Ameloblastoma Differential Radiographic Findings in Children and Adolescents

ABSTRACT: The aim of this research was to investigate the radiographic, clinical, and histological features of cases of ameloblastoma from a period of 17 years in a Brazilian center and to explore potential differences in children and adolescen ts in relation to adults. Seventy-five patients diagnosed with ameloblastoma from 2001 to 2018 were included. Data from each patient including gender, age, histologic type, location, and radiographic characteristics were reviewed and analyzed retrospectively. The association between the clinical, radiographic, and histologic findings was investigated. No differences regarding the histological pattern of the lesions were observed between groups. Children and adolescents presented well- defined lesions associated with an unerupted tooth compared to adults (p<0.05). The presence of an unerupted tooth was associated with cortical erosion and expansion and MC displacement (p<0.05). Despite similar histologic characteristics, differential radiographic appearance was observed between young patients and adults.

RESUMEN: El objetivo de este trabajo fue investigar las características radiográficas, clínicas e histológicas de casos de ameloblastoma en un período de 17 años, en un centro brasileño y explorar las posibles diferencias en niños y adolescentes en relación con los adultos. Se incluyeron 75 pacientes diagnosticados con ameloblastoma desde 2001 hasta 2018. Los datos de cada paciente, incluyendo el sexo, la edad, el tipo histológico, la ubicación y las características radiográficas, se revisaron y analizaron retrospectivamente. Se investigó la asociación entre los hallazgos clínicos, radiográficos e histológicos. No se observaron diferencias en cuanto al patrón histológico de las lesiones entre los grupos. Los niños y adolescentes presentaron lesiones bien definidas asociadas a un diente no erupcionado en comparación con los adultos (p<0,05). La presencia de un diente no erupcionado se asoció con erosión y expansión cortical y desplazamiento de MC (p<0,05). A pesar de las características histológicas similares, se observó una apariencia radiográfica diferente entre pacientes jóvenes y adultos.

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.

Root Canal Shape of Human Permanent Teeth Determined by New Cone-Beam Computed Tomographic Software.

INTRODUCTION: The purpose of this study was to determine root canal cross-sectional shapes (RCCSSs) of human permanent teeth using new cone-beam computed tomographic (CBCT) software. METHODS: RCCSS was determined on CBCT scans of 1400 teeth (422 patients) as follows: (1) circular, (2) conical/pyramidal, (3) oval/long oval, (4) flat/ribbonlike, (5) 8 shaped, (6) C shaped, (7) calcified, (8) trapezoidal, (9) drop shaped, and (10) other shapes. Root canal shapes were evaluated in the coronal and middle thirds, 2 mm below their beginning, and in the apical third, 1 and 2 mm short of the apical foramen. Categoric variables were described as frequencies and percentages and analyzed using the chi-square test. The level of significance was set at P = .05. RESULTS: Maxillary anterior teeth and maxillary first and second premolars had a circular RCCSS at 1 and 2 mm from the apical foramen in more than 45% of the cases. The most frequent RCCSS in the buccal canal of maxillary first premolars at 1 mm from the apical foramen was circular (71%) followed by flat/ribbonlike (10%) and oval/long oval (6%). In mesiobuccal roots of maxillary and mandibular first molars at 1 mm from the apical foramen, the circular shape was found in 52% and 49%, respectively. CONCLUSIONS: The RCCSSs in human permanent teeth are variable according to the tooth group and root thirds. The highest frequency of the circular-shaped canal at 1 and 2 mm from the apical foramen was found in maxillary central incisors and mandibular first and second premolars. Oval-shaped canals were detected in practically all tooth groups and root thirds.

Association between the Anatomy of the Mandibular Canal and Facial Types: A Cone-Beam Computed Tomography Analysis.

We evaluated the anatomical variations of the mandibular canal associated with various facial types, age, sex, and side of the face studied. We analyzed 348 hemimandibles in subjects without a history of trauma, lesions in the lower arch, or orthognathic or repair surgery in the posterior mandible. Facial type was determined using the VERT index. The canal path was classified as Type 1 (a large, single structure passing very close to the root tips); Type 2 (a canal passing closest to the mandibular base); and Type 3 (a canal present in the posterior mandibular region, with a lower canal running through the mandibular branch, reaching the anterior region). Bifid canals (type 3) were classified into four categories according to the course and number of mandibular canals. The brachyfacial and mesofacial types presented a Type 1 canal in 95.5% (n=166) of subjects, in dolichofacial types, 68.2% (n=45) presented a Type 2 canal, while in the mesofacial type, a lower prevalence of the bifid mandibular canal was observed (13.0%, n=23) than in the other facial types. The bifid canal showed significant association with facial type only (p < 0.05), but no significant association was observed with the anterior loop type (p > 0.05). Facial type is significantly associated with the path and morphological variations of the mandibular canal, independently of the side of the face studied, age, and sex.

Unusual Case of Graphite Tattoo in a Pediatric Patient: Clinical Presentation and Differential Diagnosis.

Graphite tattoo, a rare finding in children, is characterized by a localized blue-grey macule of variable sizes and shapes. Intraoral graphite implantation may cause this pigmentation through accidental injury with a graphite pencil. The purpose of this paper is to report an unusual case of graphite tattoo involving the anterior palate region in a seven-year-old girl. A diagnosis was made based on clinical and radiographic examinations and histopathology features. This report also highlights the importance of differential diagnosis and management of oral benign and malignant pigmented lesions in children.

Prevalence of oral lesions in hospitalized patients with infectious diseases in northern Brazil.

The aim of this study was to assess the prevalence of oral lesions in infectious-contagious diseases patients being treated in the University Hospital of the Federal University of Pará, northern Brazil. One hundred seven patients with infectious diseases were clinically investigated for oral lesions at the University Hospital of Pará, northern Brazil. From total sample, most patients were men (65.7%) with a mean age of 45.4 years. About prevalence of systemic diseases, tuberculosis was the most frequent illness, followed by AIDS, hepatitis types B and C, leishmaniasis, and meningitis. Analyzing oral manifestations, periodontal diseases and candidiasis were the most prevalent diseases in both genders, followed by recurrent aphthous ulcers, saburral tongue, simplex herpes, and squamous cell carcinoma. Of all 107 patients, only 10 males and 6 females did not present any oral manifestation. There was no statistical difference between genders with any systemic condition (P>0.05). The great prevalence of oral manifestations in hospitalized patients with systemic disorder emphasizes the need of integral dental care in this context, aiming at a multidisciplinary approach of patients. Therefore, presence of some oral conditions, such as candidiasis, should be an alert to different systemic conditions, once in assistance with physicians; dentists can influence the early diagnosis and treatment.