Análise comparativa dos estimadores do surto de crescimento puberal: métodos de Martins e Sakima e Grave e Brown

The aim of this study was to evaluate whether Martins and Sakima and Grave and Brown methods are useful for the study of pubertal growth spurt in children with cleft lip and palate. A total of 132 hand-wrist radiographs of patients from HRAC/USP aged 7 to 17 years old were analyzed, including girls and boys. Six radiographs of each age and gender were employed. These methods were applied to evaluating the stages of the hand-wrist ossification and epiphyseal formation, by graphic representation. The Martins and Sakima and the Grave and Brown methods revealed that the initial, peak and final stages of pubertal growth spurt occurred between 9 to 10, 12 and 15 years old, respectively, in the female gender. Similarly, in the male gender, both Martins and Sakima and Grave and Brown methods showed similar mean ages: 12, 14 and 16 years old for initial, peak and final stages of pubertal growth spurt, respectively. The Pearson's correlation test showed high and significant correlation (r = 0.99 and p < 0.001) between the methods investigated. In conclusion, the methods appeared to be highly and significantly correlated as regards the analysis of children with cleft lip and palate. Moreover, based on the literature and present results, it is possible to suggest that the two methods have shown similar pattern and may be used with equal efficiency for assessment of the pubertal growth spurt in children with cleft lip and palate.O objetivo deste trabalho foi avaliar se os métodos de Martins e Sakima e Grave e Brown são aplicáveis para o estudo do surto de crescimento puberal (SCP) de crianças com fissuras lábio-palatais. Foram analisadas 132 radiografias carpais de pacientes do HRAC-USP, dos gêneros masculino e feminino, com a faixa etária de 7 a 17 anos, utilizando 6 radiografias de cada idade e gênero. Ambos os métodos estudam os estágios de ossificação dos ossos da mão e punho e os estágios que se encontram as epífises, através de gráficos. Com relação a este estudo, no gênero feminino, tanto para Martins e Sakima quanto para Grave e Brown, o início, pico e final do SCP ocorreram entre 9 e 10 anos, 12 anos e 15 anos, respectivamente. Da mesma forma, para o gênero masculino, Martins e Sakima e Grave e Brown mostraram médias de idade similares: 12, 14 e 16 anos para início, pico e final do SCP, respectivamente. O teste de correlação de Pearson mostrou uma alta e significativa correlação (r = 0,99 e P < 0,001) entre os métodos estudados. Em conclusão, esses dois métodos de avaliação do surto de crescimento e desenvolvimento apresentaram uma alta correlação quando aplicados na avaliação de crianças com fissuras lábio-palatais. Baseando-se na literatura e nos resultados dessa pesquisa, é possível sugerir que ambos os métodos podem ser aplicados nos pacientes com fissuras lábio-palatais para a obtenção do surto de crescimento puberal

Comparação entre filmes radiográficos e o sistema digital Digora, no diagnóstico de lesões de cárie dentinária em superfície proximal de molares decíduos

This study evaluated the diagnostic performance of the Agfa M2 and Ektaspeed Plus dental films and the Digora digital system. The material comprised 37 extracted primary molars radiographed with 50, 70 and 90 kV. The images of 41 approximal surfaces were examined under standardized conditions. Five imaging modes (0.5 X, 1 X, 2 X, "Negative" and 3D) available in the software of the digital system, were used. The teeth were sectioned and observed under a stereomicroscope (40 X). The data were analysed for sensitivity, specificity, accuracy and unweighted kappa. Ektaspeed plus exposed to 50 kV obtained the highest sensitivity, accuracy and kappa values. The specificity values of the films were comparable. Digora presented the highest values of sensitivity when the "Negative" mode was used. The majority of the reduced images (0.5 X) revealed the highest specificity. The average accuracy values of the digital system were very similar. Unweighted kappa revealed that all digital image modes established good agreement. The sensitivity values of the digital system were higher than that of the conventional films, but films revealed higher values of specificity. The average accuracy values of Digora were higher than that of the films, for all kilovoltages. Except for Ektaspeed Plus at 50 kV, the films did not reach the kappa values of Digora in the diagnosis of dentinal caries. Cohens kappa revealed good intra-examiner reliability (0.758). It was demonstrated that the digital system is comparable to the conventional radiographic method in the diagnosis of approximal dentinal caries in primary molars.O estudo comparou o desempenho diagnóstico dos filmes Agfa M2 e Ektaspeed Plus e do sistema digital Digora. A amostra foi composta por 37 molares decíduos, radiografados em 50, 70 e 90 kV. As imagens de 41 superfícies proximais foram avaliadas sob condições padronizadas. Cinco recursos de edição de imagem (0,5 X, 1 X, 2 X, "Negativo" e 3D), disponíveis no software do sistema digital, foram utilizados. Após a secção dos dentes e a validação em estereomicroscopia (40 X), calculou-se a sensibilidade, especificidade, acurácia e kappa não-ponderado dos métodos. O filme Ektaspeed Plus, exposto a 50 kV, diferenciou-se devido aos valores expressos para sensibilidade, acurácia e kappa não-ponderado. A especificidade dos filmes revelou valores comparáveis. Com a utilização do sistema digital Digora, a taxa de diagnósticos positivo-verdadeiros alcançou maior valor ao ser utilizado o recurso de imagem "Negativo". A imagem comprimida (0,5 X) foi, majoritariamente, a mais específica. As acurácias médias do sistema digital Digora resultaram em valores aproximados. Ao ser utilizada a estatística kappa, não houve distinção entre os recursos de imagem obtidos com o software. O método digital foi mais sensível que os filmes, porém, estes foram mais específicos. A acurácia média do sistema digital suplantou a dos filmes. Excetuando-se o Ektaspeed Plus, em 50 kV, os filmes não alcançaram os valores de kappa demonstrados pelo sistema digital Digora. Cohens kappa revelou boa concordância intra-examinador (0,758). Devido aos resultados observados, o sistema digital demonstrou-se comparável ao método radiográfico convencional, no diagnóstico de lesões de cárie dentinária em superfícies proximais de molares decíduos

