Evaluation of the quality of different endodontic obturation techniques by digital radiography.

OBJECTIVES: This study was aimed to evaluate different endodontic obturation techniques (Thermafil, lateral condensation, and Tagger's hybrid technique) regarding the homogeneity of the obturation radiopacity. MATERIALS AND METHODS: Seventy roots of human upper central incisors were filled using the Thermafil system, lateral condensation. and Tagger's hybrid technique. Radiopacity of the filling was evaluated based on mean of grey levels, and its homogeneity was assessed by the coefficient of variation (CV), analyzing the histograms obtained of digitized and digital radiographs. RESULTS: The increase in mean grey levels (p < 0.001) and reduction in the CV (p < 0.05) were higher for Tagger's hybrid technique compared with other methods. CONCLUSIONS: Tagger's hybrid technique provided better homogeneity of the obturation radiopacity and better apical sealing compared with lateral condensation technique. CLINICAL RELEVANCE: The results suggest that Tagger's hybrid technique provided the best compaction of the root canal filling material, an important factor for the sealing of obturations and, consequently, for the effectiveness of treatment.

Accuracy of linear measurements before and after digitizing periapical and panoramic radiography images.

The aim of this study was to evaluate the accuracy of linear measurements made on conventional and digitized periapical and panoramic radiographic images of dry human hemi-mandibles. Images from the posterior region of 22 dry human hemi-mandibles were obtained by conventional panoramic and periapical radiography technique. Using a digital caliper, 3 vertical measurements were marked directly on the dry hemi-mandibles (reference measurements) as well as on the tracing from the conventional radiographic images of the specimens made onto acetate paper sheet: Distance 1: between the upper limit of the alveolar ridge and the lower limit at the mandible base; Distance 2: between the upper limit of the alveolar ridge and the upper limit of the mandibular canal; Distance 3: between the lower limit of the mandibular canal and the lower limit of the mandible base. Next, the radiographs were digitized and the three measurements were made on the digital images using UTHSCSA Image Tool software. Data were analyzed statistically by one-way ANOVA (α=0.05). There was no statistically significant differences (p>0.05) between periapical and panoramic radiographs or between the measurements recorded using the digital caliper and UTHSCSA software compared with dry mandible specimens for Distances 1 (p=0.783), 2 (p=0.986) and 3 (p=0.129). In conclusion, the radiographic techniques evaluated in this study are reliable for vertical bone measurements on selected areas and the UTHSCA Image Tool software is an appropriate measurement method.

Accuracy of linear measurements before and after digitizing periapical and panoramic radiography images

The aim of this study was to evaluate the accuracy of linear measurements made on conventional and digitized periapical and panoramic radiographic images of dry human hemi-mandibles. Images from the posterior region of 22 dry human hemi-mandibles were obtained by conventional panoramic and periapical radiography technique. Using a digital caliper, 3 vertical measurements were marked directly on the dry hemi-mandibles (reference measurements) as well as on the tracing from the conventional radiographic images of the specimens made onto acetate paper sheet: Distance 1: between the upper limit of the alveolar ridge and the lower limit at the mandible base; Distance 2: between the upper limit of the alveolar ridge and the upper limit of the mandibular canal; Distance 3: between the lower limit of the mandibular canal and the lower limit of the mandible base. Next, the radiographs were digitized and the three measurements were made on the digital images using UTHSCSA Image Tool software. Data were analyzed statistically by one-way ANOVA (α=0.05). There was no statistically significant differences (p>0.05) between periapical and panoramic radiographs or between the measurements recorded using the digital caliper and UTHSCSA software compared with dry mandible specimens for Distances 1 (p=0.783), 2 (p=0.986) and 3 (p=0.129). In conclusion, the radiographic techniques evaluated in this study are reliable for vertical bone measurements on selected areas and the UTHSCA Image Tool software is an appropriate measurement method.

