[In-vitro comparison of the diagnostic accuracy of CBCT and helical CT for detection of mandibular condyle erosions]

Temporomandibular joint [TMJ] dysfunction is the most common jaw disorder. TMJ imaging may be necessary to supplement information obtained from the clinical examination. The purpose of this study was to compare the diagnostic accuracy of helical computed tomography [CT] and cone beam computed tomography [CBCT] for detection of simulated mandibular condyle erosions. In this in-vitro study, simulated lesions were created in 15 dry mandibles using a dental round bur. Using CBCT and helical CT techniques, mandibular condyles were radiographed before and after creating the lesions. The images were examined by two oral and maxillofacial radiologists for absence or presence of lesions. The accuracy for detecting mandibular condyle lesions was expressed as sensitivity, specificity, positive and negative predictive values. Differences between the two radiographic modalities were analyzed by McNemar's test. Inter-observer agreement was determined using Kappa coefficient. The maximum sensitivity, specificity and accuracy were 100%, 100% and 100% for CBCT images, respectively and 88%, 100% and 98% for helical CT images, respectively. No statistically significant difference was found between the accuracy of CBCT and helical CT for detection of mandibular condyle erosions [P = 1]. CBCT is a lower-dose cost-effective alternative to helical CT for diagnostic evaluation of erosion of the mandibular condyle

[ effect of low-level LASER on pain improvement and function in patients affected anterior knee pain]

Backgroun and aims: Anterior knee pain is a common problem among adults and young people. This study aimed to investigate the effects of low-level LASER on improvement of knee pain and function in patients with anterior knee pain

Methods: This double-blind, randomized clinical trial was carried out in Zahedan University of Medical Sciences, in 2008. In this study, thirty patients were randomly divided into experimental [N=15] and control groups [N=15]. In the experimental group, beside the exercise, a low-level Ga-As LASER was applied with a 100 mW average power, wavelength 905 nm and 8 J/cm2 dosages for 3 minutes duration. In the control group, sham LASER was used. A 16 session treatment program [during 4 weeks, 4 sessions per weeks] was performed for both groups. Before and after the intervention, we measured the pain level through visual analog scale [VAS] and the function by Knee and Osteoarthritis Outcome Score [KOOS] and range of knee flexion by goniometry. Paired and Independent t-tests were used for data analysis

Results: The knee pain decreased from 6.06+/-2.6 to 2.7+/-2.6 in the experimental group [P<0.001] and from 6.4+/-1.9 to 3.4+/-1.4 in the control group [P=0.003]. KOOS score was decreased from 87.2+/-29.8 to 48.4+/-24.1 in the experimental group and from 94.8+/-20.9 to 61.7+/-15.3 in the control group [P<0.001]. Level of pain was significantly decreased in the experimental group compared to the control group [P=0.012]

Conclusion: The results showed that exercise therapy with or without LASER can reduce pain and cause better knee function and expansion of the ranges of knee flexion. However; LASER is more effective in decreasing anterior knee pain