Diagnostic capability of biological markers in assessment of obstructive sleep apnea: a systematic review and meta-analysis.

OBJECTIVE: The purpose of this systematic review is to evaluate the diagnostic value of biological markers (exhaled breath condensate, blood, salivary and urinary) in the diagnosis of OSA in comparison to the gold standard of nocturnal PSG. METHODS: Studies that differentiated OSA from controls based on PSG results, without age restriction, were eligible for inclusion. The sample of selected studies could include studies in obese patients and with known cardiac disease. A detailed individual search strategy for each of the following bibliographic databases was developed: Cochrane, EMBASE, MEDLINE, PubMed, and LILACS. The references cited in these articles were also crosschecked and a partial grey literature search was undertaken using Google Scholar. The methodology of selected studies was evaluated using the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies. RESULTS: After a two-step selection process, nine articles were identified and subjected to qualitative and quantitative analyses. Among them, only one study conducted in children and one in adults found biomarkers that exhibit sufficiently satisfactory diagnostic accuracy that enables application as a diagnostic method for OSA. CONCLUSION: Kallikrein-1, uromodulin, urocotin-3, and orosomucoid-1 when combined have enough accuracy to be an OSA diagnostic test in children. IL-6 and IL-10 plasma levels have potential to be good biomarkers in identifying or excluding the presence of OSA in adults.

Measurement accuracy and reliability of tooth length on conventional and CBCT reconstructed panoramic radiographs

INTRODUCTION: This in vivo study assessed accuracy and reliability of tooth length measurements obtained from conventional panoramic radiographs and CBCT panoramic reconstructions to that of a digital caliper (gold standard). METHODS: The sample consisted of subjects who had CBCT and conventional panoramic radiographic imaging and who required maxillary premolar extraction for routine orthodontic treatment. A total of 48 teeth extracted from 26 subjects were measured directly with digital calipers. Radiographic images were scanned and digitally measured in Dolphin 3D software. Accuracy of tooth length measurements made by CBCT panoramic reconstructions, conventional panoramic radiographs and digital caliper (gold standard) were compared to each other by repeated measures one-way ANOVA with Bonferroni correction and by single measures intraclass correlation coefficient. RESULTS: Repeated root length measures with digital calipers, panoramic radiographs and CBCT constructed panoramic-like images were all individually highly reliable. Compared to the caliper (gold standard), tooth measurements obtained from conventional panoramic radiographs were on average 6.3 mm (SD = 2.0 mm) longer, while tooth measurements from CBCT panoramic reconstructions were an average of 1.7 mm (SD = 1.2 mm) shorter. CONCLUSIONS: In comparison to actual tooth lengths, conventional panoramic radiographs were relatively inaccurate, overestimating the lengths by 29%, while CBCT panoramic reconstructions underestimated the lengths by 4%. .

INTRODUÇÃO: este estudo in vivo avaliou a precisão e a confiabilidade de medições do comprimento dentário realizadas em radiografias panorâmicas convencionais e em reconstruções panorâmicas de tomografias computadorizadas de feixe cônico (TCFC), comparando-as com medições feitas com um paquímetro digital, consideradas o padrão-ouro. MÉTODOS: a amostra incluiu indivíduos que já tivessem realizado tanto exames imaginológicos de TCFC quanto radiografias panorâmicas, e cujo tratamento ortodôntico exigisse a extração de pré-molar superior. No total, 48 dentes extraídos, de 26 pacientes, foram mensurados diretamente com paquímetros digitais. As radiografias foram escaneadas e digitalmente avaliadas com a ajuda do software Dolphin 3D. Por meio da análise de variância simples com correção de Bonferroni e Coeficiente de Correlação Intraclasse simples, comparou-se a precisão das medições de comprimento dentário realizadas em reconstruções panorâmicas de TCFC, em radiografias panorâmicas convencionais e com paquímetro digital. RESULTADOS: medições repetidas de comprimento dentário feitas com o paquímetro digital, radiografias panorâmicas e reconstruções panorâmicas de TCFC foram todas consideradas, individualmente, altamente confiáveis. Em comparação ao paquímetro, as medidas obtidas por meio de radiografias panorâmicas convencionais foram, em média, 6,3 ± 2,0mm mais longas, enquanto as medidas obtidas por meio das reconstruções panorâmicas de TCFC foram, em média, 1,7 ± 1,2mm mais curtas. CONCLUSÕES: em comparação com o real comprimento dentário, as radiografias panorâmicas convencionais foram relativamente ...