O objetivo deste estudo foi avaliar a acurácia de medidas lineares realizadas em radiografias panorâmicas e periapicais convencionais e digitalizadas de hemimandíbulas humanas secas. Imagens da região posterior de 22 hemimandíbulas humanas secas foram obtidas pelas técnicas panorâmica e periapical convencionais. Com o paquímetro eletrônico digital, foram realizadas três medições verticais diretamente sobre as hemimandíbulas (medidas referenciais), bem como sobre o decalque das imagens convencionais, em papel de acetato: Distância 1: Distância entre o limite superior do rebordo alveolar e o limite inferior da base da mandíbula; Distância 2: Distância entre o limite superior do rebordo alveolar e o limite superior do canal mandibular e Distância 3: Distância entre o limite inferior do canal mandibular e o limite inferior da base da mandíbula. Posteriormente, as radiografias foram digitalizadas e as três medidas foram realizadas nas imagens digitais utilizando o programa UTHSCSA Image Tool. Os dados foram analisados estatisticamente pelo teste ANOVA a um critério (α=0,05). Não houve diferenças estatisticamente significantes (p>0,05) entre as radiografias panorâmicas e periapicais, assim como para as medidas obtidas com o paquímetro e pelo programa UTHSCSA Image Tool, quando comparados aos espécimes mandibulares, avaliando as distâncias 1 (p=0,783), 2 (p=0,986) e 3 (p=0,129). Em conclusão, as técnicas radiográficas avaliadas neste estudo mostraram-se confiáveis para mensurações ósseas verticais na área selecionada e o programa de digitalização de imagens UTHSCSA Image Tool é um método adequado de aferição.

Effects of radio-opacifier addition in dental impression material.

OBJECTIVE: The aim of this in vitro study was to determine the effects of barium sulfate addition in two dental impression materials previously proved as radiolucent. MATERIALS AND METHODS: An irreversible hydrocolloid (IH) and polyether (PE) were tested for optical density, linear dimension stability and detail reproduction. STATISTICAL ANALYSIS USED: The optical density data were submitted to Kolmogorov-Smirnov normality test and compared with two-way ANOVA and Tukey (alpha=0.05). RESULTS: The results of optical density (pixel) were: IH control 45.24 f (+/-7.6), PE control 54.93 e (+/-4.45), PE 5Wt% 60.43 d (+/-6.27), IH 1Wt% 61.54 cd (+/-5.3), PE 1Wt% 66.9 bc (+/-5.05), IH 5Wt% 67.17 b (+/-6.01), PE 10Wt% 84.55 a (+/-5.14), IH 10Wt% 85.33 a (+/-5.53). On detail reproduction, polyether control was able to copy the 6 microm line. Adding 1 or 5Wt% of barium sulfate have not change this characteristic. For the irreversible hydrocolloid, the control group was able to copy a line with 14 microm, however, adding 1Wt% barium sulfate, the capability decreased to 22 microm. Adding barium sulfate in the polyether promoted an increase in between the copied lines, for the control, the average distance was 931.6 microm, 936 microm to 1Wt% and 954.5 microm to 5 Wt%. For the IH, the control presented 975 microm in comparison to 987.25 microm for 1 Wt% samples. CONCLUSION: The addition of barium sulfate was capable of increasing significantly the optical density of tested material, have changed the linear dimension stability, however, have not interfered in detail reproduction only for PE.

Accuracy of periapical radiography, panoramic radiography and computed tomography for examining the mental foramen region / Acurácia de radiografia periapical, radiografia panorâmica e tomografia computadorizada para exame da região do forame mentual

Purpose: To determine the accuracy of different radiographic methods for bone height estimation at the mental foramen area. Methods: Twenty dry human hemimandibles were examed by using periapical and panoramic radiography, and computed tomography. An electronic digital caliper was used to measure the tracings obtained from the radiographies in three different times (groups A1, A2 and A3) and inthe cross-sectioned hemimandibles (group B). Measurements consisted of: Measure 1 - from the upper limit of the alveolar ridge to the upper limit of the mental foramen; Measure 2 - from the upper limit of the mental foramen to the inferior limit of the cortical bone of the base of the jaw; Measure 3 - from the upper limit of the alveolar ridge to the inferior limit of the cortical bone of the base of the jaw. Data were analyzed with Student-t and Friedman tests. Results: The average difference values in Measure 1 were 0.33 mm, 0.35 mm and 0.85 mm for the periapical radiography, computed tomography and panoramic radiography, respectively (confidence intervals of 0.17 mm to 0.49 mm, 0.18 mm to 0.53 mm and 0.38 mm to 1.32 mm, respectively). Panoramic radiographies showed the greatest differences in Measures 2 and 3, with average values of 1.05 mm and 1.93 mm, respectively. Conclusion: Periapical radiography and computed tomography showed the best accuracy. Asafety margin for surgical purposes has been suggested.

