Bioactivity of an Experimental Dental Implant with Anodized Surface.

BACKGROUND: Several studies proved that anodic oxidation improves osseointegration. This study aimed to optimize osseointegration through anodization in dental implants, obtaining anatase phase and controlled nanotopography. METHODS: The division of the groups with 60 titanium implants was: control (CG); sandblasted (SG); anodized (AG): anodized pulsed current (duty cycle 30%, 30 V, 0.2 A and 1000 Hz). Before surgery, surface characterization was performed using Atomic Force Microscopy (AFM), Scanning Electron Microscopy (SEM), X-ray Dispersive Energy Spectroscopy (EDS) and Raman Spectroscopy. For in vivo tests, 10 New Zealand white rabbits received an implant from each group. The sacrifice period was 2 and 6 weeks (n = 5) and the specimens were subjected to computed microtomography (µCT) and reverse torque test. RESULTS: AFM and SEM demonstrated a particular nanotopography on the surface in AG; the anatase phase was proved by Raman spectroscopy. In the µCT and in the reverse torque test, the AG group presented better results than the other groups. CONCLUSION: The chemical composition and structure of the TiO2 film were positively affected by the anodizing technique, intensifying the biological characteristics in osseointegration.

Aggressive unicystic ameloblastoma affecting the posterior mandible: late diagnosis during orthodontic treatment.

Maxillofacial images must be examined to find pathologies not identified during clinical examination. Unicystic ameloblastoma (UA) extending to the mandibular body and ramus was neglected on initial panoramic radiographic examination. After orthodontic therapy, a huge lesion was observed clinically and through imaging exams. After the conservative surgery, no recurrence was observed during five years of follow-up. This case emphasized the need for careful evaluation of patient images focusing on the oral diagnosis before any dental treatment planning, including orthodontic therapy.

Sinais radiográficos da densidade mineral óssea em radiografias panorâmicas de pacientes pré e pós-menopausa / Radiographic signs of bone mineral density in panoramic radiographs from pre and postmenopausal patients

Objetivo: O objetivo deste estudo foi avaliar o potencial de radiografias panorâmicas (RP) e seus índices radiomorfométricos como método auxiliar para o diagnóstico da osteoporose. Material e Método: Foram selecionadas vinte e cinco mulheres, que tinham sido encaminhadas para PR com fins diferentes. As PR foram analisadas de acordo com o MCI, que avalia o córtex mandibular abaixo do forame mentual, e, em seguida, divididos em dois grupos: normal, e perda mineral de osso. Scans de densitometria óssea foram obtidos (DXA) da coluna lombar e colo do fémur / fêmur inteiro, que foram utilizados como padrão-ouro para comparação com o MCI. Teste de Kappa (p < 0,05) foi utilizado para determinar a associação entre a MCI e leituras de densitometria óssea. Resultados: Em relação à DXA, 7 pacientes eram normais na coluna lombar ou fêmur, 24 pacientes apresentaram osteopenia na coluna lombar ou fémur e 9 indivíduos tinham osteoporose na coluna lombar ou fêmur. Em relação à associação entre a DXA e MCI, 18 pacientes apresentaram algum grau de perda óssea na coluna detectado por ambos DXA e o índice Klemetti. Conclusões: PR não deve ser utilizada para confirmar o diagnóstico de osteoporose ou osteopenia, mas pode ser útil para avaliar o risco de tais doenças estar presente.(AU)

Objective: The aim of this study was to evaluate the potential of panoramic radiographs (PR) and their radiomorphometric indices as an auxiliary method for the diagnosis of osteoporosis. Material and Methods: Twenty five women were selected, who had been prescribed PR for different purposes. The PR were analysed according to the MCI, which evaluates the mandibular cortex below the mental foramen, and then divided into two groups: normal and bone mineral loss. Bone densitometry scans were obtained (DXA) from the lumbar spine and neck of the femur/whole femur, which were used as the gold standard for comparison against the MCI. Kappa test (p< 0.05) was used to determine the association between the MCI and bone densitometry readings. Results: Regarding the DXA, 7 patients were normal at the lumbar spine or femur, 24 subjects showed osteopenia at the lumbar spine or femur and 9 subjects had osteoporosis at the lumbar spine or femur. Regarding the association between DXA and MCI, 18 subjects showed some degree of bone loss at the spine detected by both DXA and the Klemetti index. Conclusions: PR should not be used to confirm the diagnosis of osteoporosis or osteopenia, but may be useful to assess the risk of such diseases being present.(AU)

Comparison of accuracy between dental and skeletal age in the estimation of chronological age of Down syndrome individuals.

