Maturation stages of the sutures in the median palatine evaluated with cone-beam computed tomography.

INTRODUCTION: This study aimed to evaluate the influence of age, sex, and facial growth patterns on the maturation stage of midpalatal sutures. METHODS: We selected 90 total skull cone-beam computed tomography scans and divided them into the following 3 groups: brachyfacial (n = 30), mesofacial (n = 30), and dolichofacial (n = 30). These groups were determined using Ricketts VERT 3-dimensional cephalometric analysis. All patients were aged ≥18 years and were divided into those aged ≥30 years and >30 years. The maturational stage of the median palatine sutures was determined by evaluating the central transverse axial dimension in the maxillary-mandibular palate. Maturational stages were classified as A, B, C, D, and E. RESULTS: Of the 90 images reviewed, 55 (61.1%) were female patients, and 35 were male patients (38.9%). The age of patients ranged from 18 to 59 years, with 55 patients aged <30 years (61.1%) and 35 aged ≥30 years (38.9%). Regarding the maturational stages, 3.3% of brachyfacial, 6.7% of mesiofacial, and 16.7% of dolichofacial subjects (P = 0.032) were classified as stages B and C. CONCLUSIONS: The patients' facial patterns were found to be a significant signal for the maturation stage of midpalatal sutures. Adult dolichofacial patients are the most likely to have stage B and C.

Accuracy of Panoramic Radiography for Degenerative Changes of the Temporomandibular Joint.

BACKGROUND: Temporomandibular joint (TMJ) morphologies are complex, and changes in joint components have been studied extensively. TMJ conditions have many different etiologies, appearances, and relevant clinical significance. OBJECTIVE: The objective of this study was to evaluate the concordance of the diagnosis of degenerative changes in the TMJ in panoramic radiographs. MATERIALS AND METHODS: Cone beam computed tomography (CBCT) was used as a reference standard. Images of 84 patients (168 TMJs), 61 females (72.6%) and 23 males (27.4%) with an average age of 47.4 years, were evaluated by three radiologists who established the presence or absence of degenerative changes in the jaw heads. The data were collected and organized in a spreadsheet. Concordance between evaluators was analyzed using agreement percentages, statistical κ, and confidence intervals. In the analysis of compliance with CBCT, sensitivity, specificity, predictive positive and negative values, and probabilities of false positives and negatives were also calculated. All inferential tests were performed with a 5% significance level. RESULTS: The percentage of agreement among raters in panoramic radiographs ranged from 66.7% to 82.9%, considered mild to moderate. Correlation between radiographic and tomographic images ranged from 45.5% to 64.9% in the inter-evaluator reviews, representing a very mild agreement. Sensitivity ranged from 28.6% to 58.7% and specificity from 66.7% to 100.0%. Positive predictive value ranged from 77.1% to 100.0%; the negative predictive value was lower, ranging from 32.2% to 54.8%. The probability of false negatives was higher than that of false positives, ranging from 45.2% to 67.8%. CONCLUSION: The rater did not reach acceptable diagnosis levels.

Evaluation of Bone Repair in the Mandible of Rabbits Using Biphasic Calcium Phosphate Micro-Macroporous Hydroxyapatite Bioceramics and Beta-Tricalcium Phosphate

Objective: To perform a clinical and histological evaluation, characterizing and proving the feasibility of the use of beta tricalcium phosphate (HA/ßTCP) bioceramics as a bone defect repair material, comparing it with autogenous bone and blood clot in terms of osteoinductive, conductive, and genic capacities. Material and Methods: The experiment was based on 3 critical defects in the mandible of 11 New Zealand rabbits. The defects were filled with HA/ßTCP bioceramics and autogenous bone, respectively, collected and ground during the development of defects and blood clots. The animals were euthanized after the 90-day experiment and samples were collected for histomorphological examination. To evaluate differences between the groups, a one-way analysis of variance (ANOVA) was performed with Tukey's post hoc test. An α value lower than 0.05 was considered statistically significant. Results: Microscopy revealed the presence of osteoblasts, osteoclasts, and osteocytes associated or not associated with the presence of mature or immature bone. All the studied materials presented bone neoformation in all cases, with the presence of mature and immature bone. Regarding the presence of HA/ßTCP bioceramic residual material, the same was found in 7 of 11 slides. Conclusion: HA/ßTCP bioceramics were shown to be a biocompatible bone substitute, with osteoinductive and osteoconductive characteristics, accelerating the process of new bone formation when compared with autogenous and blood clotted bone, thereby showing promise for bone defect repair with safety and efficacy.

