Potencial del uso de la radiografía panorámica como ayuda diagnóstica en derechohabientes de una institución de seguridad social / Potential for the use of panoramic radiography as a diagnostic aid in beneficiaries of a social security institution

Introducción: A pesar de que actualmente la radiografía panorámica es un instrumento auxiliar de diagnóstico de uso común, desafortunadamente sus beneficios no se aprovechan en su totalidad y su empleo se limita al uso en determinadas áreas de la odontología y en ocasiones se omiten hallazgos que pueden tener un significado clínico importante. Material y métodos: Estudio transversal y descriptivo de una muestra aleatoria de 500 estudios de imagen (radiografías panorámicas) durante el periodo de enero a mayo de 2018 analizadas por expertos estandarizados y empleando estadística descriptiva básica mediante el paquete estadístico Excel. Resultados: Se incluyeron 500 estudios, 67% correspondió a mujeres en un rango de cinco a 91 años de edad con una mediana de 43 años, 48% presentó alteraciones siendo las más frecuentas pérdida del proceso alveolar 45%, alteraciones en articulación temporomandibular 34%, y calcificación del ligamento estilohioideo 31%. Conclusión: Se reportaron hallazgos clínico-radiográficos significativos, resaltando la necesidad de un análisis cuidadoso de los métodos auxiliares de diagnóstico que permitan visualizar de manera contextual el tratamiento odontológico de los pacientes y/o reportar al especialista correspondiente otro tipo de hallazgos (AU))

Introduction: Although panoramic radiography is currently a commonly used diagnostic auxiliary instrument, unfortunately its benefits are not fully exploited and its use is limited to use in certain areas of Dentistry and eventually findings that may have important clinical significance are omitted. Material and methods: Crosssectional and descriptive study of a random sample of 500 imaging studies (panoramic radiographs) during the period from January to May 2018, analyzed by standardized experts and using basic descriptive statistics using the Excel statistical package. Results: 500 studies were included corresponding to 67% women and an age range from five to 91 years of age with a median of 43 years, 48% presented alterations, the most frequent being loss of the alveolar process 45%, alterations in the temporomandibular joint 34%, and calcification of the hyoid ligament 31%. Conclusion: In this study significant clinical-radiographic findings are reported, highlighting the need for a careful analysis of auxiliary diagnostic methods that allow visualize the dental treatment of the patients and / or report other findings to the corresponding specialist (AU)

Mucosal vitiligo in angles of the mouth: clinical and fluorescence aspects

SUMMARY Vitiligo is the most common depigmenting, chronic acquired disease of the skin and mucosa. However, vitiligo of an unclassified type and mucosal subtype affecting only one area of the mucosa is considered quite uncommon. The diagnosis of vitiligo, regardless of its type, is clinical. Nonetheless, a device that allows the visualization of the tissue fluorescence may be useful for confirming the diagnosis. We present the use of wide-field optical fluorescence device for complementary examination and diagnosis of unusual cases of mucosal vitiligo located only in angles of the mouth.

RESUMO O vitiligo é a doença crônica adquirida despigmentante mais comum da pele e/ou da mucosa. Entretanto, o vitiligo do tipo não classificado e subtipo de mucosa afetando apenas uma área da mucosa é considerado bastante incomum. O diagnóstico de vitiligo, independentemente do seu tipo, é clínico. No entanto, o uso de um dispositivo que permite a visualização da fluorescência tecidual pode ser útil para a confirmação do diagnóstico de vitiligo. Apresentamos o uso do dispositivo de exame complementar de fluorescência óptica de campo amplo para o diagnóstico de um caso incomum de vitiligo de mucosa localizado apenas em ângulos da boca.

Termografia infravermelha na odontologia / Infrared thermography in dentistry

A termografia infravermelha consiste em um exame de imagem complementar aplicada na avaliação da temperatura corporal com base na emissão de radiação infravermelha através da pele, podendo auxiliar no diagnóstico ou monitoramento das intervenções terapêuticas. Trata-se de uma técnica não ionizante e não invasiva que capta e registra a distribuição térmica da superfície cutânea avaliada por meio das alterações na microcirculação dos pacientes frente a diferentes condições patológicas. Dentre as aplicações na Odontologia, a termografia pode complementar o exame físico anatômico, visto que apresenta em tempo real condições fisiológicas, de acordo com a temperatura. Esta técnica pode auxiliar no diagnóstico e planejamento do tratamento de alterações orofaciais, como processos inflamatórios e infecciosos na região orofacial, acompanhamento pós-cirúrgico e na avaliação de pacientes com desordens temporomandibulares (DTM). A termografia ainda é pouco utilizada na Odontologia, e protocolos para avaliação de alterações na região de cabeça e pescoço ainda devem ser testados e estabelecidos. Porém, já mostra ser um exame complementar de boa performance na detecção de pontos gatilho da dor, acompanhamento de pacientes de forma não invasiva e como documentação médico-legal.