This study aimed to evaluate the accuracy of dental age (DA) and skeletal age (SA) methods in order to estimate chronological age (CA) in individuals with Down syndrome (DS), contributing to the Forensic Dentistry and making the identification of these individuals age possible. For this, 278 images of individuals were selected and divided in 2 groups: 216 non-DS patients and 62 with DS. At first, DA was evaluated by Nolla method, on panoramic radiographs, followed by SA, evaluated by Greulich and Pyle method. The linear correlation coefficient of Pearson was used for the analysis of concordance between the methods. Paired t-test with confidence interval was used to evaluate the accuracy and Bland and Altman method was applied to estimate limits of concordance. Complementary to this first analysis, descriptive statistics and ANOVA test were applied for comparison among chronological age (CA), dental age (DA) and skeletal age (SA), with a significance level of 95% (p≥0.05), ordering to observe the differences among them. DA, estimated by Nolla, is underestimated in both, DS and non-DS individuals, and it is more notable in DS individuals. SA estimated by Greulich and Pyle method is overestimated, except for non-DS males. The range of variance is greater in SA and DS than DA and non-DS individuals, respectively. A greater accordance was found for DA×CA if compared to SA×CA, indicating that DA, estimated by Nolla method, is more accurate than SA, evaluated by Greulich and Pyle method, for estimating CA of both, DS and non-DS individuals. However, neither method seems to be precise and more caution is required for age estimation in DS individuals.

Prevalence of bifid mandibular canals by cone beam computed tomography.

PURPOSE: The aim of this study was to evaluate the prevalence of bifid mandibular canals (BMC) by cone beam computed tomography (CBCT). MATERIALS AND METHODS: We examined CT scans from 300 patients both male and female, aged 25 to 87 years. The subjects were divided into groups according to gender, male group (MG) and female group (FG) as well as subgroups according to the side, right (R) and left (L). Tomographic acquisitions were performed on the device I-Cat ® Classic. Image analysis was performed on the XoranCat ® software of the equipment itself, aided by image filters associated with transverse, oblique, and panoramic reconstruction cuts for analysis of the BMC. The results were displayed as descriptive analysis of the values and comparisons between factors were performed using ANOVA at a significance level of 95 %. RESULTS: BMC was observed in 80 cases (26.67 %), of which, 39 (48.75 %) were in males and 41 (51.25 %) in females; no difference was seen between genders, neither by affected side, although the right side was more frequently affected (66.67 %) when both genders were combined. CONCLUSION: The prevalence of BMC is significant and should not be overlooked.

A posteriori registration and subtraction of periapical radiographs for the evaluation of external apical root resorption after orthodontic treatment.

PURPOSE: This study employed a posteriori registration and subtraction of radiographic images to quantify the apical root resorption in maxillary permanent central incisors after orthodontic treatment, and assessed whether the external apical root resorption (EARR) was related to a range of parameters involved in the treatment. MATERIALS AND METHODS: A sample of 79 patients (mean age, 13.5±2.2 years) with no history of trauma or endodontic treatment of the maxillary permanent central incisors was selected. Periapical radiographs taken before and after orthodontic treatment were digitized and imported to the Regeemy software. Based on an analysis of the posttreatment radiographs, the length of the incisors was measured using Image J software. The mean EARR was described in pixels and relative root resorption (%). The patient's age and gender, tooth extraction, use of elastics, and treatment duration were evaluated to identify possible correlations with EARR. RESULTS: The mean EARR observed was 15.44±12.1 pixels (5.1% resorption). No differences in the mean EARR were observed according to patient characteristics (gender, age) or treatment parameters (use of elastics, treatment duration). The only parameter that influenced the mean EARR of a patient was the need for tooth extraction. CONCLUSION: A posteriori registration and subtraction of periapical radiographs was a suitable method to quantify EARR after orthodontic treatment, and the need for tooth extraction increased the extent of root resorption after orthodontic treatment.

Location and classification of Canalis sinuosus for cone beam computed tomography: avoiding misdiagnosis.

The aim of this study was to assess the presence, location and, multiplanar distance of the canalis sinuosus (CS) between the incisive foramen and the anterior maxillary alveolar ridge using cone beam computed tomography (CBCT). Therefore, 500 CBCT maxillary images obtained from male and female patients aged 20 to 80 years were selected to assist in the dental treatment. Low-quality tomographic images were discarded. All images were captured with the i-CATTM Classic tomograph and assessed using the XoranCatTM software. The axial sections were analyzed at the incisive foramen in order to verify the CS presence in laterality and location. Furthermore, linear measurements of the nasal cavity floor, buccal cortical bone, and alveolar ridge crest were made. All the collected data were statistically analyzed. Results show a variation of the CS in relation to the classification and distance of anatomical structures, but no significant difference between the right and left sides. It should be highlighted that CBCT is necessary before invasive procedures in order to preserve important anatomical structures. In conclusion, the location of the CS varies in relation to the alveolar ridge crest and buccal cortical bone, assuming that it is going to be located by the upper lateral incisor palatine.

