a doenças sistêmicas. OBJETIVO: Avaliar a associação entre NP e doenças sistêmicas. MÉTODOS: Estudo caso-controle com inclusão de indivíduos de 18 a 65 anos de idade, de ambos os sexos. Foram analisadas 1047 radiografias panorâmicas digitais. Os controles não poderiam ter dentes com NP; os casos foram o contrário. Foi aplicado um questionário aos participantes, contendo variáveis demográficas, de hábitos e de saúde geral (diabetes, problemas com vasos sanguíneos, nível de colesterol alterado, ataque cardíaco, cálculo renal ou biliar, artrite ou doença autoimune, e para as mulheres, endometrioses e cisto no ovário). Os dados foram submetidos ao teste t de Student para identificar diferenças entre os grupos em relação ao sexo e à idade. O teste Qui-quadrado foi aplicado para a tabulação cruzada. As análises foram realizadas no SPSS®, versão 25.0, com nível de significância de 5%. RESULTADOS: Participaram 490 pacientes (242 casos e 248 controles). Não houve diferença entre os grupos para sexo (p=0,966) e idade (p=0,186). Apenas "cálculo renal" associou-se ao grupo caso (p=0,001), sendo quase três vezes maior quando comparado ao grupo controle. Não foram encontradas diferenças significativas no sexo feminino em relação à presença ou ausência de PS (p>0,05). CONCLUSÃO: Nesta pesquisa, sugere-se a existência de uma associação entre cálculos renais e presença de Nódulos pulpares.

Unusually Pronounced and Expansive Mandibular Foramen. A Incidental Radiological Finding / Foramen Mandibular Inusualmente Pronunciado y Expansivo: Un Hallazgo Radiológico Incidental

SUMMARY: The mandibular foramen and its canal are one of the most important structures in the skull, as they solely supply the mandible through their associated nerves and vessels. Many anatomical variations have been reported in the literature until now, and this case report represents a clear-cut appearance of its shape in a panoramic radiograph, which is not mostly seen in normal panoramic radiographs. These factors are of utmost importance when it comes to performing various surgeries and preventing complications due to their varied anatomy, which will allow dentists to create a better treatment plan and provide better treatments without any complications.

El foramen mandibular y su canal son algunas de las estructuras más importantes del cráneo y cara, ya que a través de ellos la mandíbula es inervada por nervios e irrigada por vasos. Hasta ahora, en la literatura consultada, se han informado de numerosas variaciones anatómicas. En este trabajo reportamos la forma y trayecto del foramen y canal mandibular, obtenidos en una radiografía panorámica, que no es observada normalmente en este tipo de radiografía. Los factores anatómicos son de importancia a la hora de realizar las cirugías para prevenir complicaciones debido a su variada anatomía, permitiendo a los odontólogos crear un mejor plan de tratamiento sin ningún tipo de complicaciones.

Quality analysis of four filling techniques in ovoid root canals prepared with M® instruments

Aims: This study aimed to assess the quality of various filling techniques in ovoid root canals prepared using M® instruments. Materials and Methods: Sixty ovoid root canals underwent endodontic treatment with M® instruments and were subsequently divided randomly into four experimental groups, each employing a different obturation technique: TU - single cone; TL - active lateral condensation; TH - Tagger hybrid; TS - Schilder technique. Digital radiographs were taken in both mesiodistal and buccolingual directions to examine the filled teeth. The percentage of filling material and empty spaces was quantified using Photoshop® software. Data were subjected to statistical analysis using the one-way ANOVA test and T test (? = 0.05). Results: In the TL and TS groups, there was a significantly lower average percentage of unfilled spaces compared to the TU and TH groups (P<0.0001). When analyzing the radiographic directions, the mesiodistal view exhibited the highest mean percentage of unfilled spaces, with differences in filling quality observed only in the TU and TL groups. Conclusions: Active lateral condensation and Schilder techniques demonstrated superior performance in achieving effective filling of ovoid root canals.