Objetivo: Determinar a acurácia de diferentes métodos radiográficos para estimação de altura óssea na região do forame mentual. Metodologia: Vinte hemi-mandíbulas humanas, secas, foram examinadas por radiografia periapical e panorâmica e tomografia computadorizada. Um paquímetro digital foi usado para medir os traçados obtidos das radiografias em três diferentes tempos (grupos A1, A2 e A3) e nas hemi-mandíbulas seccionadas transversalmente (grupo B). As medições foram: Medida 1 - do limite superior da crista óssea ao limite superior do forame mentual; Medida 2 - do limite superior do forame mentual ao limite inferior do osso cortical da base da mandíbula; Medida 3 - do limite superior da crista óssea ao limite inferior do osso cortical da base da mandíbula. Os dados foram analisados por teste t de Student e teste de Friedman. Resultados: Os valores médios de diferença na Medida 1 foram 0,33 mm, 0,35 mm e 0,85 mm para a radiografia periapical, tomografia computadorizada e radiografia panorâmica, respectivamente (intervalos de confiança de 0,17 a 0,49 mm, 0,18 a 0,53 mm e 0,38 a 1,32 mm, respectivamente). As radiografias panorâmicas mostraram as maiores diferenças nas Medidas 2 e 3, com valores médios de 1,05 mm e 1,93 mm, respectivamente. Conclusão: A radiografia periapical e a tomografia computadorizada mostraram a melhor acurácia. Sugere-se uma margem de segurança em caso de cirurgias.

Range of exposure time and image quality in conventional and digital radiographs: an in vitro study

The purpose of this study was to determine the range of exposure time to obtain acceptable bitewing radiographic images using conventional (InSight, Kodak) and digital (DenOptixTM, Gendex) systems. Thirty sound molars were radiographed by bitewing technique at exposure times ranging from 0.06s to 2.50s. Five dental radiologists evaluated the resulting 340 radiographs, classifying them as(1) unacceptable, (2) acceptable and (3) of good quality. Frequencies were analyzed by Kruskal-Wallis and Wilcoxon tests, and inter-examiner agreement was determined by Cohen’s kappa statistics. Radiographs of good diagnostic quality in conventional system were obtained with exposure times ranging from 0.10s to 1.00s while in digital system the time ranged from 0.06s to 1.60s (P<0.05). It was also observed that 75.3 per cent of the digital images and 47.1 per cent of the conventional images were considered of good quality...

O objetivo deste estudo foi determinar o intervalo de tempo de exposição aceitável para obter imagens radiográficas interproximais utilizando sistemas convencionais (Insight, Kodak) e digital (DenOptixTM, Gendex). Trinta molares foram radiografados pela técnica interproximal em tempos de exposição variando de 0.06s de 2.50s. Cinco radiologistas odontólogos avaliaram 340 radiografias classificando-as como (1) inaceitáveis, (2) aceitável e (3) de boa qualidade. As freqüências foram analisadas pelo teste de Kruskal-Wallis e Wilcoxon, e concordância entre os examinadores foi determinada pela estatística kappa de Cohen. As radiografias de boa qualidade diagnóstica em sistema convencional foram obtidos com tempos de exposição variando de 0,10s a 1.00s, enquanto no sistema digital, o tempo variou de 0.06s a 1.60s para (P <0,05). Também foi observado que 75,3 por cento das imagens digitais e 47,1 por cento das imagens convencionais foram considerados de boa qualidade...

Optical density and chemical composition of microfilled and microhybrid composite resins.