Keratocystic odontogenic tumor: role of cone beam computed tomography and magnetic resonance imaging.

Keratocystic odontogenic tumors (KCOTs) are known for unique and varied behavior, high recurrence rates, and distinctive histopathologic findings. Differential diagnosis and management of KCOTs may be challenging because other jaw lesions may present similar characteristics. Careful interpretation of cone beam computed tomograms and magnetic resonance images has great significance for precise assessment of KCOTs and their relationships to adjacent anatomic structures as well as for treatment planning. This case report describes a KCOT that developed in the left angle and mandibular ramus in association with a semierupted third molar.

Location and classification of Canalis sinuosus for cone beam computed tomography: avoiding misdiagnosis

Abstract The aim of this study was to assess the presence, location and, multiplanar distance of the canalis sinuosus (CS) between the incisive foramen and the anterior maxillary alveolar ridge using cone beam computed tomography (CBCT). Therefore, 500 CBCT maxillary images obtained from male and female patients aged 20 to 80 years were selected to assist in the dental treatment. Low-quality tomographic images were discarded. All images were captured with the i-CATTM Classic tomograph and assessed using the XoranCatTM software. The axial sections were analyzed at the incisive foramen in order to verify the CS presence in laterality and location. Furthermore, linear measurements of the nasal cavity floor, buccal cortical bone, and alveolar ridge crest were made. All the collected data were statistically analyzed. Results show a variation of the CS in relation to the classification and distance of anatomical structures, but no significant difference between the right and left sides. It should be highlighted that CBCT is necessary before invasive procedures in order to preserve important anatomical structures. In conclusion, the location of the CS varies in relation to the alveolar ridge crest and buccal cortical bone, assuming that it is going to be located by the upper lateral incisor palatine.

Clinic and Cone beam computed tomography characterizationof the bone maxilofacial lesions from Estomatology Clinic / Caracterização clínica e por tomografia computadorizada de feixe cônico de lesões ósseas maxilofaciais da clínica Clínica dePropedêutica Estomatológica

To characterize the maxillofacial bone lesions by associating clinical and imaging aspects, through Cone Beam Computed Tomography (CBCT) and compare the findings with those reported by the literature. Material and Methods: Twelve files were selected from the Clinics of Stomatological Propedeutics (ICT-UNESP) reporting maxillofacial bone lesions with previous CBCT indication. CBCT was carried out withi-CAT Next Generation scanner (imaging Sciences International, Hatfield, PA, USA) at the Radiology Clinics of the institution. First, we recorded the clinical information on gender, age range, and main complaints. Then, CBCT images were assessed regarding to: site, lesion internal architecture and limits, effect on bone corticals, effect on teeth and support structures, and the lesion internal aspects. All images were evaluated with the aid of i-CAT Vision software at multi-planar reconstruction model (MPR). Results: We studied four root cyst lesions, two keratocystic odontogenic tumors, one compound odontoma, one odontogenic hamartoma, one focal osseous dysplasia, one calcifying cysticodontogenic tumor, and two fibrous scars. CBCT helpedin achieving the diagnosis because of tridimensionality, but sometimes, the lesion characteristics disagreed from those described in the literature because the latter were based on two-dimensional radiographs. Conclusion: CBCT is highly valuable in characterizing bone lesions, but the literature demands a specific approach for CBCT images because the latter differs from conventional radiographic images...

Caracterizar as lesões ósseas da região maxilofacial conjugando seus aspectos clínicos ao simaginológicos, por tomografia computadorizada de feixecônico (TCFC), comparando estes achados da literatura.Material e Métodos: Foram selecionados 12 prontuários da Clínica de Propedêutica Estomatológica do ICT-UNESP, apresentando lesões ósseas na região maxilofacial, com prévia indicação de exame por TCFC, realizados em tomógrafo i-CAT Next Generation (imaging Sciences International, Hatfield, PA, EUA) na clínica de Radiologia da instituição. Foram levantadas informações clínicas como sexo, faixa etária e queixas principais. Avaliou-se as imagens de TCFC quanto: localização, arquitetura interna e limites da lesão, efeito nas corticais ósseas, efeito nos dentes e estruturas de suporte dentário e os aspectos internos da lesão. As imagens foram avaliadas no software i-CAT Vision do tomógrafo em janelas de reconstrução multiplanar (MPR). Resultados: Foram estudadas 04 lesões correspondentes a cistos radiculares, 02 a tumores odontogênicos queratocísticos, 01 a odontoma composto,01 a hamartoma odontogênico, 01 a displasia óssea focal, 01 tumor odontogênico cístico calcificante e 02 cicatrizes fibrosas. A TCFC auxiliou na conclusão dos diagnósticos, visto sua característica de tridimensionalidade, houve,algumas vezes, divergências em relação aos achados descritos na literatura, eminentemente baseados radiografias bidimensionais. Conclusão: a TCFC é de grande valia na caracterização das lesões ósseas, observa se uma necessidade na literatura de uma abordagem específica para esta modalidade de imagens, diferente das radiográficas convencionais...

