Evaluation of two methods of tracings for implants in panoramic radiographs

In the last years, computer programs have appeared in order to help dental practitioners in implants planning. These programs aim to facilitate the acquisition of adequate measures in digitalized radiographs. The aims of this study were: to evaluate the intra-examiner agreement in the acquisition of measures using two methods (manual and computer program - Radioimp), comparing their performances. Three examiners analyzed twenty-one panoramic radiographs. They used the two methods in two occasions. In the manual method, the examiners made a tracing on a paper fixed to the images and measured nine regions with a caliper. The images were digitalized and showed in a computer screen to be analyzed in the computer program. The examiners acquired measures of the same regions by the manual method. Vertical measures of spheres in the images were acquired in order to discount the magnifying factor of the technique. Through statistics analysis (p=.05), it was possible to conclude that there were differences in intra-examiner agreement and the examiners had greater difficulty in reproducing the measures when they used the computer program; the measures acquired by the manual method were closer to the real ones.Nos últimos anos, surgiram, na Odontologia, programas de computador para auxiliar o profissional no planejamento de implantes. Esses programas visam facilitar a obtenção de medidas adequadas em exames radiográficos digitalizados. Os objetivos desse trabalho foram: avaliar a concordância intra-examinador na obtenção de medidas por dois métodos (o manual e o com um programa de computador - Radioimp); e comparar o desempenho dos dois métodos. Para isso, 21 radiografias panorâmicas foram analisadas por três avaliadores, pelos dois métodos, em duas ocasiões. No método manual, os avaliadores realizaram um traçado sobre papel acetato fixado às imagens, e, com um paquímetro, obtiveram medidas de nove regiões. Para a análise das imagens no programa de computador, essas foram digitalizadas e exibidas em uma tela de computador. Os avaliadores obtiveram medidas das mesmas regiões analisadas pelo método manual. Para desconto da ampliação inerente à técnica, foram obtidas medidas verticais de esferas presentes nas imagens. Os resultados foram submetidos à análise estatística (p=0.05). Houve diferenças entre os avaliadores na concordância intra-examinador, sendo que esses apresentaram maior dificuldade na reprodução das medidas, quando utilizaram o programa de computador; a maioria das medidas que apresentaram falta de exatidão foi obtida ao se utilizar o mesmo programa. Dessa forma, os programas destinados ao planejamento de implantes devem ser utilizados com cautela por pessoas treinadas

Reprodutibilidade diagnóstica do alongamento do processo estilóide

The aim of this study was to estimate the reproducibility related to the presence and to the measurements of elongated styloid process (ESP), based on panoramic radiographs and the prevalence of ESP. Experimental design: one hundred sixty six panoramic radiographs were used, from edentulous patients from the Radiology Clinic files, at Araraquara Dental School, Unesp, during a four-year period. One hundred and twenty one were female and 45 were male. Two calibrated observers evaluated the radiographs. A caliper was used to measure, in mm, the ESP from the base of the temporal bone to the tip of the structure. The ESP was considered present when the measurements were 30mm or more. Kappa statistics (k ) and intra-class correlation coefficient (r ), were applied to estimate the reproducibility. The results showed that related to the presence of ESP, the interobserver agreement was k =0.85. Related to the measurements of ESP, the interobserver agreement was r =0.52. The prevalence of ESP was estimated in 12.6%. ESP distribution in females was similar to that for males. In conclusion, we found a greater level of agreement when observers evaluated the presence of ESP than when they did the measurement of ESP. The prevalence of ESP was 12.6%.O objetivo deste trabalho foi avaliar a reprodutibilidade relacionada à presença e às medidas do alongamento e a prevalência do processo estilóide (APE), utilizando radiografias panorâmicas. Foram utilizadas cento e sessenta e seis radiografias, do arquivo da Clínica de Radiologia, da Faculdade de Odontologia de Araraquara, Unesp, de pacientes desdentados, atendidos num período de quatro anos. Cento e vinte um pacientes eram do gênero feminino e quarenta e cinco do masculino. Dois examinadores calibrados avaliaram as radiografias. Foi utilizado um paquímetro para medir, em mm, o APE da base do osso temporal à extremidade da estrutura. O APE foi considerado presente quando as medidas ultrapassaram 30 mm. A reprodutibilidade foi avaliada utilizando a estatística Kappa (ê) e o coeficiente de correlação intra-classe (ñ). Os resultados mostraram que a concordância interexaminador foi ê=0,85, relativa à presença do APE e ñ=0,52 relativa às medidas do APE. A prevalência do APE foi 12,6%. A distribuição do APE no gênero feminino foi semelhante ao masculino. Concluindo, o nível de concordância entre os dois examinadores quanto à presença do APE foi maior do que quando eles mediram o APE. A prevalência do APE foi 12,6%

CBCT post-processing tools to manage the progression of invasive cervical resorption: a case report