This study evaluated the optical density of two microfilled and two microhybrid resins, as well as the composition of these materials with regard to their optical density. Cavities prepared in 12 2-mm- or 4-mm-thick acrylic plastic plates were filled with Z250 (3M-ESPE), A110 (3M-ESPE), Charisma (Heraeus-Kulzer) and DurafillVS (Heraeus-Kulzer). The resin increments (2-mm-thick) were light-cured for 40 s. Three 0.12-s radiographic exposures were made of each #2 acrylic plastic plate. DenOptix system optical plates were used to obtain the digital images. Three readings of the composite resin surface were made in each radiograph, totalizing 216 readings. The mean of highest and lowest grey-scale values was obtained. Two specimens of each composite resin were prepared for SEM analysis of the chemical elements related to optical density, using energy dispersive x-ray analysis (EDX). The results were subjected to Shapiro-Wilk's test, ANOVA, Tukey's test at 1% level of significance and Pearson's correlation. The mean grey-scale values at 2 mm and 4 mm were: Z250 = 154.27a and 185.33w; A110 = 46.77b and 63.05y; Charisma = 163.40c and 200.46z; DurafillVS = 43.92b and 58.99x, respectively. Pearson's test did not show any positive correlation between optical density and percentage weight of optical density chemical elements. It was concluded that the microhybrid resins had higher optical density means than the microfilled resins; among the evaluated resins, Charisma had the highest optical density means.

Preload and torque removal evaluation of three different abutment screws for single standing implant restorations.

Several authors still consider the mechanical problems of fracture and component loosening as the main causes of failure of implant-supported restorations. The purpose of this in vitro study was to compare the preload of three types of screw for transmucosal abutment attachment used in single implant-supported prosthesis through strain gauge and removal torque measurements. Three external hex fixtures were used, and each received a transmucosal abutment (Cera One), which was fixed to the implant with its respective screw: Group A- gold screw, Group B- titanium screw and Group C- surface-treated titanium screw (Ti-Tite). Ten screws of each type were attached applying a 30.07+/-0.28 Ncm torque force and maintained in position for 5 minutes. After this, the preload values were measured using strain gauges and a measurement cell. Gold screws presented higher preload values (131.72+/-8.98 N), followed by surface-treated titanium screws (97.78+/-4.68 N) and titanium screws (37.03+/-5.69 N). ANOVA (p<0.05) and Tukey's test (p<0.05) were applied. Statistically significant differences were found among the groups for both preload and removal torque values. In conclusion, gold screws may be indicated to achieve superior longevity of the abutment-implant connection and, consequently, prosthetic restoration due to greater preload values yielded.

Radiopacity of impression materials using an indirect digital system / Radiopacidade de materiais de moldagem usando um sistema digital indireto

Purpose: This in vitro study evaluated the radiopacity of impression materials using an indirect digital system. Methods: Samples of four polyvinyl siloxanes, one polyether, one polysulfide, and one irreversible hydrocolloid were fabricated with 1.0, 1.5, and 3.5mm-thickness. Three samples of different thickness were placed on the Digora optical plate and exposed. The optical density (pixels) was recorded in three areas resulting in a total of 360 measurements. Data were analyzed by 2-way ANOVA and Tukey tests (α=0.05). Results: Significant differences were observed among all materials and thicknesses tested (P<0.001). Irreversible hydrocolloid and polyether showed the lowest optical density. Polysulfide showed the highest optical density under all evaluated conditions. Conclusion: There was a significant difference in optical density for all impression materials tested. Composition changes are suggested to allow radiographic detection and improve safety during clinical use of impression materials.