Evaluation of Incidental Findings on Cone Beam Computed Tomography

Objective: To assess the prevalence of incidental findings in relation to the side of a patient's face, location, and age group on cone beam computed tomography. Material and Methods: 175 CBCT examinations were performed on patients aged between 12 and 77 years, consisting of recordings of the anatomical location and findings following each examination. For standardization of tomographic evaluations, acquired images were analyzed by two previously trained expert radiologists. After positional adjustment of the multi-dimensional images on the monitor screen, examination of each scan was conducted simultaneously on the coronal, axial, and sagittal planes. Fisher's exact tests and Chi-square tests were used to compare the frequencies of incidental findings using a significance level of 0.05. Results: The most frequent incidental finding was maxillary sinus mucosal thickening, which occurred on the right and left side in 46.3% and 46.9% of the patients, respectively. The second most frequent incidental finding was flattening of the mandibular condyle, occurring on the right and left side in 29.7% and 24% of the patients, respectively. No significant difference was observed among the individual age groups. The number of incidental findings per patient varied from 0 to 5 on the right side and left side and from 0 to 12 in total. The Kendall correlation coefficient for the number of incidental findings between the sides was 0.25 (p<0.0001), indicating a weak but significant and positive association between the sides in relation to the number of incidental findings. The mean total number of incidental findings was 4.07. Conclusion: The prevalence of the individual incidental findings and the total number of findings were not statistically different. However, some alterations were more likely to be observed bilaterally.

Self-Perception of Brazilian Adolescents who need Orthodontic Treatment

Objective: To evaluate the self-perception of adolescents regarding the need to undergo orthodontic treatment. Material and Methods: It was performed a cross-sectional study. The sample (n = 200) was composed of adolescents aged 11 to 18 years, of both sexes, divided into 2 groups (G1 ­ in treatment group, G2 - beginner group). A structured questionnaire was divided into three categories for data collection: teeth, face, and symptomatology. Considering the age group, data were tabulated and the first measures of central tendency and dispersion (mean, median, standard deviation, minimum value and maximum value), frequencies, and percentages for other variables were calculated. Student's t-test, Chi-square test, Fisher's exact were used to compare the groups for the age group and other variables at a 5% significance level. Results: The mean age was 15.47 (SD = 1.56) years, 59% of the individuals were women. The main reason for deciding to wear orthodontic appliances was due to necessity and malpositioned teeth (94.5%) and for other reasons (5.5%), with no significant difference between G1 and G2 groups (p>0.05); 20.5% wanted their front teeth to be longer/shorter, and 18.5% wanted their upper teeth to be moved forward/backward. There was no significant difference between the groups in the categories "what would you like to change in your appearance" and "pain and discomfort" (p<0.05). Conclusion: Esthetics related to dental positioning of the upper incisors greatly influenced motivation of the adolescents to seek orthodontic treatment. Skeletal anomalies and pain symptomatology had little influence on the adolescent perception.

