Thermographic Analysis of Tooth Vascularization Using Thermal Stimulation.

OBJECTIVE: The current pulp diagnostic techniques based on subjective patient response to electrical or thermal stimuli are unable to assess tooth vascularization, which is a true indicator of pulp vitality. The present study evaluates thermography as a pulp vitality test, assessing tooth recovery following thermal stimulation. METHODS: A model simulating intrapulpal circulation was developed. Superficial thermographic measurements were obtained from teeth with and without elevation of the intracoronal temperature before and after applying thermal stress with cold. The data were analyzed using analysis of variance (ANOVA), and the level of significance was set at P<0.05. RESULTS: The model obtained could help differentiate between teeth with and without simulated pulp circulation. Recovery following application of thermal stress showed significant differences between the two types of teeth. CONCLUSION: Thermography has the potential to be used as a diagnostic tool for the vascularity status of the dental pulp.

Use of self-organizing maps for analyzing the behavior of canines displaced towards midline under interceptive treatment.

BACKGROUND: Displaced maxillary permanent canine is one of the more frequent findings in canine eruption process and it's easy to be outlined and early diagnosed by means of x-ray images. Late diagnosis frequently needs surgery to rescue the impacted permanent canine. In many cases, interceptive treatment to redirect canine eruption is needed. However, some patients treated by interceptive means end up requiring fenestration to orthodontically guide the canine to its normal occlusal position. It would be interesting, therefore, to discover the dental characteristics of patients who will need additional surgical treatment to interceptive treatment. MATERIAL AND METHODS: To study the dental characteristics associated with canine impaction, conventional statistics have traditionally been used. This approach, although serving to illustrate many features of this problem, has not provided a satisfactory response or not provided an overall idea of the characteristics of these types of patients, each one of them with their own particular set of variables. Faced with this situation, and in order to analyze the problem of impaction despite interceptive treatment, we have used an alternative method for representing the variables that have an influence on this syndrome. This method is known as Self-Organizing Maps (SOM), a method used for analyzing problems with multiple variables. RESULTS: We analyzed 78 patients with a PMC angulation higher than 100 . All of them were subject to interceptive treatment and in 21 cases it was necessary to undertake the above-mentioned fenestration to achieve the final eruption of the canine. CONCLUSIONS: In this study, we describe the process of debugging variables and selecting the appropriate number of cells in SOM so as to adequately visualize the problem posed and the dental characteristics of patients with regard to a greater or lesser probability of the need for fenestration.

Orthodontic camouflage versus orthognathic surgery for class III deformity: comparative cephalometric analysis.

The objective of this study was to compare different cephalometric variables in adult patients with class III malocclusions before and after treatment, in order to determine which variables are indicative of orthodontic camouflage or orthognathic surgery. The cases of 156 adult patients were assessed: 77 treated with orthodontic camouflage and 79 treated with orthodontics and orthognathic surgery. The following cephalometric variables were measured on pre-treatment (T1) and post-treatment (T2) lateral cephalograms: sella-nasion-A-point (SNA), sella-nasion-B-point (SNB), and A-point-nasion-B-point (ANB) angles, Wits appraisal, facial axis angle, mandibular plane angle, upper and lower incisor inclination, and inter-incisal angle. There were statistically significant differences in cephalometric variables before and after treatment between the two groups. The percentage of normal pre-treatment measurements in the camouflage orthodontics group was 30.7%, which worsened slightly to 28.4% post-treatment. However in the group receiving surgery, this was 24.5% pre-treatment, improving to 33.5% after surgery. SNA, SNB, Wits appraisal, lower incisor inclination, and inter-incisal angle showed differences between the two groups before and after treatment. Wits appraisal, lower incisor inclination, and inter-incisal angle were indicative of one or other treatment. Upper and lower incisor decompensation in both groups did not reach ideal values, which impeded complete skeletal correction in 52% of surgical cases.

Sclerosis in bisphosphonate-related osteonecrosis of the jaws and its correlation with the clinical stages: study of 43 cases.