Objetivo: Este estudo in vitro comparou a radiopacidade de materiais de moldagem usando um método radiográfico digital indireto. Metodologia: Amostras de quatro polivinil-siloxanos, um poliéter, um polissulfeto e um hidrocolóide irreversível foram confeccionadas com alturas de 1, 1,5 e 3,5mm. Três amostras das diferentes espessuras foram dispostas sobre uma placa óptica Digora e exposta. A densidade óptica (pixels) foi registrada em três diferentes áreas de cada amostra. Os dados foram analisados pelo teste de análise de variância de dois fatores e teste de Tukey (α=0,05). Resultados: Diferenças significantes foram observadas entre todos os materiais e espessuras testadas (P<0,001). O hidrocolóide irreversível e o poliéter apresentaram a menor densidade óptica. O polissulfeto apresentou a maior densidade óptica em todas as condições avaliadas. Conclusão: Há diferença significativa na densidade óptica dos materiais de moldagem avaliados. Alterações na composição são necessárias para facilitar a detecção destes materiais a fim de aumentar a segurança no uso clínico.

A comparison between panoramic digital and digitized images to detect simulated periapical lesions using radiographic subtraction.

This study compared digital and digitized panoramic radiographs to detect incipient periapical lesions using the digital subtraction radiography (DSR) technique. Bone defects were created in 77 apical sites of dried human mandibles through the application of 70% perchloric acid. Conventional and digital radiographs were obtained twice at time zero and 2, 4, and 6 hours after application of the acid solution. Conventional radiographs were digitized by using the same attributes than direct digital radiographs. The baseline images were subtracted of the negative control and experimental groups and assessed by an experienced and blinded observer who assigned score 0 (normal) or 1 (mineral loss) to each image. The sensitivity of both modalities was statistically different in relation to experimental times. The percentage of correct responses significantly increased regarding experimental times. The specificity was high both for digitized and digital images. DSR of panoramic images, both digitized and digital, allows for the diagnosis of incipient-simulated periapical lesions with no differences in their performance.

Optical density and chemical composition of microfilled and microhybrid composite resins

This study evaluated the optical density of two microfilled and two microhybrid resins, as well as the composition of these materials with regard to their optical density. Cavities prepared in 12 2-mm- or 4-mm-thick acrylic plastic plates were filled with Z250 (3M-ESPE), A110 (3M-ESPE), Charisma (Heraeus-Kulzer) and DurafillVS (Heraeus-Kulzer). The resin increments (2-mm-thick) were light-cured for 40 s. Three 0.12-s radiographic exposures were made of each #2 acrylic plastic plate. DenOptix system optical plates were used to obtain the digital images. Three readings of the composite resin surface were made in each radiograph, totalizing 216 readings. The mean of highest and lowest grey-scale values was obtained. Two specimens of each composite resin were prepared for SEM analysis of the chemical elements related to optical density, using energy dispersive x-ray analysis (EDX). The results were subjected to Shapiro-Wilk's test, ANOVA, Tukey's test at 1 percent level of significance and Pearson's correlation. The mean grey-scale values at 2 mm and 4 mm were: Z250 = 154.27a and 185.33w; A110 = 46.77b and 63.05y; Charisma = 163.40c and 200.46z; DurafillVS = 43.92b and 58.99x, respectively. Pearson's test did not show any positive correlation between optical density and percentage weight of optical density chemical elements. It was concluded that the microhybrid resins had higher optical density means than the microfilled resins; among the evaluated resins, Charisma had the highest optical density means.

Preload and torque removal evaluation of three different abutment screws for single standing implant restorations

Several authors still consider the mechanical problems of fracture and component loosening as the main causes of failure of implant-supported restorations. The purpose of this in vitro study was to compare the preload of three types of screw for transmucosal abutment attachment used in single implant-supported prosthesis through strain gauge and removal torque measurements. Three external hex fixtures were used, and each received a transmucosal abutment (Cera One®), which was fixed to the implant with its respective screw: Group A- gold screw, Group B- titanium screw and Group C- surface-treated titanium screw (Ti-Tite®). Ten screws of each type were attached applying a 30.07±0.28 Ncm torque force and maintained in position for 5 minutes. After this, the preload values were measured using strain gauges and a measurement cell. Gold screws presented higher preload values (131.72±8.98 N), followed by surface-treated titanium screws (97.78±4.68 N) and titanium screws (37.03±5.69 N). ANOVA (p<0.05) and Tukey's test (p<0.05) were applied. Statistically significant differences were found among the groups for both preload and removal torque values. In conclusion, gold screws may be indicated to achieve superior longevity of the abutment-implant connection and, consequently, prosthetic restoration due to greater preload values yielded.

