Parameters in panoramic radiography for differentiation of radiolucent lesions

OBJECTIVE: The aims of this study were to establish parameters in panoramic radiography for interpretation of unilocular radiolucent lesions, and to compare the accuracy of diagnoses given by examiners before and after using these parameters. MATERIAL AND METHODS: In Part I, 12 specialists analyzed 24 images and the diagnostic criteria used by each examiner to make correct diagnoses were used to build a list of basic radiographic parameters for each pathology (ameloblastoma, keratocystic odontogenic tumor, dentigerous cyst, and idiopathic bone cavity). In Part II, this list was used by 6 undergraduate students (Un), 8 recently graduated dentists (D), 3 oral pathologists, 3 stomatologists, 3 oral radiologists, and 3 oral surgeons to diagnose the corresponding pathologies in the other set of 24 panoramic radiographs (T2). The same analysis occurred without using this list (T1). The method of generalized estimating equations (GEE) was used in order to estimate the probability of making a correct diagnosis depending on the specialty of the examiner, type of lesion, and moment of the evaluation, T1 or T2 (before or after they had access to the list of parameters, respectively). RESULTS: Higher values were obtained for the probability (GEE) of making a correct diagnosis on T2; the group Un presented the highest improvement (14.6 %); no differences between the probabilities were observed either between Un and D, or among the different groups of specialists. CONCLUSIONS: The use of panoramic radiographic parameters did allow improving the diagnostic accuracy for all groups of examiners

Use of mouthwashes in patients with oral and oropharynx cancer

Objective: To evaluate the use of mouthwashes in patients with oral and oropharyngeal cancer. Materials and methods: Fifty-three patients were interviewed through a specific questionnaire at two reference centers for diagnosis and treatment of cancer. The Case Group consisted of 33 patients with final diagnosis of epidermoid carcinoma of the mouth and oropharynx. The Control Group consisted of 20 patients attended to by services not connected with oncology. Results: In the Case Group, 81.8% did not make use of dental floss, showing statistically significant difference from the Control Group (p=0.036). As for toothbrushing, we noticed a contrary behavior in which the Cases brushed more times per day than the Controls. The Control Group made less use of mouthwashes when compared to the Case Group, which used it more times per day (p=0.028). Patients in the Case Group smoked more than those in the Control Group, with this difference being significant (p=0.004). The same behavior was observed for alcohol consumption – consumption in milliliters per day during the year (p=0.031). Relevance: Various risk factors have been associated with cancers of the oral cavity, among them the consumption of alcoholic beverages. The mechanism by which alcoholic beverages cause oral cancer is unknown, but probably involves topical exposure. Conclusion: From this study, we concluded that even with the small casuistic, by means of a stratified analysis, the use of mouthwashes was four times higher in alcohol consumers; however, no increase of risk in smokers, abstainers from alcohol and non-smokers was observed

Parameters in panoramic radiography for differentiation of radiolucent lesions

OBJECTIVE: The aims of this study were to establish parameters in panoramic radiography for interpretation of unilocular radiolucent lesions, and to compare the accuracy of diagnoses given by examiners before and after using these parameters. MATERIAL AND METHODS: In Part I, 12 specialists analyzed 24 images and the diagnostic criteria used by each examiner to make correct diagnoses were used to build a list of basic radiographic parameters for each pathology (ameloblastoma, keratocystic odontogenic tumor, dentigerous cyst, and idiopathic bone cavity). In Part II, this list was used by 6 undergraduate students (Un), 8 recently graduated dentists (D), 3 oral pathologists, 3 stomatologists, 3 oral radiologists, and 3 oral surgeons to diagnose the corresponding pathologies in the other set of 24 panoramic radiographs (T2). The same analysis occurred without using this list (T1). The method of generalized estimating equations (GEE) was used in order to estimate the probability of making a correct diagnosis depending on the specialty of the examiner, type of lesion, and moment of the evaluation, T1 or T2 (before or after they had access to the list of parameters, respectively). RESULTS: Higher values were obtained for the probability (GEE) of making a correct diagnosis on T2; the group Un presented the highest improvement (14.6 %); no differences between the probabilities were observed either between Un and D, or among the different groups of specialists. CONCLUSIONS: The use of panoramic radiographic parameters did allow improving the diagnostic accuracy for all groups of examiners