Measurement accuracy and reliability of tooth length on conventional and CBCT reconstructed panoramic radiographs.

INTRODUCTION: This in vivo study assessed accuracy and reliability of tooth length measurements obtained from conventional panoramic radiographs and CBCT panoramic reconstructions to that of a digital caliper (gold standard). METHODS: The sample consisted of subjects who had CBCT and conventional panoramic radiographic imaging and who required maxillary premolar extraction for routine orthodontic treatment. A total of 48 teeth extracted from 26 subjects were measured directly with digital calipers. Radiographic images were scanned and digitally measured in Dolphin 3D software. Accuracy of tooth length measurements made by CBCT panoramic reconstructions, conventional panoramic radiographs and digital caliper (gold standard) were compared to each other by repeated measures one-way ANOVA with Bonferroni correction and by single measures intraclass correlation coefficient. RESULTS: Repeated root length measures with digital calipers, panoramic radiographs and CBCT constructed panoramic-like images were all individually highly reliable. Compared to the caliper (gold standard), tooth measurements obtained from conventional panoramic radiographs were on average 6.3 mm (SD = 2.0 mm) longer, while tooth measurements from CBCT panoramic reconstructions were an average of 1.7 mm (SD = 1.2 mm) shorter. CONCLUSIONS: In comparison to actual tooth lengths, conventional panoramic radiographs were relatively inaccurate, overestimating the lengths by 29%, while CBCT panoramic reconstructions underestimated the lengths by 4%.

Effect of buccolingual root angulation on the mesiodistal angulation shown on panoramic radiographs.

INTRODUCTION: The purpose of this study was to evaluate the effect of buccolingual root angulation on the perception of root parallelism in panoramic images. METHODS: A skull-typodont device was constructed according to cephalometric norms. The bases of the typodont were partially sectioned so that the buccolingual orientation of 4 adjacent pairs of teeth could be easily modified. Three buccolingual angulations were used for each tooth. Nine image sequences were necessary to analyze all possible buccolingual orientation combinations between adjacent teeth. The true root parallelism angulations relative to an orthodontic archwire were compared with the angulations obtained from scanned panoramic films. RESULTS: The largest root parallelism differences for adjacent teeth occurred between the maxillary canine and the first premolar. The second largest differences occurred in the mandibular canine-premolar area. No significant differences were found in the incisor area. CONCLUSIONS: The root parallelism expression in the canine-premolar region can be modified by altering the buccolingual orientation. Buccolingual orientation changes do not seem to affect the incisor area. The clinical usefulness of panoramic radiography to assess root parallelism should be approached with caution, especially in premolar extraction sites.

Cambios a largo plazo del arco dental después del tratamiento de expansión rápida del maxilar: revisión sistemática / Long-term dental arch changes after rapid maxillary expansion treatment: a systematic review

Esta revisión sistemática evaluó los cambios a largo plazo del arco dental después del tratamiento de expansión rápida del maxilar en pacientes ortodónticos con arcos estrechos. Fueron seleccionados ensayos clínicos que determinaron los cambios del arco dental a través de medidas en modelos dentales o radiografías cefalométricas. Ningún paciente con tratamiento quirúrgico u otra aparatología usada en simultáneo durante el periodo de expansión activa fue aceptado. Las bases de datos electrónicos fueron buscadas con la ayuda de una bibiotecaria expecializada en las bases de datos de ciencias de saludl. Los artículos originales fueron obtenidos después de seleccionar los resúmenes considerados potencialmente útiles. Las referencias bibliográficas de los artículos seleccionados fueron tambien revisados para corroborar que ningún potencia artículo no haya parecido en lso buscadores bibliográficos. 41 artículos cumplieron con los criteris iniciales de inclusión, pero 35 fueron rechazadas porque carecieron de un grupo de control o solamente evaluaron cambios esqueléticos o utilizaron una técnica semi rápida. Algunos de ellos también carecieron de reportes de error de medición. De los cuatro artículos finales, dos evaluaron los cambios de medida en los modelos dentales y dos a través de radiografías (una a través de radiografías cefalométricas laterales y otra de radiografías anteroposteriores). Expansión similar en molares superiores y sus cúspides se pudo encontrar en adolescentes y adultos jóvenes. Se obtuvo una expansión significativamente menor en las molares inferiores y sus caninos en adultos comparaodos con los adolescentes. Un significativo aumento total en el perímetro del arco maxilar y mandibular fue encontrado en adolescentes. Mayores cambios transversales del arco dental fueron encontrados antes de la pubertad al ser comparados con los cambios después de la misma, pero la diferencia puede no ser considera clínicamente significativa. Nose encontró...