Correlação dos níveis salivares de Streptococcus mutans com as condições de higiene bucal em escolares de 6 a 12 anos / Correlation of salivary levels of Streptococcus mutans with the conditionsof oral hygiene in schoolchildren between the ages of 6 and 12

Objetive: To evaluate the microbiological salivary levels of Streptococcus mutans by correlating them with conditions of oral hygiene by measuring rates of Oral Simplified Hygiene and the plaque index in schoolchildren between 6 and 12 years of age, enrolled in a State school in the city of Campina Grande, Paraíba. Methods: The sample consisted of 25 students of both genders. An observational study was carried out using comparative, statistical and descriptive procedures, by direct observation through clinical and microbiological analysis. We first measured the simplified oral hygiene index and the plaque index and immediately afterwards the saliva was collected from the schoolchildren in order to perform a count of the colonies of Streptococcus mutans. Results: There was a normal oral hygiene and the mean simplified oral hygiene index equal to 1.7 is in line with the average of 1.6 for the plaque index. A quantitative analysis of the number of colony forming units of Streptococcus mutans showed a variation of between 0.1 x104 CFU/ml and 7.7 x 104 CFU/ml. These data correlated with the index card shows a weak correlation in wich only 11.7% of the variability of the plaque indexis explained by the amount of Streptococcus mutans (CFU/ml x 104)Conclusion: It was shown, therefore, that the Plaque Index present in these schoolchildren, is not related to the amount of salivary microorganisms of thetype Streptococcus mutans (CFU/ml x104).

Objetivo: Avaliar os níveis salivares de Streptococcus mutans correlacionando-os com as condições de higiene bucal através da mensuração dos Índices de Higiene Oral Simplificado e Índice de Placa Bacteriana em escolares de 6 a 12 anos de idade matriculados em uma escola Estadual do município de Campina Grande, Paraíba. Métodos: A amostra foi constituída de 25 escolares de ambos os sexos. Realizou-se um estudo observacional com procedimento comparativo, estatístico e descritivo, através da observação direta por meio do exame clínico e análise microbiológica. Primeiramente foi mensurado o Índice de Higiene Oral Simplificado e o Índice de Placa Bacteriana e logo após foi coletada a saliva dos escolares para contagem das colônias de Streptococcus mutans. Resultados: Observou-se uma higiene bucal regular sendo a média de Índice de Higiene Oral Simplificado igual a 1,7 estando de acordo com a média do Índice de Placa Bacteriana que foi de 1,6. A análise quantitativa do número de unidades formadoras de colônia de Streptococcus mutans revelou uma variação de 0,1x104 UFC/ml a 7,7 x 104 UFC/ml. Esses dados correlacionados com o Ìndice de Placa demonstram uma correlação fraca na qual apenas 11,7% da variabilidade do ìndice de Placa Bacteriana é explicada pela quantidade de Streptococcus mutans (UFC/ml x 104). Conclusão: Com isso, foi demonstrado que o Índice de Placa presente nos escolares não está associado à quantidade de micro-organismos salivares do tipo Streptococcus mutans (UFC/ml x104).

Aplicação da técnica cirúrgica de Caldwell-Luc para remoção de corpo estranho do seio maxilar; relato de caso / Application of surgical technique of Caldwell-Luc for removal of foreign body of the maxillary sinus: a case report

Os seios maxilares são cavidades que por suas particularidades anatômicas podem oferecer uma série de problemas cirúrgicos. Diferentes corpos estranhos podem penetrar na cavidade sinusal no decorrer de acidentes ou mesmo de tratamentos odontológicos. Relata-se um caso clínico de um paciente de 24 anos, do sexo feminino e leucoderma que compareceu ao Setor de Cirurgia Buco-Maxilo-Facial do Instituto de Pós-Graduação e Ensino de Campina Grande (IPE-CG) para remoção de corpo estranho iatrogênico localizado em seio maxilar homolateral. A retirada do mesmo foi realizada através da técnica de Caldwell-Luc, com sucesso e rápida recuperação do paciente.

The maxillary sinuses are cavities that by their anatomical features may provide a range of surgical problems. Various foreign bodies can penetrate the sinus cavity during accidents or dental care. We report the case of a patient 24 years old, female and leucoderma who was attended at the Department of Oral and Maxillofacial Surgery of the Institute of Postgraduate Studies in Campina Grande, (EPI-CG) for the removal of iatrogenic foreign bodies located in within homolateral jaw. The withdrawal of that was accomplished through the Caldwell-Luc, successful and fast patient recovery.