Densidade óptica e composição química de resinas compostas / Radiopacity and chemical composition of composite resins

Verificou-se a densidade óptica de quatro resinas compostas disponíveis atualmente no mercado, bem como a composição desses materiais quanto à presença de elementos químicos responsáveis por sua densidade óptica. As resinas Z250 e Supreme (3M-ESPE), 4Seasons (Ivoclar Vivadent) e EsthetX (Dentsply), foram inseridas em orifícios existentes em 12 placas de acrílico divididas em espessuras de 2 e 4mm. Os incrementos de resina (2mm) foram fotopolimerizados por 40s. Realizaram-se 3 tomadas radiográficas de cada placa com o tempo de exposição de 0,12s. As imagens digitais foram obtidas através do sistema DenOptix. Foram realizadas 3 leituras de cada tomada radiográfica em cada resina no software VixWin, sendo calculada a média dos maiores e menores valores de densidade óptica (em pixels), totalizando 216 leituras. Confeccionaram-se 2 amostras de cada resina para análise dos elementos químicos em Microscopia Eletrônica de Varredura através de Espectroscopia por Dispersão de Energia (EDS). Os resultados foram submetidos ao teste de Shapiro-Wilk, à Análise de Variância, ao teste de Tukey a 1% e Correlação de Pearson. As médias de densidade óptica (pixels) em 2mm e 4mm, respectivamente, foram (valores seguidos de mesma letra não diferem estatisticamente entre si): Z250 = 171,17a e 199,58x; Supreme = 167,78a e 195,30w; 4Seasons =176,32b e 208,50y; EsthetX = 190,85c e 213,56z. Os maiores valores foram obtidos pela resina EsthetX, nas duas espessuras avaliadas. Com base nos resultados encontrados concluiu-se que não houve correlação entre os valores médios de densidade óptica das resinas testadas e o percentual em peso de elementos que lhe conferem esta característica.

Avaliação da densidade óptica da superfície oclusal através de radiografias digitalizadas e sua relação com a presença de lesões de cárie em molares decíduos / Occlusal surface optical density measurement in digitized radiographs and the presence of caries in deciduous molars

O objetivo deste estudo foi comparar o desempenho de dois sistemas de medição de densidade óptica numa amostra composta por segundos molares decíduos, assim como relacionar a presença de lesão de cßrie dentinária na superfície oclusal de segundos molares decíduos com os valores de densidade óptica desta superfície, utilizando dois programas de computador. Para isso foi realizada a medição da densidade óptica de 28 radiografias padronizadas de segundos molares decíduos em dois programas de computador diferentes. Os resultados obtidos com o programa Digora® for Windows 2.1 foram comparados com os obtidos no programa Image Tool for Windows 3.0. Ainda, os valores de densidade óptica encontrados foram relacionados aos diagnósticos obtidos com o exame dos dentes no estereomicroscópio. Os programas Digora e Image Tool apresentaram valores de densidade óptica semelhantes, sem diferença estatisticamente significativa. Ainda, a densidade óptica observada nos dentes que não apresentavam lesões de cßrie dentinßrias na superfície oclusal foi diferente daquela cujos dentes possuiam lesão em dentina (p = 0,035). Entretanto, com os resultados obtidos neste estudo não foi possível estabelecer intervalos de densidade óptica correspondentes a superfícies oclusais com presença ou ausência de lesões de cßrie em dentina.

Effect of laser therapy on bone tissue submitted to radiotherapy: experimental study in rats.