We analysed the degree of sclerosis in the different stages of bisphosphonate-related osteonecrosis of the jaws (BRONJ) and studied the relation between the grade of sclerosis, the clinical symptoms, and the depth of lucency. We compared 43 patients with mandibular BRONJ with a control group of 40 cases with no bony lesions. The presence of sclerotic bone, cortical irregularities, radiolucency, fragmentation or sequestration, periostitis, and narrowing of the mandibular canal were studied from computed tomographic (CT) scans using the program ImageJ 1.47v (National Institute of Health, Bethesda, USA) to measure the radiolucency, width of the cortices, and degree of sclerosis. Patients with BRONJ had more severe sclerosis than controls (p<0.01). There was also a significant difference among the different stages of BRONJ, with the highest values found in stage III (p=0.02). The degree of sclerosis differed according to sex, type of bisphosphonate, and the clinical characteristics such as pain, or suppuration, but not significantly so (p>0.05). We conclude that the degree of sclerosis increases with the clinical stage of BRONJ, and is correlated with the depth of lucency.

A comparison between dental measurements taken from CBCT models and those taken from a digital method.

The aims of the study were to assess speed, reliability, accuracy, and reproducibility in measuring mesiodistal tooth sizes, bicanine widths, bimolar widths, and arch lengths (ALs) using cone beam computed tomography (CBCT) and to compare them with the same measurements obtained using a two-dimensional (2D) Digital Method. Plaster study models were made for 27 patients and then digitalized and measured using a 2D Digital Method. CBCTs were undertaken on the same 27 patients using the Dental Picasso Master 3D® and the images obtained were then analysed using the InVivoDental program. The correlation study of the two measuring methods, which were compared by determining the regression parameters and the values of one method as opposed to the other, show how both methods are comparable, although the mean and standard deviation of all the measurements analysed present statistically significant differences for the first upper right premolar, first upper left molar, first lower left premolar, and second lower right premolar, as well for the lower intercanine distance and lower AL. The differences, however, are less than 1 per cent. CBCT digital models are as accurate and reliable as the digital models obtained from plaster casts. The differences existing between both methods are clinically acceptable.

Diseño de una cefalometría tridimensional con la tomografía computarizada de haz cónico (CBCT ) / No disponible

Introducción: el uso de los CBCT se está imponiendo actualmente en los pacientes ortodóncicos ya que estos sistemas suponen una alternativa a la radiografía convencional y a la tomografía computarizada(TC). Objetivos: Definir una serie de planos de referencia y medidas lineales y diseñar una cefalometría en tres dimensiones que incluya un análisis esquelético, de asimetrías, de proporciones craneofaciales y dentoalveolar. Conclusiones: En el presente estudio se muestra una cefalometría sencilla en tres dimensiones, que puede servir para poder medir directamente a nuestros pacientes en los cortes y en la reconstrucción tridimensional obtenidas con un equipo CBCT, sin necesidad de emplear la telerradiografía convencional (AU)

Introduction: The use of CBCT is currently imposing on orthodontic patients because these systems offer an alternative to conventional radiography and computed tomography (CT). Objectives: Define a set of reference planes and linear measurements and design a three-dimensional cephalometric analysis including a skeletal analysis, an analysis of asymmetries, a craniofacial relationships analysis and adentoalveolar analysis. Conclusions: This study shows a simple three-dimensional cephalometry, which can serve to measure directly our patients with CBCT equipment, without using conventional teleradiography (AU)

Prediction of arch length based on intercanine width.

Arch length (AL), intercanine width (ICW), and intermolar width (IMW) are essential for diagnosis and treatment planning and are closely related factors in orthodontics. The aim of the present study was to determine correlations between these measurements and to predict some of these measurements based on others. The dental casts of 197 Spanish patients (119 females and 78 males) with a mean age of 18 years (11-26 years) in the permanent dentition attending the Orthodontic Department of the University of Valencia, Spain, were selected. ICW, IMW, and AL on each dental cast were measured using a previously tested digital method. Correlation between variables was determined using Pearson's correlation coefficient. Linear regression analysis was applied and the 95 per cent confidence intervals (CIs) for slope and intercept were determined. The data showed very high correlations between ICW and AL, both for the upper and lower arches and for males and females, r = 0.925. This coefficient was very close to 1, indicating a linear relationship. The regression equation for AL and ICW was AL = 1.36 ICW + 29.39 for both arches. There was very high correlations between AL and ICW for the upper and lower arches and a regression equation between both magnitudes was established indicating that the size of one factor can be predicted by knowing the other. For an increase of 1 mm in ICW, the AL increases approximately 1.36 mm with a 95 per cent CI (1.30-1.42).

