Computed tomography assessment of maxillary sinus hypoplasia and associated anatomical variations: a systematic review and meta-analysis of global evidence.

OBJECTIVE: To summarize the scientific evidence on the prevalence of maxillary sinus hypoplasia (MSH) and associated anatomical variations as assessed by computed tomography scans. STUDY DESIGN: This PROSPERO-registered systematic review followed the recommendations of the PRISMA guidelines. Search algorithms were constructed for each of the six databases and gray literature. After screening the references (Rayyan®), the extracted data were meta-analyzed according to a random-effects model. The joanna briggs critical appraisal tool assessed the methodological quality of the included studies. The GRADE approach was used to estimate the certainty of the evidence. RESULTS: From a total of 2781 studies screened, 22 were considered for four meta-analysis. The prevalence of MSH in 7358 patients was 5.65% (CI95% = 4.07-7.47%) with significant heterogeneity between studies (p < 0.001, I2 = 89.30%). MSH was identified in 295 patients, of whom 82.38% (CI95% = 75.82-88.09%) had unilateral hypoplasia and 17.62% (CI95% = 11.91-24.18%) bilateral hypoplasia with moderate heterogeneity between studies (p < 0.0503, I2 = 42.87%). The prevalence of MSH in 9998 maxillary sinuses was 3.77% (95% CI = 2.44-5.38%), with significant heterogeneity between studies (p < 0.001, I2 = 92.84%). Hypoplastic/aplastic uncinate process, concha bullosa and paradoxical concha were the most reported anatomical variations. The studies presented a low-moderate methodological quality. The certainty of the evidence was very low to moderate. CONCLUSION: The prevalence of maxillary sinus hypoplasia observed was 5.65%, with most cases being unilateral.

Mandibular assessment of panoramic radiographs for sex identification / Análise do dimorfismo sexual através de índices radiomorfométricos em radiografias panorâmicas

ABSTRACT Sex determination plays a crucial role in the post-mortem identification of human remains. One effective approach for obtaining sex-related data is to use measurements of anatomical structures such as the mandible. This study aimed to evaluate the potential of mandibular radiomorphometric indices from panoramic radiographs (PRs) for the identification of sexual dimorphism. The study sample included 300 PRs of individuals aged 51 to 80 years from the northeastern region of Brazil. Four linear measures and three numerical indices were analyzed with Inkscape® version 1.0.1 for Windows by two blinded evaluators. After statistical analysis, the results showed that the linear measurements obtained from PRs are a reliable method for sex identification. However, the calculated indices of these measurements exhibited lower efficacy for the same purpose. Therefore, PRs proved to be a valuable method for sexual identification through mandibular assessment.

RESUMO A determinação do sexo é um dado importante para a identificação post-mortem de um indivíduo ou de restos mortais humanos. Uma maneira de adquirir dados quanto ao sexo é utilizar mensurações de estruturas como a mandíbula. O objetivo principal deste estudo é avaliar a utilização de índices radiomorfométricos de mandíbulas para a identificação de dimorfismo sexual, através de radiografias panorâmicas. O estudo foi realizado em exames radiográficos panorâmicos de 300 indivíduos entre 51 e 80 anos, residentes do Nordeste brasileiro. Foram analisadas quatro medidas lineares e três índices numéricos no software Inkscape® versão 1.0.1 para Windows, por dois avaliadores cegos. Após análise estatística, os resultados demostraram que as medidas lineares obtidas se configuram como um método seguro para a identificação sexual. Entretanto, os índices obtidos através destas medidas demostraram menor eficiência para o mesmo fim. Logo, as radiografias panorâmicas podem ser utilizadas como método eficaz para a obtenção da caracterização sexual através da mandíbula.

Radiomorphometric indices for sex estimation in edentulous individuals: A receiver operating characteristic curve and discriminant function analysis-based study.

This study aimed to evaluate sexual dimorphism in Brazilian edentulous individuals using a formula based on mandible-related linear radiomorphometric measurements. A cross-sectional observational study was conducted with 390 panoramic radiographs (PRs) distributed into three age groups (51-60, 61-70, and 71-80 years). PRs were used to obtain linear measurements of the mandible and derived indices (superior and inferior panoramic mandibular indices [s-PMI and i-PMI, respectively], alveolar bone resorption [ABR] index), and the mandibular cortical index (MCI). Sex-related differences (and sex classifications) increased in the oldest cohort. Both s-PMI and i-PMI were shown to be significant in predicting sex in the age group from 71 to 80 years (p = 0.001 and p = 0.003, respectively) and, when considering the mean of the sides, only the s-PMI was significant (p = 0.037). The ABR index was significantly associated with sex (p = 0.004) and not influenced by MCI, and was used to construct a formula for sex estimation, which demonstrated 69.0% accuracy in the age group of 71-80 years. Sexual dimorphism was evidenced by the formula based on the s-PMI, i-PMI, and ABR indices.

An analysis of third molar mineralization in Brazilian patients with cleft lip and palate.

Purpose: This study investigated the third molar mineralization in patients with cleft lip and palate.Materials and methods: From a total of 253 digital panoramic radiographs from patients with cleft lip and palate within the age range of 7-21 years, 97 radiographs were selected (cleft group). A control group was formed from same sex individuals, without malformation and chronological age matched within 30 days. The analysis of third molar mineralization was carried out by three calibrated examiners using Demirjian's and Nolla's methods. McNemar and Wilcoxon test for paired samples were used for pairwise comparisons between the groups. The Likelihood Ratio test was used to check for an association between the type of cleft and tooth calcification.Results: In both methods, the mineralization means were smaller in the case group than in the control, with significant differences for all third molars (p < .05). The type of cleft affected dental mineralization. There was no significant difference when comparing the left or right sides, but maxillary molars showed earlier mineralization.Conclusions: A significant delay in third molar mineralization was observed in patients with cleft lip and palate according to Demirjian's and Nolla's methods.

