Texture analysis in cone-beam computed tomographic images of medication-related osteonecrosis of the jaw.

Purpose: The aim of this study was to evaluate changes in the trabecular bone through texture analysis and compare the texture analysis characteristics of different areas in patients with medication-related osteonecrosis of the jaw (MRONJ). Materials and Methods: Cone-beam computed tomographic images of 16 patients diagnosed with MRONJ were used. In sagittal images, 3 regions were chosen: active osteonecrosis (AO); intermediate tissue (IT), which presented a zone of apparently healthy tissue adjacent to the AO area; and healthy bone tissue (HT) (control area). Texture analysis was performed evaluating 7 parameters: secondary angular momentum, contrast, correlation, sum of squares, inverse moment of difference, sum of entropies, and entropy. Data were analyzed using the Kruskal-Wallis test with a significance level of 5%. Results: Comparing the areas of AO, IT, and HT, significant differences (P<0.05) were observed. The IT and AO area images showed higher values for parameters such as contrast, entropy, and secondary angular momentum than the HT area, indicating greater disorder in these tissues. Conclusion: Through texture analysis, changes in the bone pattern could be observed in areas of osteonecrosis. The texture analysis demonstrated that areas visually identified and classified as IT still had necrotic tissue, thereby increasing the accuracy of delimiting the real extension of MRONJ.

Systemic scleroderma: imaging findings of diagnosis and clinical management of temporomandibular joint disorders / Esclerodermia sistêmica: diagnóstico por achados imaginológicos e manejo clínico das disfunções temporomandibulares

Scleroderma, an autoimmune disease, directly affects the production of collagen in the connective tissue. In its systemic form, the disease causes oral manifestations such as: limited mouth opening, xerostomia, periodontal disease, thickening of the periodontal ligament and bone resorption of the mandible. This case report aims to draw attention to the difficulties encountered in providing dental care to patients with scleroderma and also to highlight the imaging findings, with emphasis on the temporomandibular joints, which are of interest to dentists about the disease. In the present case, the patient presented bilateral condylar erosion, in addition to disc displacement without reduction. Due to the systemic condition of the patient, it was decided to make an individualized occlusal splint. The limitation of mouth opening is a limiting factor for the manufacture of prostheses and plates, which is why partial prostheses are indicated and are easily removed by the patient. The decisions taken have a great impact on the health and quality of life of patients in these conditions, so there is a need for multidisciplinary involvement in order to arrive at the best treatment plan. After five years of using the stabilizing plate overnight, the patient reports greater comfort and muscle relaxation upon waking up (AU)

Esclerodermia, uma doença autoimune, afeta diretamente a produção de colágeno do tecido conjuntivo. Na forma sistêmica, a doença causa manifestações bucais, como: limitação de abertura bucal, xerostomia, doença periodontal, espessamento do ligamento periodontal e reabsorção da mandíbula. Este relato de caso tem por objetivo chamar atenção para as dificuldades encontradas ao promover atendimento odontológico para pacientes com esclerodermia e também destacar os achados imaginológicos, com ênfase na articulação temporomandibular, que são da doença e de interessa ao cirurgião-dentista. No presente caso, a paciente apresentava erosão condilar bilateral, com deslocamento de disco sem redução. Devido à condição sistêmica da paciente, foi decidido confeccionar uma placa oclusal individualizada. A limitação de abertura bucal é um fator limitante para confecção de próteses e placas, por isso próteses parciais são indicadas, além de serem de fácil remoção pelo paciente. As decisões tomadas tem grande impacto na saúde e qualidade de vida de pacientes nessas condições, deste modo é necessário uma equipe multidisciplinar envolvidas para chegar no melhor plano de tratamento. Após cinco anos fazendo uso da placa estabilizadora durante a noite, a paciente relata maior conforto e relaxamento muscular ao acordar (AU)

Prevalence of soft tissue calcifications in cone beam computed tomography images in the region of head and neck / Prevalência de calcificações de tecidos moles em exames de tomografia computadorizada de feixe cônico

Objective: to evaluate the prevalence of calcifications in the soft tissues of the cervical-facial region using cone beam computed tomography (CBCT) images. Material and Methods: two hundred and ten CBCT exames was analyzed by 01 examiner previously trained, with fild of view (FOV) of 16 x 13 cm and voxel of 0.25 mm, in ICAT Vision software (Imaging Science International, Hatfield, PA, USA) in coronal, axial and sagittal sections. The following calcifications were evaluated: tonsiloliths, sialolites, calcification of the styloid complex, calcified carotid atheromas, calcifications in laryngeal cartilages, calcified lymph nodes and osteoma cutis. The findings were tabulated according to the total of the sample, related to the gender, age group of the individuals. Results: Calcification of the styloid complex was the most frequent in the sample studied in both genres (39.04%), followed by the presence of tonsiloliths (19.52%), and calcified lymph nodes (6,67%). Conclusion: calcifications are frequent radiographic findings in CBCT and important for the diagnosis of some possible pathologies that do not present clinical symptoms (AU)