Analysis of the radiographic exposure and radiographic processing in dental offices in relation to fogging

A qualidade da imagem radiográfica depende da correta indicação da técnica radiográfica, o tipo de filme utilizado, o tempo de exposição e o uso de soluções e locais de processamento adequados. O velamento radiográfico pode surgir em descuidos relacionados ao tempo de exposição, filmes deteriorados e através do processamento radiográfico. O objetivo do presente trabalho foi verificar as condições de exposição e processamento radiográficos quanto ao velamento. Os filmes foram expostos padronizadamente em um fantoma e, com a finalidade de avaliar o processamento radiográfico, foram processados nos consultórios odontológicos. Posteriormente, foram expostos filmes radiográficos usados, em rotina, pelos profissionais, em seus aparelhos de raios X com o tempo de exposição utilizado pelos mesmos. Após, estes filmes irradiados foram processados, padronizadamente, em uma processadora automática. Dessa maneira, pretendeu-se avaliar a exposição radiográfica. Após a obtenção das radiografias, foram feitas leituras das densidades ópticas (D.O.) na área de chumbo. Conclui-se que dos consultórios odontológicos avaliados, quase a metade das radiografias avaliadas apresentaram velamento quanto à exposição radiográfica e nenhuma apresentou velamento quanto ao processamento radiográfico.The quality of the radiographic image depends on the correct indication of the technique, the kind of film, the time of exposure and the use of processing solutions and adequate processing places. Radiographic fogging can appear in errors related to time of exposure, deteriorated films and in the radiographic processing. The aim of the present study is to verify conditions of radiographic exposure and processing in relation to fogging in dental offices. The films were exposed under standardized conditions in one phantom and, with the purpose of evaluating the radiographic processing, were processed in dental offices. Later, radiographic films were exposed, in routine, by the dentists, in their X ray devices with the usual time of exposition. After, these exposed films were processed, in an automatic processing machine. After the attainment of the radiographies, had been made readings of the optic densities (D.O.) in the lead area. It is ended that of the appraised dental offices, almost half radiographies evaluated has presented fogging as for the radiographic exposure and none presented fogging as for the radiographic processing

Treatment of snoring and sleep apnea syndrome with a removable mandibular advancement device in patients without TMD

INTRODUCTION: Among the sleep disorders reported by the American Academy of Sleep, the most common is obstructive sleep apnea-hypopnea syndrome (OSAHS), which is caused by difficulties in air passage and complete interruption of air flow in the airway. This syndrome is associated with increased morbidity and mortality in apneic individuals. OBJECTIVE: It was the objective of this paper to evaluate a removable mandibular advancement device as it provides a noninvasive, straightforward treatment readily accepted by patients. METHODS: In this study, 15 patients without temporomandibular disorders (TMD) and with excessive daytime sleepiness or snoring were evaluated. Data were collected by means of: Polysomnography before and after placement of an intraoral appliance, analysis of TMD signs and symptoms using a patient history questionnaire, muscle and TMJ palpation. RESULTS: After treatment, the statistical analysis (t-test, and the "before and after" test) showed a mean reduction of 77.6% (p=0.001) in the apnea-hypopnea index, an increase in lowest oxyhemoglobin saturation (p=0.05), decrease in desaturation (p=0.05), decrease in micro-awakenings or EEG arousals (p=0.05) and highly significant improvement in daytime sleepiness (p=0.005), measured by the Epworth Sleepiness Scale. No TMD appeared during the monitoring period. CONCLUSION: The oral device developed in this study was considered effective for mild to moderate OSAHS

A Radiografia Digital na Odontologia.

