Determinação de parâmetros radiográficos de normalidade da face em crianças menores de um ano / Determination of face normality parameters in radiographs of children under one year of age

Introdução: Realizar as medidas radiográficas do comprimento da face de amostra de crianças brasileiras do nascimento até um ano de vida para determinação de parâmetros radiográficos de normalidade. Materiais e Métodos: Foi realizada análise retrospectiva de radiografias simples de crânio para mensuração da face de crianças de até 12 meses em um hospital do sul do Brasil. Os exames foram realizados entre os anos de 2013 e 2018. Foram incluídas no estudo 170 radiografias cranianas de 85 crianças menores de um ano. Definidos parâmetros de mensuração, executados por três avaliadores e posteriormente comparados utilizando-se o coeficiente de correlação intraclasse e o teste ANOVA. Resultados: O coeficiente de correlação intraclasse foi alto, demonstrando a concordância dos examinadores e a reprodutibilidade das mensurações. Houve pequeno desvio padrão entre as medidas obtidas dos diferentes períodos etários. No geral, ocorreu crescimento da face estatisticamente significativo do primeiro ao terceiro trimestre. O crescimento foi menor e sem diferença estatisticamente significativa do terceiro para o quarto trimestre. Conclusão: Observou-se um aumento progressivo das dimensões dos ossos da face com o crescimento no primeiro ano de vida, especialmente nos primeiros 9 meses. A obtenção destes dados pode auxiliar na avaliação da normalidade para este período etário. (AU)

Introduction: To perform face length measurements on radiographs of Brazilian children from birth to one year of age in order to determine radiographic parameters of normality. Materials and Methods: We performed a retrospective analysis of simple skull radiographs for face measurement of children up to 12 months of age taken in a southern Brazilian hospital between 2013 and 2018. In total, 170 skull radiographs of 85 children under one year of age were included in the study. Measurement parameters were defined, then performed by three evaluators, and later compared using intraclass correlation coefficient and analysis of variance. Results: The intraclass correlation coefficient was high, demonstrating interexaminer agreement and reproducibility of the measurements. There was a small standard deviation between the measurements obtained from the different age groups. In general, there was a statistically significant growth of the face from the first to the third trimester. The growth was smaller and with no statistically significant difference from the third to the fourth trimester. Conclusion: We observed a progressive increase in the dimensions of the facial bones with growth in the first year of life, especially in the first 9 months. Obtaining these data will assist in the assessment of normality for this age group. (AU)

The effect of hard tissue surgical changes on soft tissue displacement: a pilot CBCT study

ABSTRACT Introduction: This pilot study had as main objective to test the reliability of a new method to evaluate orthognathic surgery outcomes and also, to understand the effect of hard tissue changes on soft tissue displacement. Methods: The sample consisted of eight patients that underwent bimaxillary advancement and had CBCT at two time points (before surgery and 6-8 months follow-up). Voxel-based cranial base superimposition was used to register the scans. A different technique of iterative closest point (ICP) was used to measure and correlate the changes. The average displacement of 15 areas (4 hard tissue and 11 soft tissue) were measured twice. Results: ICC was > 0.99 for all areas. Changes in the tip of the nose did not correlate with changes in any maxillary area, whereas soft tissue A point, A point and upper lips had correlation with several areas. The highest correlation for the maxilla was between the upper lip and the left/right supra cheilion (p< 0.001, r= 0.91 and p< 0.001, r= 0.93, respectively). In the mandible, the majority of the correlations involved soft tissue pogonion, pogonion and lower incisors, with the strongest one between pogonion and lower incisors (p< 0.001, r= 0.98). Conclusion: With the proper case selection, ICP is a reliable method that can be used to assess three-dimensional changes.