Incidental findings of bone alterations in temporomandibularjoints in cone-beam computed tomography scans for implantsplanning: the importance of total acquired volumeanalysis / Achados incidentais de alterações ósseas nas articulações tempormandibulares em exames de tomografia computadorizada de feixe cônico com indicação específica para implantodontia: a importância da análise do volume total adquirido

To evaluate the frequency of bone alterations intemporomandibular joints (TMJ) in cone beam computed tomography (CBCT) images for dental implats planning. Material and Methods: 148 CBCT scanswere selected from the files of the Radiology Clinics(ICT UNESP). All theimages were performed by Next Generation iCAT scanner (Imaging Sciences Ltda, Hatfield, PA, USA), using voxelof 0.20/0.25 mm and FOV of 16.0 x 13.0 cm for dental implants planning. All the images should show both (rigthand left) TMJ condyle. The TMJ condyle were reformated using TMJ protocol, with para sagittal cuts, perpendicular to the long axis of TMJ condyle, to study the presence of the following bone alterations: osteophytes, erosion, flatenning, bone sclerosis, and cortical thinning. Results: The results showed that 63.51% of the sample were femaleand 36.49% male. In addition, it was noted that the mostfrequent bone alterations in condyle were osteophytes(56.75%) and flattening (55.4%). The erosion was the alteration with lower frequency (0.67%). Mcnemar’stestshowed that there was relationship between flatteningand erosion, flattening and bone sclerosis, flattening and cortical thinning, erosion and osteophytes, bone sclerosisand cortical thinning (p<0.0001), in both sides. There was no relationship between flattening and osteophytes, erosion and bone sclerosis, erosion and cortical thinning (p>0.01). Conclusion: The hight frequency of bone alterations findings in TMJ condyle was an indicator of the importanceof the analysis of all the structures present in the CBCT total acquired volume, regardless CBCT indication...

Estudar a frequencia de alterações ósseas nas articulações temporomandibulares (ATM) em exames por imagem de tomografia computadorizada de feixe cônico(TCFC) com indicações específicas para planejamento de implantes. Material e Métodos: 148 exames de TCFC foram selecionados do arquivo da Clínica de Radiologia do ICT UNESP. Todas as imagens foram adquiridas por meio do tomógrafo i-CAT Next Generation (Imaging Sciences Ltda,Hatfield, PA, USA), usando voxel de 0,20/0,25 mm e FOV de 16,0 x 13,0 cm com o objetivo de planejamento de implantes dentários. Todas as imagens deveriam exibir ambas (direita e esquerda) as cabeças da mandíbula das ATM. O estudo das cabeças da mandíbula foi realizado utilizando um protocolo para as ATM, com cortes parassagitais, perpendiculares aos longos eixos das mesmas, com o objetivo de se estudas as seguintes alterações ósseas: osteófitos, erosão, aplainamento, esclerose óssea, e adelgaçamento de corticais. Resultados: Os resultados evidenciaram que 63,51% da amostra pertecia ao sexo feminino e 36,49% ao sexo masculino. Adicionalmente, observou-se que a alteração óssea na cabeça da mandíbula mais frequente foi a presença de osteófitos (56,75%) e aplainamento(55,4%). A erosão foi a alteração de menor frequencia (0,67%). O teste estatístico de Mcnemar mostrou que houve relação entre: aplainamento e erosão, aplainamento e esclerose óssea, aplainamento e adelgaçamento de corticais, erosão e osteófitos,esclerose óssea e adelgaçamento de corticais (p<0,0001), em ambos os lados. Não houve relação entre aplainamento e osteófitos, erosão e esclerose óssea, erosão e adlegaçamento de corticais (p>0,01). Conclusão: A alta frequencia de alterações ósseas encontradas nas cabeças da mandíbulas nas ATM estudadas foi um idicador da importância na análise de todas as estruturas presentes no FOV adquirido nos exames de TCFC, independentemente de sua indicação...