Infrared thermography consists of a complementary imaging test applied to the assessment of body temperature based on the emission of infrared radiation through the skin, which may aid in the diagnosis or monitoring of therapeutic interventions. It is a non-ionizing and non-invasive technique that captures and records the thermal distribution of the cutaneous surface evaluated by means of the changes in the patients' microcirculation in face of different pathological conditions. Among the applications in Dentistry, thermography can complement the anatomical physical examination, since it presents in real time physiological conditions according to temperature. This technique can help in the diagnosis and planning of the treatment of orofacial alterations, such as inflammatory and infectious processes in the orofacial region, post-surgical follow-up and in the routine evaluation of patients with temporomandibular disorders (TMD). Thermography is still poorly used in Dentistry and protocols for the evaluation of head and neck disorders have yet to be tested and established. However, it already shows up as a good complementary examination for the detection of pain trigger points, follow-up of patients in a non-invasive way, and as medical-legal documentation.

Nuevas modalidades de imagen en el diagnóstico odontológico / New image modalities in dental diagnosis

La radiología odontológica ha jugado un rol fundamental en el diagnóstico odontológico. El avance en la adquisición y procesado de la imagen digital produjo el desarrollo de nuevas tecnologías que han revolucionado el manejo del intercambio de la información en odontología. Las radiografías intraorales y extraorales se han adaptado a esa revolución digital. La búsqueda automatizada, el acceso a la literatura en formato electrónico y el intercambio de texto, imágenes y sonido en tiempo real son algunas de las características que lo hacen un elemento imprescindible dentro de la práctica en salud y los actuales estándares de la atención odontológica. El reciente desarrollo de la tomografía computada de haz cónico ha reemplazado el uso de la tomografía computada médica en odontología. En este artículo se hace una introducción en los métodos actuales y en cómo han cambiado el diagnóstico radiológico en odontología.

Dental radiology has played a fundamental role in the dental diagnosis. The advance of the acquisition and processing of the digital image produced the development of new technologies that have revolutionized the management of the information exchange in dentistry. Intraoral and extraoral radiographies have adapted to this digital revolution. The automated search, access to literature in electronic format and the interchange of text, images and sound in real time, are some of the features that make an essential element within the practice in health and the standard of dental care. The recent development of cone beam computerized tomography has replaced the use of computed tomography in dentistry. This article is an introduction to the current methods employed and how they have changed the radiological diagnosis in dentistry.

Optical Coherence Tomography; A Modern Technique to Detect Oral Mucosal Lesion: A Review.

Early detection and management of potentially malignant oral lesions can significantly reduce progression of these lesions into invasive cancer, and would thus reduce morbidity and fatality rate. Cancerous and potentially malignant lesions show dysplastic feature which is mostly detected by biopsy. However, biopsy has a certain constraints like (i) biopsy can cause delay in the result, (ii) experienced pathologist must expound the biopsy sample (iii) sometimes can cause spread of cancer cells, (iv) cannot be done repeatedly. Therefore, in potentially malignant lesions and cancer optical coherence tomography (OCT) is utilized to detect early dysplastic changes. Therefore, we are presenting a review on the applications of OCT in oral mucosal lesions.

Sonoporation-Invigorating Sound in Dentistry: A Review.

Ultrasound (US), traditionally a diagnostic modality, and is emerging as a non-invasive therapy using local drug delivery and gene therapy. US exposure gene rates bio eff ects that result in shear stress, tissue heating, and cavitation eff ects, which are used in therapeutic applications. Sonoporation employs these eff ects to enhance delivery of large molecules such as DNA into the cells which is applied to muscle, head and neck tumor, in a cell disruption process called transformation and increases the permeability to bioactive materials, which is usually used in molecular biology and gene therapy. Nevertheless, it has recently become popular as a technique to enhance drug release from drug delivery systems. Th is review presents the main fi ndings in the fi eld of sonoporation, namely drug delivery, gene delivery and DNA transfer and its applications in dentistry.

Ultrasonographic evaluation of inflammatory swellings of buccal space.

Objectives : The main objective of the study was a) to differentiate cellulitis and abscess in buccal space region, b) to study the ultrasonographic anatomy of cheek region and c) to investigate the use of ultrasound in the diagnosis of inflammatory swellings of cheek region. Patients and Methods : The study consisted of 25 patients with unilateral buccal space inflammatory swellings of odontogenic origin. The contra lateral side was used as control. Toshiba ultrasonographic device with a linear array transducer (5-8 MHz) was used. The areas of interest were scanned under both transverse and longitudinal sections and were interpreted by a single observer. The clinical diagnosis of cellulitis or abscess was confirmed by the absence or presence of pus respectively both sonographically and by aspiration. Also various anatomical structures present in buccal space were studied. Results : Clinically 23(92%) were diagnosed as buccal space abscess and 2 (8%) were cellulitis. Ultrasonographically and therapeutically 24 (96%) were buccal space abscess and 1 (4%) was cellulits. The sensitivity of clinical criteria over ultrasonographic diagnosis was 96% with a specificity of 100%. Also the cheek thickness in males and females varied from 8.2 to 17.1mm with a mean of 11.6mm±2.1 (SD) and 8.2 mm to 14.2 mm with a mean of 11±1.8 (SD). The subcutaneous tissue appeared moderately echogenic, buccinator - highly echogenic, deep adipose tissue - less echogenic and parotid duct was appreciated as a thin hyperechogenic band crossing the buccinator muscle. Buccal space, masticator space and parotid space were appreciated. Conclusion : This study supports the ultrasonographic method of imaging of orofacial inflammatory swellings with high sensitivity and specificity. This imaging modality can also help in aspiration of pus in different spaces. We have described the ultrasonographic anatomy of the above mentioned spaces which can help a beginner in this field.