Determination of Bolton tooth-size ratios by digitization, and comparison with the traditional method.

The Bolton Index is one of the most useful calculations for precise orthodontic diagnosis as it shows if there is a correct ratio between dental proportions. However, at times, this calculation is not applied because it is a long and time-consuming procedure compared with digital methods. A new digital method for measuring tooth sizes and for calculating the Anterior (ABI) and the Overall (OBI) Bolton Index was tested on 100 sets of study dental casts of the permanent dentition in a Spanish sample and compared with the traditional method. The reproducibility of this digital method versus the traditional one was analysed to determine intra- and inter-examiner measurement errors by calculating the coefficients of variation. The results demonstrated that the digital method provided results comparable with those of the traditional technique, since the regression parameters for each index showed that the correlation coefficients of the two methods were very high and similar to each other: r = 0.976 and r = 0.979 for the ABI and OBI, respectively. The results also showed more discrepancies in the ABI than in the OBI using both methods in this sample.

Determination of the object surface function by structured light: application to the study of spinal deformities.

The projection of structured light is a technique frequently used to determine the surface shape of an object. In this paper, a new procedure is described that efficiently resolves the correspondence between the knots of the projected grid and those obtained on the object when the projection is made. The method is based on the use of three images of the projected grid. In two of them the grid is projected over a flat surface placed, respectively, before and behind the object; both images are used for calibration. In the third image the grid is projected over the object. It is not reliant on accurate determination of the camera and projector pair relative to the grid and object. Once the method is calibrated, we can obtain the surface function by just analysing the projected grid on the object. The procedure is especially suitable for the study of objects without discontinuities or large depth gradients. It can be employed for determining, in a non-invasive way, the patient's back surface function. Symmetry differences permit a quantitative diagnosis of spinal deformities such as scoliosis.

Primary double teeth. A retrospective clinical study of their morphological characteristics and associated anomalies.

AIM: To investigate the relationship between morphology and position of double teeth, and the occurrence of other dental anomalies in the same subjects and in their siblings. SAMPLE OF CHILDREN AND METHODS: Fifty-three double teeth in a group of 50 Spanish children were included in the study. All of these children were examined clinically and had radiographs and photographs taken at the time of examination. Twenty-two of the children had a total of 30 siblings who were also examined for the presence of anomalies. RESULTS: Of the 50 subjects, 47 had one and three subjects had two double teeth. Statistically there were no significant differences in occurrence between boys and girls, left and right sides or between maxilla and mandible. Four morphological types were identified: type I, bifid crown-single root; type II, large crown-large root; type III, two fused crowns-single root; type IV, two fused crowns-two fused roots. Type I was seen only in the maxilla and types II and III only in the mandible. Type IV was seen mostly in the maxilla. More than half of the cases showed associated anomalies in the permanent dentition and anomalies of number or shape were also present in six of the siblings. CONCLUSION: It is suggested that both double teeth and other anomalies in the same children or in their siblings may be manifestations of a primary abnormality in the distribution of dental material.

Eruption cysts: retrospective clinical study of 36 cases.

The eruption cyst is a lesion associated with an erupting tooth. It appears as a transparent, bluish, blue or blue-black swelling of the alveolar mucosa, over a temporal or permanent tooth in eruption. The analysis of the thirty-six eruption cysts cases studied, corresponding to twenty-seven patients, revealed that their most frequent location is in the maxillary permanent dentition, and that they mostly occur in a single presentation, and in an age-range of between five and nine years. Six cases out of the twenty-seven patients studied showed the characteristic of presenting two or more eruption cysts, and in three of these cases, the lesions were bilateral, symmetrical and simultaneous. Two other patients had been previously diagnosed with cyst diseases. This would suggest that, in addition to the possible infection-trauma origin, there is in some cases the possibility of a predisponent tendency.