Objetivo: avaliar por meio de imagens de tomografia computadorizada de feixe cônico (TCFC) a prevalência de calcificações em tecidos moles da região cérvicofacial. Material e Métodos: os exames foram avaliados por um examinador, previamente treinado que avaliou 210 exames de TCFC, com campo de visão (FOV) de 16 x 13 cm e voxel de 0,25 mm. Os exames foram avaliados no software ICAT Vision (Imaging Science International, Hatfield, PA, Estados Unidos da América) em cortes coronais, axiais e sagitais. As seguintes calcificações foram avaliadas: tonsilolitos, sialolitos, calcificação do complexo estiloide, ateromas da carótida calcificados, calcificações na cartilagens laríngeas, nódulos linfáticos calcificados e osteoma cútis. Os achados foram tabulados de acordo com o total da amostra, relativos ao gênero e faixa etária dos indivíduos. Resultados: a calcificação do processo estiloide foi a mais frequente na amostra estudada em ambos os sexos, seguido da presença dos tonsilolitos e linfonodos calcificados. Conclusão: as calcificações de tecidos moles são achados radiográficos frequentes na TCFC e importantes para diagnósticos de algumas possíveis patologias que não apresentam sintomatologia clínica.(AU)

Macroscopic and radiographic aspects of orthodontic movement associated with corticotomy: animal study.

INTRODUCTION: To quantify the rate of tooth movement in two corticotomy protocols in an experimental model in rats through macroscopic and radiographic analysis. METHODS: The animals were divided into three groups: orthodontic movement (CO), orthodontic movement plus corticotomy surgery (G2), and orthodontic movement and corticotomy surgery with decorticalization (G3).The euthanasia occurred in 7 and 14 days. The data were statistically analyzed (p < 0.05). RESULTS: The CO presented lower distance between the mesial surface of the first molar and the distal surface of the third molar when compared to the G2 (6.96 ± 0.24, p = 0.009) and G3 (6.93 ± 0.18, p = 0.016) in the macroscopic analysis. In the 7 days, there was no statistically significant radiographic difference between the three groups: CO(0.94 ± 0.21 mm2), G2(1.05 ± 0,27 mm2), and G3(1.08 ± 0.27 mm2).There was a statistically significant difference between CO (0.87 ± 0.12 mm2), G2 (1.00 ± 0.12 mm2), and G3 (1.11 ± 0.14 mm2) at 14 days. There was a statistically significant linear difference between the groups in all periods. CONCLUSION: Tooth movement and the region of interest were influenced by corticotomy, regardless of the surgical technique in the 14 days.

Gardner's syndrome suggested by radiographic findings / Síndrome de Gardner sugerida por achados radiográficos

Gardner's syndrome (GS) is a hereditary disorder characterized by multiple osteomas, enostosis, epidermoid cysts, subcutaneous desmoid tumors and multiple gastrointestinal polyps. Given the variety of clinical manifestations, the triad of symptoms that better characterizes the GS is composed by polyps of the colon, multiple osteomas and tumors of soft tissue. The osteomas are most common in the frontal bone and mandible. A significant feature of GS is the progression to malignancy of the intestinal polyps in almost 100% of patients. Early detection of GS allows for an excellent prognosis and may be a lifesaving event. Thus, the aim of this case report was to describe the radiographic aspects of GS in the dentomaxillofacial region and to discuss with the current scientific literature.

A síndrome de Gardner (SG) é uma desordem caracterizada por múltiplos osteomas, enostosis, cistos epidermoides, tumores desmoides subcutâneos e múltiplos pólipos gastrointestinais. Considerando a variedade de manifestações clínicas, a tríade dos sintomas que melhor caracterizam a SG é composta por pólipos do cólon, múltiplos osteomas e tumores de tecido mole. Os osteomas são mais comuns no osso frontal e mandíbula. Uma característica significativa da SG é a progressão maligna dos pólipos intestinais em aproximadamente 100% dos pacientes. A detecção precoce da SG favorece um excelente prognóstico e pode salvar vidas. Então, o objetivo deste relato de caso foi descrever os aspectos radiográficos da SG na região dento-maxilo-facial e discutir com a literatura científica atual.