OBJECTIVE: The aim of this study was to investigate the effect of laser therapy (lambda = 780 nm) on bone tissue submitted to ionizing radiation. BACKGROUND DATA: The biostimulation effect of laser in normal bone tissue has already been demonstrated successfully; however its effect on bone tissue submitted to radiotherapy has not yet been studied. METHODS: Twenty-two Wistar rats were randomly divided into four groups: group I, control (n = 4), submitted only to radiotherapy; group II, laser starting 1 day prior to radiotherapy (n = 6); group III, laser started immediately after radiotherapy (n = 6); group IV, laser 4 weeks after radiotherapy (n = 6). The source of ionizing radiation used was Cobalt 60, which was applied in a single dose of 3000 cGy on the femur. The laser groups received seven applications with a 48-h interval in four points per session of DE = 4 J/cm(2), P = 40 mW, t = 100 sec, and beam diameter of 0.04 cm(2). All animals were killed 6 weeks after radiotherapy. RESULTS: Clinical examination revealed cutaneous erosions on experimental groups (II, III, and IV) starting at the 6th week after radiotherapy. The radiographic findings showed higher bone density in groups II and IV (p < 0.05) compared to the control group. The results further showed an increase of bone marrow cells, and number of osteocytes and Haversian canals in experimental groups II and IV (p < 0.05). It was also found an increase of osteoblastic activity, in groups II, III, and IV (p < 0.05). CONCLUSION: Laser therapy on bone tissue in rats presented a positive biostimulative effect, especially when applied before or 4 weeks after radiotherapy. However, the use of laser in the parameters above should be used with caution due to epithelial erosions.

Measuring cortical thickness on panoramic radiographs: a validation study of the Mental Index.

OBJECTIVES: To validate the Mental Index assessment obtained from panoramic radiographs. STUDY DESIGN: Ten dried mandibles were selected, and standardized panoramic radiographs were obtained. The specimens were then perpendicularly sectioned at the mental foramen region, and the inferior mandibular cortical thickness was recorded using a digital caliper. Measurements of panoramic radiographs were compared with the dried mandibles. Four observers carried out twice the measurements for the panoramic radiographs. Two observers performed twice the measurements of the dried mandibles. Reliability was assessed by duplicate measurements. RESULTS: Agreement between the actual mandible measurements and the radiographic assessment was moderate for the noncorrected measurements. Agreement between anatomic and radiographic measurements improved remarkably after standard correction for magnification. CONCLUSIONS: Bone status reports based on measuring cortical thickness of the lower border of the mandible at the mental foramen based on panoramic radiographs, i.e., Mental Index, are accurate. Compensation for magnification, however, is necessary.

Efeitos da radioterapia no tecido ósseo / Effects of radiotherapy on bone tissues

OBJETIVO: Avaliar os efeitos da radioterapia e a acurácia da mensuração do nível de cinza do tecido ósseo em imagens radiográficas. MATERIAIS E MÉTODOS: Quatro ratos Wistar foram submetidos a radioterapia externa (dose única de 3.000 cGy) em uma área de 2 cm × 2 cm na perna direita. Os animais foram sacrificados seis semanas após a radioterapia, e tanto as pernas irradiadas quanto as contralaterais (não-irradiadas) foram avaliadas na sua espessura, radiografadas de forma padronizada e processadas histologicamente (hematoxilina-eosina e picrossírius). As radiografias foram digitalizadas e a média dos níveis de cinza foi mensurada no programa Image Tool®. RESULTADOS: A espessura do fêmur foi maior na perna contralateral do que na irradiada (p < 0,05). Radiograficamente, observou-se maior quantidade de tecido ósseo na perna contralateral em relação à perna irradiada, porém sem diferença estatística significante (p > 0,05). Histologicamente, foi possível observar, na perna irradiada, diminuição do número de osteócitos e dos canais de Havers, porém sem diferença estatística significante (p > 0,05). Por outro lado, foi observado aumento significante de adipócitos, com conseqüente diminuição de tecido medular na perna irradiada (p < 0,05) e maior atividade osteoblástica na perna contralateral (p < 0,05). CONCLUSÃO: A radioterapia, na dose aplicada, determinou diminuição da atividade de remodelação óssea, que pôde ser detectada radiograficamente na maioria dos espécimes avaliados.