Automatic analysis of speckle photography fringes.

Speckle interferometry is a technique adequate to metrological problems such as the measurement of object deformation. An automatic system of analysis of such measurements is given; it consists of a motorized x-y plate positioner controlled by computer, a CCD video camera, and software for image analysis. A fringe-recognition algorithm determines the spacing and orientation of the fringes and permits the calculation of the magnitude and direction of the displacement of the analyzed object point in images with variable degrees of illumination. For a 256 x 256 pixel image resolution, the procedure allows one to analyze from three fringes to a number of fringes that corresponds to 3 pixels/fringe.

Value of CA 15.3 in breast cancer and comparison with CEA and TPA: a study of specificity in disease-free follow-up patients and sensitivity in patients at diagnosis of the first metastasis.

The specificity and sensitivity of a tumor marker (TM) are important in establishing its potential clinical utility for a specific type of neoplasm. CA 15.3 is a TM specific for breast cancer; it is defined by two monoclonal antibodies (DF3 and 115D8), whose specificity, in disease-free follow-up patients, and sensitivity, in patients at diagnosis of first metastasis, have been evaluated in the present study and compared with those of carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA). Serum concentrations of all three TMs were quantified in 618 individuals: 80 healthy controls, 421 patients with local breast cancer who became free of disease following locoregional treatment, and 117 patients with disseminated disease at diagnosis of metastasis. Radioimmunoassay (RIA) was the method employed, and the cut-off values obtained were 30 U/ml for CA 15.3, 5 ng/ml for CEA, and 120 U/I for TPA. The results showed CA 15.3 and CEA specificities to be analogous (95.7 and 95.5%, respectively). TPA specificity (81.9%) was lower (p < 0.001). During adjuvant therapy, CA 15.3 serum levels were seen to increase, followed by a normalization of concentration after terminating therapy. On the other hand, CA 15.3 and TPA sensitivities (64.1 and 67.5%, respectively) were greater than for CEA (44.4%, p < 0.01). It is concluded that CA 15.3 is a useful TM for breast cancer, as it offers a greater sensitivity than CEA and a higher specificity than TPA. Combining CA 15.3 and CEA fails to increase CA 15.3 sensitivity, while combining CA 15.3 with TPA increases false-positives and so likewise offers no additional benefit.

CA 15.3, CEA and TPA tumor markers in the early diagnosis of breast cancer relapse.

To evaluate the utility of CA 15.3 in detecting breast cancer relapse before clinical evidence of metastatic disease, serial determinations of CA 15.3 serum levels were made in 444 disease-free patients after surgery, during 36 months of follow-up. The results were compared with carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA). The study found CA 15.3 to be more sensitive as an early indicator of relapse than CEA or TPA; moreover, simultaneous determination of the other markers offers no information additional to that obtained by CA 15.3 alone.

Dynamic resistance of teeth: technical considerations and applications of an experimental device.

Tooth fracture by impact is the most common cause of fracture in human incisors. We have designed an experimental system to measure the dynamic fracture force of teeth in vitro, and initial results obtained from a sample of healthy, recently removed human incisors are reported. The method was reproducible and reliable, and the results provide a baseline for studies evaluating the effect of endodontic procedures on the dynamic fracture force of teeth.

Speckle correlation technique to determine roughness in the dermatologic interval.

A non-invasive method is proposed to determine human skin roughness. The technique is based on measurement of the correlation between two field distributions scattered by a metallised triafol (cellulose acetate foil) replica of the epidermal area to be analysed. The two speckle patterns are produced from the same rough surface illuminated by two coherent plane waves (He-Ne laser) under two slightly different angles. The accuracy of the method is highlighted by measurements made on a set of standard samples with roughnesses previously determined by mechanical profilometry. Analysis of the results indicates a precision of around 10%, and an applicability within the interest range of very rough surfaces in excess of 4-5 microns.