RESUMO Objetivo: o objetivo deste estudo piloto foi testar a confiabilidade de um novo método para avaliar os resultados da cirurgia ortognática e entender o efeito das alterações dos tecidos duros no deslocamento dos tecidos moles. Métodos: a amostra selecionada consistiu de oito pacientes submetidos a avanço bimaxilar que possuíam TCFC em dois períodos de tempo (antes da cirurgia e de 6 a 8 meses após a cirurgia). A sobreposição da base do crânio pelo método voxel-based foi utilizada para registrar as varreduras, enquanto uma técnica diferente, de ponto iterativo mais próximo (ICP), foi usada para medir e correlacionar as mudanças. O deslocamento médio de 15 áreas (4 em tecidos duros e 11 em tecidos moles) foi mensurado duas vezes. Resultados: o ICC foi > 0,99 para todas as áreas. As alterações da ponta do nariz não se correlacionaram com alterações em qualquer área da maxila, enquanto o ponto A em tecido mole, o ponto A e os lábios superiores apresentaram correlação com várias áreas. A maior correlação para a maxila foi entre o lábio superior e a supracomissura esquerda/direita (p< 0,001, r = 0,91 e p< 0,001, r = 0,93, respectivamente). Na mandíbula, a maioria das correlações envolveu o pogônio em tecido mole, pogônio e incisivos inferiores, sendo a maior entre pogônio e incisivos inferiores (p< 0,001, r= 0,98). Conclusão: com a seleção adequada do caso, o ICP é um método confiável que pode ser utilizado para avaliar mudanças tridimensionais.

Morphological and radiographic studies on the skull of Indian blackbuck (Antilope cervicapra) / Estudios morfológicos y radiográficos del craneo del antilope negro (Antilope cervicapra) de la India

The phenotypic appearance of the head of animal species depends strongly on the shape of the skull. The present study has been carried out on morphological and radiographic characteristics of skull of the Indian Blackbuck. The skull comprised of cranial and facial bones. The cranial bones included occipital, sphenoid, ethmoid, interparietal, parietal, frontal and temporal. The occipital was a single bone surrounding the foramen magnum. The sphenoid was a single bone and situated between the occipital posteriorly and the ethmoid anteriorly. The ethmoid was a single bone laid ventral to the frontal and nasal bones. The interparietal was a small quadrilateral bone wedged in between the parietal anterio-laterally and the supraoccipital posteriorly. The parietal was a paired bone. The frontal bone was a paired and formed the roof of the cranial cavity. The occipital bone was roughly pentagonal in shape. The temporal was a paired bone and formed the part of the lateral wall of the cranial cavity. The facial bones included maxilla, premaxilla, palatine, pterygoid, nasal, lacrimal, zygomatic, vomer, turbinates, mandible and hyoid. The maxilla was a roughly triangular flat paired bone. The paired incisive bones were placed on the lower part of the face. The palatine was a paired bone. The pterygoid was a paired, small, slightly curved, flat plate of bone and situated on either side of the posterior nares. The nasal was a paired bone and formed the roof of nasal cavity. The lacrimal was a paired bone and located on the anterior margin of the orbit. The zygomatic was a paired bone and irregularly triangular in outline. The vomer was a single medial bone. The turbinate bone was delicate, scroll-like, complex bony plates, placed vertically in the nasal cavity, being attached to the lateral walls. The mandible was a paired bone. The hyoid bone was situated between the vertical parts of the rami of the mandible.