Anatomic characterization of mental foramen through cone beam computed tomography at dentate and edentulous areas / Caracterização anatômica do forame mentual em áreas dentadas e edêntulas por meio de Tomografia Computadorizada de Feixe Cônico (TCFC)

Objetivo: Caracterizar e comparar as posições e dimensões de abertura dos Forames Mentuais (FM) entre áreas edêntulas e dentadas em imagens por tomografia computadorizada de feixe cônico (TCFC). Material e Métodos: Analisou-se 72 exames de TCFC, abrangendo toda a mandíbula, obtidos em tomógrafo da marca i-CAT Next Generation (imaging Sciences International, Hatfield, PA, EUA). Estes foram divididas em 02 grupos: Grupo D (dentados) apresentando o 1º e 2º pré-molares inferiores correspondentes e Grupo E (edêntulos) sem ambos os pré-molares inferiores correspondentes. Foram realizadas, nos cortes transversais, 02 medidas em cada região: altura FM – correspondente à distância vertical entre o ponto mais inferior do canal mentual à cortical externa da base da mandíbula (AlFM) e abertura FM - correspondente à maior distância vertical entre as corticais externas superior e inferior do FM (AbFM). Adicionalmente, no Grupo D, foi estudada a posição do FM em relação a 04 referenciais: 1º pré-molar, entre 1º e 2º pré-molares, 2º pré-molar e outras localizações. Foi realizado o Teste t para amostras independentes e a análise descritiva. Resultados: Os resultados evidenciaram que houve diferença, estatisticamente significante, apenas na AbFM, entre os dois grupos, com tendência a um aumento desta no grupo D. No Grupo E, a houve diferença estatisticamente significante entre os sexos em relação à AbFM, com tendência a um maior valor para o sexo masculino. No grupo D, a localização do FM de maior frequência foi na região de 2o pré- molares (65,9%) e a de menor frequência na região de 1o pré-molares (4,9%). Conclusão: o edentulismo influenciou, apenas a dimensão da abertura do FM, com redução da mesma, pacientes edêntulos do gênero masculino, tendem a ter um valor maior de abertura de forame que pacientes edêntulos femininos.

Objective: To characterize and compare the positions and dimensions of the mental foramen (MF) openings between dentate and edentulous areas on cone beam computed tomography (CBCT) images. Material and Methods: Seventy-two CBCT images (i-CAT Next Generation, Imaging Sciences International, Hatfield, PA, USA) of the mandible were analyzed. The CBCT images were divided into two groups: Group D (dentate) - with first and second mandibular premolars; Group E (edentulous) - without first and second mandibular premolars. At the transversal cuts, two measurements were obtained: MF height – the vertical distance between the lowest point of the mandibular canal to the external cortical of the mandible’s base (MFH); MF opening – the greatest vertical distance between the superior and inferior MF external corticals (AbMF). Also, in Group D, the MF position was studied in relation to four landmarks: 1st premolar, between 1st and 2nd premolar; 2nd premolar; and other locations. Independent sample t-test and descriptive analysis were applied. Results: Only the distance AbMF showed statistically significant difference between groups, with tendency towards increasing in group D. Group E exhibited statistically significant difference between genders for the distance AbMF, with tendency towards greater values for males. Group D showed that MF was more frequently located at the area of the 2nd premolars (65.9%), while the area of the 1st premolars was that of smallest frequency (4.9%). Conclusion: the edentulism only reduced the dimension of MF opening. Edentulous males had a greater MF opening than edentulous females

Cone-beam computed tomography analysis of prevalence of nasal septum deviation and its relationship with the presence of middle concha bullosa / Avaliação da prevalência e relação entre o desvio de septo nasal e a presença de concha média bolhosa por meio de tomografia computadorizada de feixe cônico

Objetivo: Este estudo teve com objetivo analisar a prevalência do desvio do septo nasal e da presença de concha nasal média bolhosa e estudar a possível relação entre estes por meio de imagens por tomografia computadorizada de feixes cônicos (TCFC). Material e Métodos: Foram selecionados 118 exames de TCFC de arquivo, previamente adquiridos por indicações diversas para odontologia. Todos os exames foram realizados em tomógrafo i-CAT Next Generation (imaging Sciences International, Hatfield, PA, EUA) com o mesmo protocolo, tendo o FOV (Field of View) abrangendo o terço médio e inferior da face. Todas as imagens foram avaliadas no software especifico do sistema por 01 avaliador devidamente treinado. O desvio de septo nasal, a concha nasal média bolhosa e demais dados foram tabulados e realizada a análise descritiva dos mesmos. O teste de McNemar foi aplicado para se estudar a possível relação entre os mesmos. Resultados: Os resultados indicaram que, nos casos em que não ocorria o desvio de septo nasal, 73,5% destes não apresentaram e 26,5% destes apresentaram a concha média bolhosa. Considerando-se apenas os casos que apresentaram o desvio de septo nasal para um dos lados, a proporção que não apresentou a concha média bolhosa para o mesmo lado foi de 77,1% e a que apresentou também a concha média bolhosa para o mesmo lado foi de 22,9%. Conclusão: Concluiu-se que não houve relação (p = 0,568) entre a presença das duas variáveis analisadas na pesquisa – desvio de septo nasal e presença de concha média bolhosa.