This case report aimed to highlight the usefulness of cone beam computed tomography (CBCT) and its post-processing tools for the diagnosis, follow-up and treatment planning of invasive cervical resorption (ICR). A 16-year-old female patient was referred for periapical radiographic examination, which revealed an irregular but well demarcated radiolucency in the mandibular right central incisor. In addition, CBCT scanning was performed to distinguish between ICR and internal root resorption. After the diagnosis of ICR, the patient was advised to return shortly but did so only six years later. At that time, another CBCT scan was performed and CBCT registration and subtraction were done to document lesion progress. These imaging tools were able to show lesion progress and extent clearly and were fundamental for differential diagnosis and treatment decision.This case report aimed to highlight the usefulness of cone beam computed tomography (CBCT) and its post-processing tools for the diagnosis, follow-up and treatment planning of invasive cervical resorption (ICR). A 16-year-old female patient was referred f274476480sem informaçãosem informaçãoCom este relato de caso clínico objetiva-se enfatizar a contribuição das ferramentas de pós-processamento aplicadas às imagens de tomografia computadorizada de feixe cônico (TCFC) no diagnóstico, acompanhamento e decisão do tratamento de reabsorção cervi

More frequent detection of calcified carotid atherosclerotic plaques and mineralized laryngeal cartilages on digital than on film-based panoramic radiographs

To determine whether calcified carotid atherosclerotic plaques (CCAPs) and mineralized laryngeal cartilages (MLCs) were more frequently detected on digital or film-based panoramic radiographs. The clinical relevance of this question is that some radiopacities seen on digital radiographs may correspond to medium-density tissues that are not necessarily mineralized. Materials and Methods: Data were collected from panoramic radiographs and the respective reports issued by 2 private oral radiology centers. A total of 388 radiographs and reports were divided into film-based (group A) and digital (group D) radiographs. The frequencies of CCAPs and MLCs were analyzed using the Fisher exact test, and odds ratios were also calculated (alpha = 1%). Results: The mean age of patients whose reports and radiographs showed CCAPs and/or MLCs ranged from 50.1 to 54.1 years. There was a predominance of females. A higher frequency of CCAPs and MLCs was observed in group D than in group A at both centers (P < 0.01). CCAPs and MLCs were detected 4 times more frequently in group D than in group A at one of the centers. Conclusion: CCAPs and MLCs were more frequently detected on digital than on film-based panoramic radiographs. Further studies are needed to determine whether such radiopacities do indeed correspond to mineralized, rather than medium-density, tissues4916570sem informaçãosem informaçã

Intra-sinusal third molar: Case report

Ectopic tooth eruption into an area other than the oral cavity is rare. Nasal septum, mandibular condyle, coronoid process and infratemporal fossa space have been reported as frequent locations for ectopic tooth eruption. Ectopic teeth located within the maxillary sinus may be asymptomatic, found only in routine examinations. Headache, sinusitis and nasal obstruction are some of the associated symptoms. The differential diagnosis includes foreign bodies (rhinolith), infections (syphilis and tuberculosis), benign lesions (hemangioma, osteoma, calcified polyp) and malign lesions (osteosarcoma). Upper third molars located within the maxillary sinus may be associated with the development of mucocele or dentigerous cyst. The aim of this paper was to describe the case of a 24-year old female patient with an ectopic right upper third molar in the maxillary sinus. A hyperdense area was observed with sinus obliteration, consistent with mucous material

Evaluation of the radioprottector effect of sodium selenite on bone healing in the tibia of ovariectomized rats