La apariencia fenotípica de la cabeza de las especies animales depende principalmente de la forma del cráneo. El objetivo fue estudiar las características morfológicas y radiográficas del cráneo del antílope negro de la India. El cráneo consta de los huesos craneales y faciales. Los huesos craneales incluyen occipital, esfenoides, etmoides, interparietal, parietal, frontal y temporal. El occipital es un hueso singular que circunda el foramen occipital. El esfenoides se sitúa entre el occipital posterior y el etmoidal anterior. El etmoidal es un hueso singular situado de forma ventral a los huesos frontal y nasal. El interparietal es un pequeño hueso cuadrilátero ubicado entre el parietal anterolateral y posterior del supraoccipital. El parietal es un hueso bilateral. El hueso bilateral frontal cubría la cavidad craneal. El hueso occipital era más o menos de forma pentagonal. El hueso temporal formaba parte de la pared lateral de la cavidad craneal. Los huesos faciales incluyen el hueso maxilar, premaxila, palatina, pterigoideo, nasal, lacrimal, cigomático, vómer, conchas nasales, mandíbula y el hueso hioides. El maxilar se presentó como un hueso bilateral plano más o menos triangular. Los huesos incisivos estaban colocados en la parte inferior de la cara. El hueso palatino es un hueso bilateral. El hueso pterigoideo bilateral, plano pequeño, de hueso y situado a ambos lados de las fosas posteriores. El hueso nasal en ambos lados formaba la cubierta de la cavidad nasal. El lagrimal es un hueso asociado y situado en el margen anterior de la órbita. El cigomático es un hueso irregular de contorno triangular. El vómer esun solo hueso medial. La concha nasal delgada con forma de espiral, placas óseas complejas y colocadas verticalmente en la cavidad nasal unidas a las paredes laterales. La mandíbula es un hueso bilateral. El hueso hioides estaba situado entre las partes verticales de las ramas de la mandíbula.

Radiographic evaluation of orthodontic treatment by means of four different cephalometric superimposition methods

INTRODUCTION: Despite discussion on the merit of various cephalometric superimposition methods, there remains a need to assess which one can be used in daily practice with reasonably accuracy and less working time. OBJECTIVE: The aim of this study was to investigate four methods of cephalometric superimposition by means of assessing the longitudinal changes in craniofacial morphology caused by growth and response of adolescents with Class I malocclusion to orthodontic treatment involving first premolar extraction. METHODS: Pretreatment (T1) and post-treatment (T2) standardized lateral cephalometric radiographs of 31 adolescents (20 females and 11 males), with Angle Class I malocclusion and indication of premolar extraction, participated in this study. Radiographs were digitized, traced and had structures identified by means of a cephalometric software. Four superimposition methods were used: Björk structural method, Steiner/Tweed SN line, Ricketts N-Ba line at N-point and Ricketts N-Ba line at CC-point. Positional changes were quantified by horizontal and vertical linear changes in the following cephalometric landmarks: anterior/posterior nasal spine (ANS and PNS), gnathion (Gn), Gonion (Go), Pogonion (Pog), A-point and B-point. Differences between T1 and T2 in horizontal and vertical positional changes for all superimposition methods were assessed by one-way analysis of variance (ANOVA) and Bonferroni correction (p < 0.05). RESULTS: There were no statistically significant differences among the cephalometric superimposition methods or when patients' sex was considered. CONCLUSION: Björk structural method, Steiner/Tweed SN line, Ricketts N-Ba line at N-point and Ricketts N-Ba line at CC-point methods were reliable and presented similar precision when the overall facial changes due to active growth and/or orthodontic treatment were examined. .

INTRODUÇÃO: apesar dos debates sobre os méritos dos vários métodos de sobreposição cefalométrica, ainda há necessidade de se avaliar quais deles poderiam ser utilizados na prática diária, com razoável precisão e menor tempo de trabalho. OBJETIVO: o objetivo desta pesquisa foi investigar quatro métodos de sobreposição cefalométrica, avaliando as mudanças longitudinais na morfologia craniofacial causadas pelo crescimento e resposta ao tratamento, em adolescentes com má oclusão de Classe I tratados ortodonticamente com extração de primeiros pré-molares. MÉTODOS: foram usadas telerradiografias laterais pré-tratamento (T1) e pós-tratamento (T2) de 31 adolescentes (20 do sexo feminino e 11 do sexo masculino), com Classe I de Angle e indicação de extração de pré-molares. As radiografias foram digitalizadas, traçadas e as estruturas, identificadas com um software cefalométrico (Radiocef, Radio Memory, Belo Horizonte, Brasil). Quatro métodos de sobreposição foram utilizados para avaliar mudanças de posição devidas ao crescimento e/ou tratamento: método Estrutural de Björk; método Steiner/Tweed linha SN; Ricketts linha N-Ba no ponto N; e Ricketts linha N-Ba no ponto CC. As mudanças posicionais avaliadas pelos métodos de sobreposição foram quantificadas por mudanças lineares horizontais e verticais nos seguintes pontos cefalométricos: espinha nasal anterior (ENA), espinha nasal posterior (ENP), gnátio (Gn), Gônio (Go), Pogônio (Pog), Ponto A e Ponto B. Mudanças de posição horizontal e vertical entre T1 e T2 para todos os métodos de sobreposição foram avaliadas por análise de variância (ANOVA) e teste de Bonferroni (p < 0,05). RESULTADOS: não houve diferença estatística significativa entre os métodos de sobreposição cefalométrica em toda a amostra ou quando o sexo dos pacientes foi considerado. CONCLUSÃO: de acordo com a metodologia aplicada nesse estudo, os métodos de sobreposição cefalométrica Estrutural de Björk, de Steiner/Tweed linha SN, ...