Objective: This study aimed to analyze the prevalence of nasal septum deviation and the presence of middle nasal concha bullosa, as well as to study the possible relationship between these findings by means of cone-beam computed tomography (CBCT) images. Material and Methods: One hundred and eighteen CBCT exams were selected from a file previously acquired for diverse reasons in dentistry. All images were obtained with CT i-CAT Next Generation (Imaging Sciences International, Hatfield, PA, USA) with the same protocol, and the field of view (FOV) covered the middle and lower third of the face. All images were evaluated in the specific software system by one trained evaluator. The deviated septum, nasal concha bullosa, and other data were tabulated and a descriptive analysis was performed. The McNemar test was used to study the possible relationship between them. Results: The results indicated that, in cases without nasal septum deviation, 26.5% and 73.5% were associated or not to the presence of middle concha bullosa, respectively. Considering patients with nasal septum deviation on one side only, the proportions of 22.9% and 77.1% were associated or not to middle concha bullosa in the same direction, respectively. Conclusion: Thus, it was concluded there was no relationship (p = 0.568) between nasal septum deviation and the presence of middle concha bullosa.

Age assessment based on dental calcification in individuals with Down syndrome.

It is important to estimate both chronological age (CA) and maturational age of an individual, in order to perform orthopedic treatment or surgery, and in cases of lost documentation. Use of dental age (DA) for these purposes has been widely studied; however, the literature is scarce with regard to individuals with Down syndrome (DS), a prevalent condition worldwide. In this study the chronology of dental maturation was evaluated by analyzing the DA of individuals with DS based on the Chronological Mineralization Table proposed by Nolla (1960). Thus, second molars were evaluated in 57 panoramic radiographs of male and female individuals with DS, between 5 and 16 years-old. These data were compared with a control group of 191 nonsyndromic individuals of the same age group. Correlation between CA and DA was ascertained using Pearson's correlation coefficient (r), and the difference between these variables was measured using Student's t-test for paired samples and the method proposed by Bland and Altman. The difference between DA and CA was compared between the control and DS groups using Student's t-test for independent samples (α=0.05). DA was slightly lower than the CA; however, this difference was only significant for females. The difference between DA and CA was not significant between individuals with DS and control group (both genders, p=0.945; males, p=0.542; females, p=0.381). We concluded that dental maturation in individuals with DS occurs similarly to that of nonsyndromic individuals.

Cephalometric analysis for the diagnosis of sleep apnea: a comparative study between reference values and measurements obtained for Brazilian subjects.

OBJECTIVE: To verify if the reference values of Sleep Apnea cephalometric analysis of North American individuals are similar to the ones of Brazilian individuals presenting no craniofacial anomalies. The study also aimed to identify craniofacial alterations in Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) patients in relation to individuals without clinical characteristics of the disease through this cephalometric analysis. METHODS: It were used 55 lateral cephalograms consisting of 29 for the control group of adult individuals without clinical characteristics of OSAHS and 26 apneic adults. All radiographs were submitted to Sleep Apnea cephalometric analysis through Radiocef Studio 2.0. The standard values of this analysis were compared, by means of z test, to the ones obtained from the control group and these were compared to values from apneic group through Student's t test. RESULTS: There were no significant differences between values obtained from control group and standard values. On the group of OSAHS patients it was observed a decrease on the dimensions of upper airways and an increase on the soft palate length. CONCLUSIONS: The standard values of Sleep Apnea analysis can be used as reference in Brazilian individuals. Besides, through lateral cephalograms it was possible to identify craniofacial alterations in OSAHS patients.

Cephalometric analysis for the diagnosis of sleep apnea: a comparative study between reference values and measurements obtained for Brazilian subjects

OBJECTIVE: To verify if the reference values of Sleep Apnea cephalometric analysis of North American individuals are similar to the ones of Brazilian individuals presenting no craniofacial anomalies. The study also aimed to identify craniofacial alterations in Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) patients in relation to individuals without clinical characteristics of the disease through this cephalometric analysis. METHOD: It were used 55 lateral cephalograms consisting of 29 for the control group of adult individuals without clinical characteristics of OSAHS and 26 apneic adults. All radiographs were submitted to Sleep Apnea cephalometric analysis through Radiocef Studio 2.0. The standard values of this analysis were compared, by means of z test, to the ones obtained from the control group and these were compared to values from apneic group through Student's t test. RESULTS: There were no significant differences between values obtained from control group and standard values. On the group of OSAHS patients it was observed a decrease on the dimensions of upper airways and an increase on the soft palate length. CONCLUSIONS: The standard values of Sleep Apnea analysis can be used as reference in Brazilian individuals. Besides, through lateral cephalograms it was possible to identify craniofacial alterations in OSAHS patients.