Orientador: Solange Maria de AlmeidaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: A osteoporose e a irradiação são fatores que interferem no processo de reparação óssea e podem ocorrer simultaneamente, especialmente em mulheres idosas. Atualmente, várias substâncias, conhecidas como radioprotetores, têm sido estudadas, pois minimizam os efeitos deletérios da radiação; dentre eles, pode-se citar o selênio. O objetivo desse trabalho foi avaliar o efeito radioprotetor do selenito de sódio no processo de reparo ósseo em ratas ovariectomizadas submetidas à irradiação. Para isso, oitenta ratas foram submetidas à ovariectomia e divididas em quatro grupos: ovariectomizado, ovariectomizado/selênio, ovariectomizado/irradiado e ovariectomizado/selênio/irradiado. Quarenta dias após, um defeito ósseo foi confeccionado nas tíbias dos animais. Dois dias após essa cirurgia, os animais dos grupos ovariectomizado/selênio eovariectomizado/selênio/irradiado receberam 0,8 mg Se/Kg de peso corpóreo. No dia seguinte, apenas os animais pertencentes aos grupos ovariectomizado/irradiado e ovariectomizado/selênio/irradiado receberam 10 Gy de radiação X na região dos membros inferiores. Os animais foram sacrificados 7, 14, 21 e 28 dias após a cirurgia. O processo de reparação óssea foi avaliado por análise morfológica, utilizando-se a coloração pelo Tricrômico de Masson, e por análise do número de trabéculas ósseas e da birrefrigência (coloração pelo Picrosírius). Pela análise morfológica, foi possível observar um atraso no processo de reparo ósseo nos animais do grupo ovariectomizado/irradiado e similaridade entre os grupos ovariectomizado, ovariectomizado/selênio e ovariectomizado/selênio/irradiado, o que demonstrou o efeito radioprotetor do selênio sem toxicidadeAbstract: Osteoporosis and ionizing radiation affect the bone healing and people can suffer both conditions, especially older women. At the moment, antioxidant radioprotectors have been evaluated, such selenium compounds. This study aimed at evaluating the selenium protection in the bone repair process in ovariectomized rats submitted to an irradiation procedure. For this purpose, eighty ovariectomized female Wistar rats were randomly divided in four experimental groups: ovariectomized, ovariectomized/selenium, ovariectomizedlirradiated and ovariectomized/selenium/irradiated. Abone defect was made on all animals' tibias forty days after ovariectomy. Two days after surgery, only ovariectomized/selenium and ovariectomized/seleniumlirradiated rats received 0.8 mg Se/Kg. Three days after surgery, only ovariectomized irradiated and ovariectomized/selenium/irradiated rats received 10 Gy of X rays on the lower limbs region. The animals were sacrificed 7, 14, 21 and 28 days after surgery in order to assess the repair process, which was evaluated by morphologic analysis in Masson Tricromic. lt was also evaluated by analysis of trabecular bone number in Masson Tricromic and birefringence analysis in Picrosirius. It was possible to observe a delay in the bone repair process in the irradiated/ovariectomized group and similarity between ovariectomized, ovariectomized/selenium and ovariectomized/selenium/irradiated, which proved the selenium radioprotection without its toxicityDoutoradoRadiologia OdontologicaDoutor em Radiologia Odontológic

Avaliação de dois metodos de traçados para implantes em radiografias panoramicas

Orientador : Agenor Montebello FilhoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: Nos últimos anos, surgiram, na Odontologia, programas de computador desenvolvidos para auxiliar o profissional no planejamento de implantes. Esses programas visam facilitar a obtenção de medidas adequadas em exames radiográficos digitalizados e ainda permitem que as imagens sejam ampliadas e alteradas no contraste, brilho e tonalidade. Os objetivos desse trabalho foram: avaliar a concordância intra-examinador na obtenção de medidas por dois métodos (o manual e o com auxílio de um programa de computador); avaliar a exatidão dessas medidas; e comparar o desempenho dos dois métodos. Para isso, 21 radiografias panorâmicas foram analisadas por cinco avaliadores, pelos dois métodos, em duas ocasiões. No método manual, os avaliadores realizaram, com auxílio de um negatoscópio, um traçado sobre papel acetato fixado às imagens, e, com um paquímetro, obtiveram medidas de nove regiões. Para a análise das imagens no programa de computador, essas foram digitalizadas e exibidas em uma tela de computador. Os avaliadores obtiveram medidas das mesmas regiões analisadas pelo método manual. Para desconto da ampliação inerente à técnica, foram obtidas medidas verticais de esferas presentes nas imagens. Os resultados foram submetidos à análise estatística. Houve baixa concordância intra-examinador, sendo que os avaliadores apresentaram maior dificuldade na reprodução das medidas, quando utilizaram o programa de computador; houve falta de exatidão das medidas nas regiões anteriores e na região que envolveu a visualização do canal mandibular, sendo que a maioria dessas medidas foi obtida ao se utilizar o mesmo programa. Dessa forma, os programas destinados ao planejamento de implantes devem ser utilizados com cautelaAbstract: In the last years, computer programs have appeared in order to help dental practitioners in implants planning. These programs aim to facilitate the acquisition of adequate measures in digitalized radiographs as well as to permit these images to be magnified and to have their contrast, brightness and gray level altered. The aims of this study were: to evaluate the intra-examiner agreement in the acquisition of measures using two methods (manual and by means of a computer program), to evaluate the accuracy of these measures and to compare their performances. Five examiners analyzed twenty-one panoramic radiographs. They used the two methods in two occasions. In the manual method, the examiners made, by means of light box, a tracing on a paper fixed to the images and measured nine regions with a caliper. The images were digitalized and showed in a computer screen so that they could be analyzed in the computer program. The examiners acquired measures of the same regions by the manual method. Vertical measures of spheres in the images were acquired in order to discount the magnifying factor of the technique. Through statistics analysis, it was possible to conclude that there was low intra-examiner agreement and the examiners had greater difficulty in reproducing the measures when they used the computer program; there wasn't accuracy of the measures in the anterior regions and in the region that the visualization of the mandibular canal was involved; the measures acquired by the manual method were closer to the real onesMestradoMestre em Radiologia Odontológic