Study on the indexes of forensic identification by the occlusal-facial digital radiology / 法医学杂志

OBJECTIVE@#To discuss the coding of full dentition with 32 locations and measure the characteristics of some bony indexes in occlusal-facial digital radiology (DR).@*METHODS@#To select randomly three hundred DR orthopantomogram and code the full dentition, then analyze the diversity of dental patterns. To select randomly one hundred DR lateral cephalogram and measure six indexes (N-S,N-Me,Cd-Gn,Cd-Go,NP-SN,MP-SN) separately by one odontologist and one trained forensic graduate student, then calculate the coefficient variation (CV) of every index and take a correlation analysis for the consistency between two measurements.@*RESULTS@#(1) The total diversity of 300 dental patterns was 75%.It was a very high value. (2)All six quantitative variables had comparatively high CV value.(3) After the linear correlation analysis between two measurements, all six coefficient correlations were close to 1. This indicated that the measurements were stable and consistent.@*CONCLUSION@#The method of coding full dentition in DR orthopantomogram and measuring six bony indexes in DR lateral cephalogram can be used to forensic identification.

Craniofacial surgery and optic canal decompression in adult fibrous dysplasia.

A 29-year-old female had a 3-year history of bony swelling over the right frontal area. For 3 months she noticed proptosis of her right eye. Investigations revealed fibrous dysplasia involving the right half of the frontal bone and the right greater and lesser wings of the sphenoid bone. Visual evoked potentials (VEP) showed delayed latencies on the involved side. A craniofacial surgery with optic canal decompression was performed. Follow-up after 2 years revealed normalization of VEP.

Role of radionuclide bone scanning in early detection of metastasis in mandibulofacial bones

The metastatic tumours in the lower jaw is far less frequent than primary tumour. There is a wide variety of a late stage of primary tumours elsewhere in the body which metastatize in the mandible as cancer in breast, thyroid gland, prostate, lungs and kidneys. By conventional radiography it is difficult to recognize any metastatic foci in the mandible. The bone scanning by scintigraphy is an important method for staging the cancer and demonstration of metastatic lesion in the bone before it is evident radiographically. The aim of this study is to reveal the major role of scintigraphy in early detection of mandibular metastasis from body cancer. Thirty cancer patients were selected from El-Kasr El Eini Center of Raditation Onocology and Nuclear Medicine. Each case subjected for radiographic examination and radionuclide bone scanning of the skull. The results showed a marked superiority of scintigraphy in early demonstrating of mandibulofacial bones metastasis than in x-ray where the radiographic changes in the bone are discernible only where there has been an increase or decrease in calcium content around 50%. So it is recommended to utilize bone imaging in examination of the mandible in patients with body cancer before using radiography

Experimental errors in cephalometric studies

A number of potential sources of errors in a cephalometric study are summarized and a brief review of the literature in this relation is explained. A test designed to evaluate some sources of errors is described. The results are discussed and finally conclusions are made for the errors of anatomical points, errors of planes and angles, and errors for different observers