OBJETIVO: verificar se os valores de referência da análise cefalométrica para apneia do sono, referentes a indivíduos norte-americanos, são semelhantes aos de indivíduos brasileiros não portadores de anomalias craniofaciais. Identificar, também por meio dessa análise cefalométrica, alterações craniofaciais em indivíduos portadores de síndrome da apneia obstrutiva do sono (SAOS) em relação a indivíduos sem características clínicas da doença. MÉTODOS: foram utilizadas 55 radiografias cefalométricas laterais advindas de arquivos, sendo 29 radiografias para o grupo controle, sendo composto de indivíduos adultos sem características clínicas de SAOS, e 26 de indivíduos adultos apneicos. Todas as radiografias foram submetidas à análise cefalométrica para apneia do sono por meio do software Radiocef Studio 2.0. Por meio do teste z, valores-padrão dessa análise foram comparados aos valores obtidos do grupo controle, e esses, por sua vez, foram comparados aos valores do grupo de apneicos por meio do teste t de Student. RESULTADOS: não houve diferenças significativas entre os valores obtidos do grupo controle e os valores-padrão. No grupo de indivíduos portadores de SAOS, observou-se diminuição nas dimensões das vias aéreas superiores e aumento do comprimento do palato mole. CONCLUSÕES: os valores-padrão da análise de apneia do sono podem ser utilizados como referência em indivíduos brasileiros. Além disso, por meio da radiografia cefalométrica lateral foi possível identificar alterações craniofaciais em indivíduos portadores de SAOS.

Comparação entre subtração radiográfica digital e radiografia digital direta na detecção de reabsorções radiculares / Comparison between radiographic digital subtraction and direct digital radiography in the detection of root resorption

A reabsorção severa da raiz diagnosticada tardiamente pode acarretar a perda dentária. Devido ao fato de a técnica de subtração radiográfica digital ser um importante recurso para detecção precoce de alterações minerais, este estudo propôs avaliar a eficiência no diagnóstico precoce da reabsorção radicular externa simulada nas regiões apical e lingual, pelas técnicas de subtração radiográfica digital e radiografia digital. Foram utilizados 14 dentes incisivos de mandíbulas humanas maceradas com reabsorções de diferentes dimensões, simuladas nas regiões apical e lingual, e radiografados com variação de ângulos de projeção. As radiografias foram subtraídas pelo programa Regeemy®, e para avaliação de desempenho dos métodos de diagnóstico, pares de radiografias periapicais e imagens subtraídas foram apresentadas a dois radiologistas. De acordo com os resultados, não foram observadas diferenças estatisticamente significantes entre os métodos na detecção de reabsorções linguais, independentemente do tamanho da lesão. Também não houve diversidade entre os métodos na detecção de reabsorções apicais, com exceção do examinador dois quanto às variações angular vertical e horizontal de 10º, utilizando o maior nível de desgaste, que apresentou a radiografia digital como método superior na avaliação em relação à subtração radiográfica. Também foi observado que o aumento do nível de desgaste permitiu melhor avaliação nas regiões de reabsorções apicais e linguais, e a menor variação dos ângulos verticais e horizontais nas detecções de reabsorções apicais e linguais permitiu uma melhor avaliação da imagem, principalmente no menor nível de desgaste.

The delay on diagnose severe root resorption can lead to tooth loss. Due to the fact that digital subtraction radiography is an important resource to detect initial mineral changes, this study aimed at evaluating the effectiveness of the digital subtraction radiography and digital radiography in early diagnosis of the simulated apical and lingual external root resorption. Fourteen human lower incisors, submitted to simulated apical and lingual resorption cavities of different sizes, imaged with different angle projection variations were included in this study. The images were subtracted by the Regeemy® program, and receiver operating characteristic analysis was used to evaluate the diagnostic performance for each imaging system, and the diagnostic accuracy of both diagnosis methods for detecting lesions was conducted by the assessment of the pairs of radiography (digital and subtracted) by two radiologists. According to the results, there were no statistically significant differences between the methods in detecting lingual resorption, independently of the lesion dimension. There was also no difference on the apical resorption detection, except by the viewer two as to 10º horizontal and vertical angles, who related that on the larger cavity, the digital radiography was more reliable than the subtraction radiography. It was also further noticed that the deeper the cavity size, the better the apical and lingual resorption detection; and the radiography taken of the apical and lingual resorption, with the smaller vertical and horizontal angles variation ensured a better assessment of the image, mainly on the shallower cavity size.