Association between Facet Fluid on Supine Axial T2-Weighted MRI and Sagittal Instability on Dynamic Standing Lateral Radiographs in Patients with Degenerative Lumbar Disease

Study Design: Prospective observational study conducted at a large tertiary care center in Karachi, Pakistan. Purpose: To examine the association between positive facet fluid on T2-weighted MRI of lumbosacral spine and the presence of instability on lateral flexion/extension radiographs, and to determine whether a correlation exists between the quantity of facet fluid on axial MRI and the degree of spinal instability on lateral standing flexion/extension radiographs. Overview of literature: The presence of increased facet fluid on axial T2-weighted magnetic resonance imaging (MRI) has been proposed as a potential marker for motion segment instability in the lumbar spine. Both facet fluid on MRI and spinal instability on dynamic x-rays are crucial in diagnosing and managing low back pain, guiding decisions on surgical interventions. Methods: We analyzed the prospectively collected data from patients meeting the inclusion criteria. Facet fluid measurements were made according to Schinnerer's criteria on axial T2-weighted images and anterior translation as a marker of instability was evaluated on dynamic radiographs for all eligible patients. Statistical analysis was performed using IBM SPSS version 23, employing cross-tabulations, chi-square tests, and Pearson correlation. The study utilized a null hypothesis to evaluate the association between facet fluid and spinal instability. Results: Our findings demonstrated a statistically significant association between positive facet fluid on MRI and the occurrence of instability on lateral flexion/extension radiographs. Moreover, we found a strong positive correlation between the volume of facet fluid on axial MRI and the level of spinal instability on standing flexion/extension radiographs. Conclusion: Based upon these outcomes, we propose that standing lateral flexion–extension radiographs should be routinely administered to patients exhibiting increased facet fluid signals on MRI, as they may provide valuable information regarding potential spinal instability. Further research will help establish the clinical utility of this approach in managing degenerative lumbar diseases.

Pediatric dental radiography: safety, techniques and diagnostic applications

Children, with their higher cellular metabolism, longer lifespans, and smaller bodies, require specific adjustments in X-ray settings. The increased mitotic cell activity in children, coupled with their longer life expectancy, raises concerns about the potential long-term effects of radiation exposure, such as tumor development or cancer-related deaths. Therefore, radiographs should be prescribed based on individual patient needs, balancing the necessity for diagnostic clarity with the risks of radiation. Radiographs play a vital role in the diagnosis of traumatic dental injuries, as they can reveal injuries that may not be apparent through clinical examination alone. In pediatric dentistry, radiography is essential for diagnosing dental caries, monitoring growth, and identifying developmental or pathological conditions. They are invaluable in treatment planning and assessing dentofacial structures. However, the decision to use radiography should follow a comprehensive assessment, considering each child's medical, dental, as well as the clinical background, as well as environmental factors. Special techniques and considerations are necessary for infants, young children, individuals with disabilities, as well as those with gag reflexes.

Two-year follow-up of the outcomes of endoscope-assisted minimally invasive nonsurgical periodontal therapy for deep intrabony defects / 口腔疾病防治

Objective@#To explore the clinical efficacy and imaging changes of minimally invasive nonsurgical periodontal therapy (MINST) assisted by endoscopy for deep intrabony defects and to compare its effectiveness with that of traditional scaling and root planning (SRP) to therefore provide a reference for clinical periodontal treatment.@*Methods@#Patients with deep intrabony defects ≥ 4 mm in size were selected and divided into two groups: the MINST (MINST, 20 cases, 81 sites) group and the classic scaling and root planing (SRP, 20 cases, 80 sites) group. Before treatment and 12 and 24 months after treatment, probing depth (PD) and clinical attachment loss (CAL) were examined. Moreover, changes in the depth and angle of the intrabony defects were analyzed. Follow-up examination and maintenance treatment should be conducted every 3 months for 12 months after the initial treatment and every 6 months thereafter until 24 months.@*Results@#The PD and CAL of patients in both groups continued to decrease (P<0.001), and imaging examinations revealed a decrease in defect depth and an increase in intrabony defect angle (P<0.001). The changes in the first 12 months were significantly greater than those in the last 12 months in both groups (P<0.001). The decreases in PD, CAL, and depth of intrabony defects and increase in angle in the MINST group were significantly greater than those in the SRP group (P<0.001). At 12 and 24 months after treatment, the PD and CAL in the MINST group were lower than those in the SRP group (P<0.001). The defect height of the MINST group decreased more than that of the SRP group (P<0.001), and the defect angle of the MINST group increased more than that of the SRP group (P<0.001).@*Conclusion@#Minimally invasive nonsurgical periodontal therapy can significantly promote the healing of deep intrabony defects and the regeneration of alveolar bone. Imaging reflects that alveolar bone healing is rapid at first and then slows. Compared with traditional SRP, endoscopically assisted MINST can yield better clinical indicators and imaging changes in intrabony defects.