This systematic review assessed the long-term changes of dental arch after treatment of rapid maxillary expansion in orthodontic patients with narrow arches. We selected trials that determined the dental arch changes through measures on dental casts or cephalometric radiographs. No patients with surgical or other appliances used simultaneously during the active expansion period were accepted. The electronic databases were searched with the help of a bibiotecaria expecializada databases in science saludl. The original articles were obtained after selecting the abstracts considered potentially useful. The references of selected articles were also reviewed to confirm that there is no article similar power in lso bibliographic search engines. 41 articles met the initial inclusion criteris but 35 were rejected because they lacked a control group or only evaluated skeletal changes or used a technique semi fast. Some of them also lacked reporting measurement error. End of four articles, two assessed as changes in the dental casts and two through radiographs (one through lateral cephalometric radiographs and one anteroposterior radiographs). Similar expansion in upper molars and cusps could be found in adolescents and young adults. There was a significantly lower growth in the lower molars and canines in adults comparaodos with adolescents. A significant overall increase in the perimeter of the maxillary and mandibular arch was found in adolescents. Senior transverse dental arch changes were found before puberty when compared with the changes after the same but the difference can not be considered clinically significant. Nose found ...

Association between growth stunting with dental development and skeletal maturation stage.

The aim of this study was to determine the influence of growth stunting on the maturation stage of the medium phalanx of the third finger (MP3) and the dental development of the left mandibular canine in 280 high school children (140 stunted and 140 normal controls; equally distributed by sex) between 9.5 and 16.5 years of age, from a representative Peruvian school. Periapical radiographs of the MP3 from the left hand were used to determine the skeletal maturity stage, according to an adaptation of the Hägg and Taranger method. Panoramic radiographs were used to determine the dental maturity stage of the lower left canine, according to Demirjian method. Stunting was determined by relating height and age, according to the World Health Organization recommendations. There was no statistically significant difference in the skeletal maturation stage (P = .134) and the dental development stage (P = .497) according to nutritional status, even when considering different age groups (P > .183). A high correlation (r = 0.85) was found between both maturity indicators regardless of the nutritional status (growth stunted, r = 0.855 and normal controls, r = 0.863) or sex (boys, r = 0.809 and girls, r = 0.892). When skeletal level was considered, correlations values were similar between advanced (r = 0.903) and average (r = 0.895) maturers but lower (r = 0.751) for delayed maturers. Growth stunting was not associated with dental development and skeletal maturity stages in Peruvian school children.

Tooth-width ratio discrepancies in a sample of Peruvian adolescents.

Previous studies have demonstrated different tooth-width ratio discrepancies in different populations. The objective of this study was to determine maxillary to mandibular tooth-size ratios in a Peruvian sample; 200 children were selected who had complete permanent dentition, without clinically visible dental caries or proximal restorations, and no previous or active orthodontic treatment. Their dental casts were measured to the nearest 0.1 mm with a sliding caliper and a Vernier scale. The Kolmogorov-Smirnov test, t test, and Pearson correlation test were used. No significant differences were found in anterior (P =.713) and total (P =.174) tooth-size sums according to sex. The anterior tooth-width ratios were 77.78% +/- 2.44% for females and 78.39% +/- 2.81% for males (P =.103). The total ratios were 90.79% +/- 1.71% for females and 91.33% +/- 2.07% for males (P =.048). For this reason, the combined male and female anterior total ratio was calculated (78.09 +/- 2.64%). There were clinically significant tooth-size discrepancies in almost one third of the sample. The 2-standard deviation range from the Bolton standard did not predict clinically significant anterior and total tooth-width ratio discrepancies.