A Radiografia Digital na Odontologia

Dental agenesis in cleft lip and/or palate pf the “Centro Pró-Sorriso” – Universidade José do Rosário Vellano

Objective: Analyze periapical and panoramic radiographs in order to define the incidence of dental agenesis in carriers of cleft lip and/or cleft palate among patients of UNIFENAS “Centro Pró-Sorriso” (Pro-Smile Center) in Alfenas – MG. Methods: Periapical and panoramic radiographs from recorders of 172 patients treated at Centro Pró-Sorriso (Center Pro-Smile) of UNIFENAS in Alfenas,MG, for cleft lips and palates, unilateral or bilateral, complete or incomplete, in both genders, aged from 0 to 15 years. Results: From the total above mentioned 172 patients fulfilled the requirements, ninety eight (57.0%) presented cleft lips, alveoli and palates. 32 (18.6%) presented cleft lip and alveolus cleft: 28 (16.3%) presented only cleft palate. 14 (8.1%) presented only cleft lip. The masculine gender predominated in all types of cleft except for right lip and palate cleft, at which the feminine gender was preeminent. Inthe relation between ethnical characteristics and type of cleft, disregarding the side of incidence, no significant difference was noticed. The greatest incidence of cleft lip, alveolus (LAP) and palate occurred as follows: 47 (27.35%) on the left side; 31 (18.0%) were bilateral; 20 11.6%) on the right side. In the group of lip and alveolus cleft, 17 (9.9%) were on the left side; 11 (6.4%) in the right side, and 4 (2.3%) were bilateral. In the group of lip cleft only, 11 (6.4%) were on the left side, and 3 (1.7%) in the right side. If the regions of incidence(right, left, bilateral) are considered, regardless of the type of cleft, the incidence on the left side was significantly greater than at right or the bilateral modality. No significant difference was noticed between the right side and the bilateral modality. Conclusion: he incidence of LAP cleft was significantly greater than that of the other types, and LA clefts were statistically more numerous than L cleft. With respect to LA clefts, the left side prevailed over the bilateral modality. 60.9% being of agenesis

Análise das condições de exposição e processamento radiográficos em consultórios odontológicos quanto ao velamento

The quality of the radiographic image depends on the correct indication of the technique, the kind of film, the time of exposure and the use of processing solutions and adequate processing places. Radiographic fogging can appear in errors related to time of exposure, deteriorated films and in the radiographic processing. The aim of the present study is to verify conditions of radiographic exposure and processing in relation to fogging in dental offices. The films were exposed under standardized conditions in one phantom and, with the purpose of evaluating the radiographic processing, were processed in dental offices. Later, radiographic films were exposed, in routine, by the dentists, in their X ray devices with the usual time of exposition. After, these exposed films were processed, in an automatic processing machine. After the attainment of the radiographies, had been made readings of the optic densities (D.O.) in the lead area. It is ended that of the appraised dental offices, almost half radiographies evaluated has presented fogging as for the radiographic exposure and none presented fogging as for the radiographic processing.A qualidade da imagem radiográfica depende da correta indicação da técnica radiográfica, o tipo de filme utilizado, o tempo de exposição e o uso de soluções e locais de processamento adequados. O velamento radiográfico pode surgir em descuidos relacionados ao tempo de exposição, filmes deteriorados e através do processamento radiográfico. O objetivo do presente trabalho foi verificar as condições de exposição e processamento radiográficos quanto ao velamento. Os filmes foram expostos padronizadamente em um fantoma e, com a finalidade de avaliar o processamento radiográfico, foram processados nos consultórios odontológicos. Posteriormente, foram expostos filmes radiográficos usados, em rotina, pelos profissionais, em seus aparelhos de raios X com o tempo de exposição utilizado pelos mesmos. Após, estes filmes irradiados foram processados, padronizadamente, em uma processadora automática. Dessa maneira, pretendeu-se avaliar a exposição radiográfica. Após a obtenção das radiografias, foram feitas leituras das densidades ópticas (D.O.) na área de chumbo. Conclui-se que dos consultórios odontológicos avaliados, quase a metade das radiografias avaliadas apresentaram velamento quanto à exposição radiográfica e nenhuma apresentou velamento quanto ao processamento radiográfico