Value of digital X-ray radiography and SPECT radionuclide bone imaging in diagnosing intertrochanteric fracture of femur / 中国医学装备

Objective:To investigate the application value of digital X-ray radiotherapy and single photon emission computed tomography(SPECT)radionuclide bone imaging in the diagnosis of intertrochanteric fracture of femur.Methods:A total of 70 patients who were diagnosed as intertrochanteric fracture of femur in Shijiazhuang People's hospital from January 2017 to December 2020 were selected,and they were divided into study group and control group according to random number method,with 35 cases in each group.Digital X-ray radiography combined with SPECT radionuclide bone imaging was used in the study group,and digital X-ray radiography was used in the control group.And then,the accuracy of the diagnostic results between the two groups were compared.Results:The radiographic examination indicated that 31 cases(88.6%)of 35 cases in the study group were confirmed,and 24 cases(68.6%)of 35 cases in the control group were confirmed.The diagnostic accuracy rate of the study group was significantly higher than that of the control group,and the difference was statistically significant(x2=4.158,P<0.05).The preoperative imaging diagnosis indicated that diagnosed number of fracture blocks in the study group was(3.57±0.50),which was significantly higher than that(2.67±0.40)in the control group,and the difference of that between two groups was statistically significant(t=8.315,P<0.05).In the actual intraoperative examining for bone continuity,5 cases were continuity and 30 cases were non-continuity.In the bone stability,13 cases were stability and 22 cases were non-stability.The study group was closer to intraoperative bone continuity and bone stability,and the differences of them between two groups were statistically significant(x2=12.857,4.644,P<0.05),respectively.Conclusion:The combination of digital X-ray radiography and SPECT radionuclide bone imaging has higher diagnostic value for intertrochanteric fracture of femur,which can provide important reference for clinical diagnosis.

Feasible analysis of DR long board detector in clinical application / 中国医学装备

Objective:To explore the feasibility of long board detector of digital radiography(DR)in clinical application.Methods:The long board detector(detector)was erected and placed upright.The scale long ruler with marked metal lead wire was placed at 20 cm in front of the center of long axis of the board of detector,which paralleled medial axis.Three test cards of spatial resolution were respectively placed at three positions(upper,middle and lower)of detector,and they were stuck on the board of detector as 30cm intervals between each other and 45° position.The exposures were conducted at 100,150,and 200 cm of source image distance(SID).The incident doses were tested,which obtained from different SID spots of upper,middle and lower positions of detector.The spatial resolutions of 3 positions were determined through observed the images of cards.The ratio of the marked scale length with metal lead wire to actual length of lead wire was measured through the projection of the scale length,so as to obtain the amplification rate of different spot positions.The spatial distribution of effective focal plane on the direction of long axis of detector,and the morphological change of that were observed.Results:When SID spots were respectively 100,150 and 200cm,the amplification rates of images decreased with increasing SID.The difference of amplification rates among three SID spots was significant(F=223.80,P<0.001).There was significant difference in the corresponding radiation doses among different SID spots(F=7.57,P<0.05).The spatial resolution was constantly 1.8 LP/mm.There was heel effect along with the direction of short axis of detector.The effective focal spot on the direction of long axis of detector appeared up-down symmetrical display.Conclusion:The long board detector of DR equipment has realized the capture for the images of the overall length of spine or the overall length of lower limbs in one exposure,which can meet the clinical requirement,and improve the detection efficiency of X-ray.