OBJECTIVE: To investigate the effects of radiotherapy on bone tissues and the accuracy of gray level measurements on radiographic images. MATERIALS AND METHODS: Four Wistar rats were submitted to external radiotherapy (single 3000 cGy dose) on an area of 2 cm × 2 cm of their right legs. The animals were sacrificed six weeks after radiotherapy, and both irradiated and contralateral (non-irradiated) legs were removed, dissected, evaluated for thickness, x-rayed in a standardized form and histologically processed (stained with hematoxylin-eosin and picrosirius red). The radiographs were digitalized and the gray level average was measured with the ImageTool® software. RESULTS: The femur thickness of non-irradiated legs was greater than that of the irradiated legs (p < 0.05). Radiographically, the findings indicated a higher bone density in the non-irradiated legs, although with no statistically significant difference (p > 0.05). Histological analysis of the irradiated legs demonstrated a decrease in the number of osteocytes and Haversian canals, although with no statistically significance (p > 0.05). On the other hand, a significant increase in adipocytes was observed, resulting in a reduction of medullary tissue in the irradiated legs (p < 0.05), besides a higher osteoblastic activity in the non-irradiated legs (p < 0.05). CONCLUSION: Radiotherapy within the above mentioned parameters determined a decrease in activity of bone remodeling, which could be radiographically detected in the majority of the evaluated specimens.

Primary stability of turned and acid-etched screw-type implants: a removal torque and histomorphometric study in rabbits.

PURPOSE: This study evaluated the effect of primary stability on the osseointegration of turned and acid-etched screw implants in a rabbit model. MATERIALS AND METHODS: One pair of turned and acid-etched implants (3.75 in diameter, 5.5 mm long) was placed in each tibia of 15 rabbits. In the right tibial metaphysis the implants were inserted according to a standard surgical protocol. In the left tibia, the osteotomy sites were enlarged using a sequence of drills, and 2 implants were placed with reduction of primary stability. Animals were sacrificed 9 weeks after surgery. Histomorphometric and removal torque analyses were performed to evaluate bone-implant contact and strength of osseointegration. RESULTS: Surface texture had a significant effect on percentage of bone-implant contact (P = .001). Acid-etched implants with high primary stability showed the highest percentage of bone-implant contact (77%), followed by acid-etched implants with low primary stability (61%), turned implants with low primary stability (56%), and turned implants with high primary stability (46%). For removal torque, acid-etched implants had higher peak mean values than turned implant groups (P < .001). Reduction of primary stability was not significant to either percentage of bone-implant contact (P = .645) or removal torque values (P = .214). CONCLUSION: Acid-etched implants had higher bone response and implant fixation than turned implants, regardless of primary stability.

Radiographic evaluation of periodontal osseous defects: in vitro study

Introdução: Embora os métodos de diagnóstico por imagem tenham evoluído permitindo um avanço na detecção precoce das doenças, o exame radiográfico convencional ainda é uma ferramenta importante para a avaliação da condição periodontal. Na literatura correlata existem poucas investigações sobre a especificidade da imagem radiográfica dos defeitos ósseos, evidenciando-se a necessidade de estudos adicionais sobre a temática. Objetivo: Descrever os aspectos radiográficos de defeitos ósseos periodontais produzidos artificialmente em mandíbulas secas, ressaltando os determinantes anatômicos que contribuem na formação dos diferentes tipos de defeito. Método: Foram utilizadas quatorze mandíbulas secas nas quais oito tipos de defeitos ósseos periodontais foram produzidos. Fotografias digitais e radiografias convencionais foram obtidas de forma padronizada de cada sítio, antes e após a confecção dos referidos defeitos. Em seguida, as radiografias foram dispostas em negatoscópio e avaliadas por três examinadores. Resultados: Os defeitos ósseos apresentaram características radiográficas distintas, em grande parte, permitindo sua identificação, com exceção dos defeitos de uma, duas e três paredes ósseas. O defeito do septo radicular foi o mais difícil de interpretação enquanto que os defeitos horizontal e vertical foram maisfacilmente interpretados. Considerações finais: A interpretação das imagens radiográficas de defeitos ósseos periodontais é dependente do tipo de reabsorção que está sendo avaliada. A descrição do defeito ósseo pode ser facilitada para aqueles tipos que apresentam a morfologia com menor superposição de estruturas óssea e dentária.