Estudo comparativo do padrão de crescimento entre as análises USP, Ricketts, McNamara e Jarabak / Comparative study of growth standart among the USP, Ricketts, McNamara and Jarabak

Objetivo: o objetivo desse estudo foi comparar o diagnóstico de quatro grandezas cefalométricas rotineiramente utilizadas na determinação do padrão de crescimento craniofacial e verificar a possibilidade, ou não, de concordância entre elas. Métodos: a amostra foi composta por 30 telerradiografias laterais de indivíduos brasileiros, sendo 18 do sexo feminino e 12 do sexo masculino, com idade média de 21 anos. As análises cefalométricas avaliadas foram USP, Ricketts, McNamara e Jarabak. Para obtenção das grandezas NS.Gn (padrão USP), AFAI (padrão McNamara), Eixo Facial (padrão Ricketts) e Percentual S-Go/N-Me (padrão Jarabak), foi usado o software Radiocef 4.0. Conclusão: para os braquicefálicos a análise de Jarabak apresenta o maior percentual e difere apenas da análise de Ricketts (0%). Nos dolicocefálicos, Jarabak foi diferente de todos os demais testes e nos mesocefálicos não existem diferenças estatísticas para os testes, mesmo entre McNamara e Ricketts, apresentando o valor de 20%.

Noninvasive aspergillosis as a maxillary antrolith: report of a rare case.

Maxillary antrolithiasis is characterized by masses of tissue of endogenous or exogenous origin that calcify within the maxillary sinuses. Aspergillosis is a fungal disease in which the maxillary sinus is a primary site of infection. Aspergillosis mycetoma, its noninvasive form, is the most prevalent modality of the disease in the maxillary sinuses. In approximately half of the cases reported in the literature, calcification of the fungal mycelia, which later became antroliths, was verified. This article reports a rare case of the accidental discovery of a maxillary antrolith associated with noninvasive aspergillosis in an immunocompetent and asymptomatic 56-year-old woman. The diagnosis and therapeutic procedures used in treating the patient are discussed as well as the probable iatrogenic origin of the fungal pathology.

Evaluation and development of a bone age assessment method in patients with Down syndrome / Avaliação e desenvolvimento de um método de verificação de idade óssea em portadores de síndrome de Down

This study evaluated the applicability of the method developed by Caldas to measure vertebral bone age for Brazilians suffering from Down syndrome. A database comprised of 57 case records of individuals with this syndrome, both male and female, with age ranging between 5 and 18 years, was assessed. These records had lateral cefalometric radiographies and radiographies of hand and wrist, being all obtained on the same date. Also, 48 records of individuals not suffering from Down syndrome were assessed. For the hand and wrist radiographies the Tanner and Whitehouse (TW3) method was used, and bone age was obtained. The Caldas method was employed on the lateral cefalometric radiographies in order to obtain the vertebral bone age. From the information about the bone age, vertebral bone age and chronological age, the Wilcoxon test was used to compare all the ages in pairs. There was a statistically significant difference between the three ages mentioned above for both male and female control group and female Down syndrome group. Therefore, this method was only suitable for Down syndrome male individuals. Based on the results, a formula to obtain the bone age for Down syndrome individuals was developed

Este estudo avaliou a aplicabilidade do método desenvolvido por Caldas para medir a idade óssea vertebral em brasileiros, quando empregada em indivíduos portadores da síndrome de Down. Foram estudados 57 prontuários de indivíduos com síndrome de Down, de ambos os sexos, com idade variando entre 5 e 18 anos. Estes prontuários continham radiografias cefalométricas laterais e radiografias de mão e punho, obtidos no mesmo dia, e também foram avaliados 48 prontuários de indivíduos não portadores de síndrome de Down. Para as radiografias de mão e punho o método de Tanner e Whitehouse (TW3) foi usado para que pudéssemos obter a idade óssea. O método de Caldas foi empregado nas radiografias cefalométricas laterais, e assim obtivemos a idade óssea vertebral. A partir das informações sobre a idade óssea, idade óssea vertebral e idade cronológica, utilizou-se o teste de Wilcoxon para comparar todas as idades aos pares o qual mostrou uma diferença estatisticamente significativa entre estas três idades citadas acima para ambos os sexos do grupo controle e grupo com síndrome de Down do sexo feminino. Portanto, este método foi aplicável apenas em indivíduos do sexo masculino portadores da síndrome de Down. Com base nos resultados uma fórmula para obtenção da idade óssea de indivíduos com síndrome de Down foi desenvolvida