Expert consensus on digital X-ray osteoarthrographic technique and protection specifications in Guangdong-Hong Kong-Macao Greater Bay Area / 中华放射医学与防护杂志

In recent years, digital radiography (DR) system is widely used in China, and digital X-ray radiography is one of the most common examinations for bone and joint. Optimizing the osteoarthrographic technique, standardizing osteoarthrogram, and summarizing the requirements for radiation protection, will further enhance the clinical application value of digital X-ray imaging in bone and joint examination. Referring to domestic and foreign literatures, and combining the clinical situation of Guangdong-Hong Kong-Macao Greater Bay Area, the experts recruited by the Guangdong-Hong Kong-Macao Greater Bay Area Imaging Technology Alliance reach a consensus on the technique and protection specifications for bone and joint examination to guide and standardize the work related to X-ray examination of bone and joint in the medical imaging department of medical institutions at all levels in the Greater Bay Area.

The position of the fibular sesamoid bone of hallux valgus was assessed by weight-bearing anteroposterior and sesamoid axial radiographs / 实用放射学杂志

Objective To investigate the changes in the position of the fibular sesamoid bone with hallux valgus aggravated under two conditions:the foot bearing anteroposterior radiography(reflecting the static bearing state of the foot)and the sesamoid bone bearing axial radiography(reflecting the foot movement state).Methods Seventy-four feet with clinically suspected hallux valgus were finally enrolled in 49 feet,including 14 in the mild group,23 in the moderate group,and 12 in the severe group.Three indica-tors were measured on anteroposterior and axial radiographs:the position of the fibular sesamoid bone in anteroposterior radiographs(SP)and sesamoid axial position(SAP),and the rotation angle of the fibular sesamoid articular surface(RAf).The vertical distance between the fibular sesamoid bone and the second metatarsal bone was used to represent the position of the fibular sesamoid bone,then the position of the fibular sesamoid in the anteroposterior and axial positions was specifically marked as SPf-2 and SAPf-2.To cor-rect the anatomical differences of each foot,the ratio of the measured distance index to the length of the second metatarsal bone(AB),namely SPf-2/AB,SAPf-2/AB,was included in the statistical analysis.Results SPf-2/AB and SAPf-2/AB had no significant difference between hallux valgus groups(P＞0.05).The mean values of SPf-2/AB and SAPf-2/AB were significantly different(P＜0.05).RAf was positively correlated with hallux valgus angle(HVA)(r=0.725,P＜0.001),increased as HVA increased.Conclusion Both weight-bearing anteroposterior and sesamoid axial radiographs(foot at rest and in motion),the position of the fibular sesamoid bone is not affected by hallux valgus,and the distance from the center of the fibular sesamoid bone to the second metatarsal bone remains unchanged.The position of the fibular sesamoid bone is not the same between the anteroposterior and axial radiographs,so it is necessary to evaluate the position of the fibular sesamoid bone in the two states respectively and combine the two methods.RAf increases with the increase of HVA in axial view,it is considered that although the central position of the fibular sesamoid bone remains the same under foot movement,it does reverse spin movement toward the tibial side with the aggravation of hallux valgus.

Exploration of pneumoperitoneum signs in neonates based on X-ray examination of bedside abdominal lying film / 实用放射学杂志

Objective To explore the pneumoperitoneum signs of neonates on the bedside abdominal lying film.Methods The pneumoperitoneum signs of 52 neonates on the bedside abdominal lying films were analyzed retrospectively.Results Among 52 neonates with pneumoperitoneum,2 cases had no perforation,and there were 50 cases of digestive tract perforation,with 22 cases of gastric perforation,17 cases of small intestinal perforation and 11 cases of large intestinal perforation.Congenital muscular defect of gastric wall and necrotizing enterocolitis(NEC)were the most common causes of perforation.Forty-three cases with anteroposterior films all had pneumoperitoneum signs;and in 9 cases with anteroposterior and lateral films,6 cases with anteroposterior and lateral films all showed pneumoperitoneum signs,while 3 cases showed pneumoperitoneum signs only on lateral films.Pneumoperitoneum signs included 38 episodes of liver falciform ligament signs,37 episodes of football signs,22 episodes of Rigler signs,21 episodes of round liver ligament signs,10 episodes of liver area bright shadows,9 episodes of inverted"V"signs,6 episodes of scrotal gas,5 episodes of triangular signs,4 episodes of Cupola signs and 1 episodes of dolphin sign.Two or more signs were seen in 46 cases and three or more signs were seen in 31 cases.There was no statistically significant difference in the pneumoperitoneum signs except for scrotal gas among the three groups of gastric,small intestinal and large intestinal perforations(P>0.05).Conclusion Various signs such as liver falciform ligament signs,football signs,Rigler signs and round liver ligament signs can be seen on the bedside abdominal lying film for neonates pneumoperitoneum,and understanding the above signs is conducive to rapid and accurate diagnosis.

Construction of artificial intelligence-based prediction models for non-recognizable thoracolumbar compression fractures by X-ray inspection / 实用放射学杂志

Objective To evaluate the potency of applying an artificial intelligence(AI)based model for classifying vertebral fractures in lumbar X-ray images.Methods Patients who underwent lateral lumbar X-ray and MRI were retrospectively selected.Based on MRI results,the vertebrae were categorized as fresh fractures,old fractures,and normal vertebrae.A ResNet-18 classification model was constructed using delineated region of interest(ROI)on the X-ray images,and the model's performance was evaluated.Results A total of 272 patients(662 vertebrae)were included in this study.The vertebrae were randomly divided into training(n=529)and validation(n=133)sets.The model's performance in discerning normal vertebrae,fresh fractures,and old fractures revealed accuracy of 0.91,0.42,and 0.75,and the sensitivity were 0.91,0.408,and 0.72,while the specificity were 0.796,0.892,and 0.796,respectively.Conclusion The X-ray-based ResNet-18 AI model has significant accuracy for distinguishing old fractures and normal vertebrae;However,the model's accuracy needs further improvement for distinguishing fresh fractures.

Correlation between the lateral and anteroposterior sacral ratios in anorectal malformation / 实用放射学杂志

Objective To determine the correlation and agreement of sacral ratio(SR)measured by lateral and anteroposterior radiographs in patients with anorectal malformation(ARM).Methods A retrospective analysis was conducted on the anteroposterior and lateral radiographs images of the sacral vertebrae of patients with ARM.All SR values were measured by three radiologists.Pearson's correlation coefficient were used to assess the correlation between the SR measured by lateral and anteroposterior radiographs.A weighted Kappa statistic was used to measure the agreement between how the anteroposterior and lateral SR categorized observations into risk groups.Results Of the 385 ARM patients,25 patients whose radiographs image quality was insufficient to calculate SR value were excluded.For a given pair of measurements,the mean lateral SR value was 0.08 units greater than the anteroposterior SR value[95%confidence interval(CI)0.06-0.09,P<0.01].Anteroposterior and lateral images had a moderate positive correlation(r=0.79,95%CI 0.73-0.79,P<0.01)and moderate agreement in risk categorization(Kappa=0.62,P<0.01).Anteroposterior and lateral readings conducted by all three radiologists had excellent inter-rater reliability with intraclass correlation coefficient(ICC)for anteroposterior and lateral SR of 0.88 and 0.84,respectively.Conclusion Even though the anteroposterior and lateral SR values have moderate positive correlation,the mean SR value determined by images in the lateral is 0.08 units greater than the anteroposterior.Anteroposterior and lateral SR value conclude different risk categories relatively often.The SR values measured by lateral sacral radiographs are more clinically significant than those measured by anteroposterior radiographs.