Avaliação da adequação de aparelhos de raios-x intraorais à portaria 453/1998 da secretaria de vigilância sanitária / Assessment of the adequacy of intraoral x-ray equipment to the ordinance 453/ 1998 of the health surveillance secretariat

Introdução: No Brasil, a Portaria 453/98 da Secretaria de Vigilância Sanitária estabelece um conjunto de diretrizes para que os serviços de radiologia trabalhem com segurança equalidade, o que requer o atendimento de uma série de itens relacionados aos equipamentos de raios-X. Objetivo: Avaliar as condições dos aparelhos de raios-X dos consultórios odontológicos de Patos-PB, no que se refere à segurança daqueles que o utilizam segundo a Portaria. Materiais e métodos: Dos 43 consultórios odontológicos visitados, 35aceitaram participar da pesquisa. Realizou-se a inspeçãovisual dos aparelhos de raios-X e entrevista. Foram observados itens como: fabricante, modelo, tensão; presença de seletorde tempo digital; formato e comprimento do localizador;presença de filtro e equivalência de alumínio adequada;existência do botão retardo; tamanho do fio que liga o painelde controle ao aparelho; tempo médio de exposição; existênciade procedimentos de monitoração periódicos e de programasde garantia de qualidade. Resultados: Foram observadas anormalidades em vários consultórios, como a persistência dobotão retardo (31,5%), e do seletor de tempo do tipo mecânico(34,3%). Os itens mais frequentemente encontrados em acordocom a legislação foram o comprimento do fio do controle e oformato do localizador. Notou-se também o desconhecimento da necessidade de calibração periódica do aparelho.Conclusão: Foram observadas muitas falhas na adoção das exigências da Portaria, podendo estar relacionadas com afalta de conscientização, por parte dos profissionais, dos efeitos deletérios das radiações ionizantes. Assim, tornam-senecessários uma maior fiscalização e esclarecimentos aos cirurgiões-dentistas a respeito da legislação vigente.

Introduction: In Brazil, the Ordinance 453/98 of the Health Surveillance Secretariat establishes a set of guidelines forradiology services to work with safety and quality, whichrequires the attendance of a number of items related to Xrayequipment. Objective: To evaluate the conditions of Xraymachines in dental offices in the city of Patos, PB, withregard to the safety of users according to the Ordinance. Materials and Methods: Of the 43 dental offices visited, 35agreed to participate. A visual inspection of the X-ray machine and an interview were carried out. The following information was collected: manufacturer, model, tension; presence ofdigital time selector; format and length of the locator; presenceof suitable filter and aluminum equivalence; existence of thedelay button; size of the wire which connects the controlpanel to the machine; mean duration of exposure; existenceof periodic monitoring procedures and quality assuranceprograms. Results: Some abnormalities were observed invarious offices, such as the persistence of the delay button(31.5%), and mechanical time selector (34.3%). The items most frequently found to comply with the law were the controlwire length and the locator format. We also observedunawareness of the need for periodic instrument calibration.Conclusion: Many failures were observed to adopt ther equirements of the Ordinance, which may be related to thelack of awareness by the professionals about the deleterious effects of ionizing radiation. Thus, it becomes necessary toperform more inspections of the offices as well as providedentists with clarifications about the law.

Análise radiográfica e tomográfica da íntima relação dos terceiros molares inferiores com o canal mandibular / Radiographic and tomographic analysis of the relationship between inferior third molars and the mandibular canal

Objetivo: Avaliar a íntima relação entre os terceiros molares inferiores impactados e o canal mandibular, em imagens panorâmicas e de tomografia computadorizada de feixe cônico. Métodos: O universo foi constituído por 432 tomografias computadorizadas de feixe cônico (TCFC) e 713 radiografias panorâmicas. Obteve-se uma amostra de 13 pares de exames (radiografia panorâmica e TCFC), totalizando 20 dentes de pacientes atendidos em um serviço de radiologia odontológica particular da cidade de Patos - PB. Foram realizadas análises dos exames por dois avaliadores em dois momentos. As radiografias panorâmicas foram analisadas segundo as classificações de Winter, Félez-Gutiérrez e Koong. A TCFC foi considerada padrão-ouro para a avaliação. Os dados foram analisados de forma descritiva, utilizando o programa Microsoft Excel 2013, por meio de gráficos, tabelas e porcentagens. Resultados: Segundo a classificação de Winter, o posicionamento mais frequente dos terceiros molares inferiores foi o mesioangulado, os sinais radiográficos mais prevalentes foram o estreitamento do canal e ápices em ilha na classificação de Félez-Gutiérrez, e na classificação de Koong os sinais de estreitamento do canal e ápices superpostos foram os mais frequentes. Nas tomografias, o relacionamento mais frequente foi o canal passando inferiormente aos terceiros molares. Na comparação dos sinais radiográficos com o padrão-ouro, houve 45% de falso-positivos, tanto na classificação de FélezGutiérrez como na de Koong. Conclusão: A TCFC é o exame de escolha para o planejamento cirúrgico, nos casos onde há íntimo contato entre os terceiros molares inferiores com o canal mandibular

Objetctive: This research aimed to evaluate the intimate relationship between impacted lower third molars and the mandibular canal in panoramic images and cone beam computed tomography (CBCT). Methods: The sample consisted of 432 CBCTs and 713 panoramic radiographs. A sample of 13 pairs of exams (panoramic radiography and CBTC) were obtained, totaling 20 teeth from patients who received dental care at a private radiology unit in the city of Patos, PB, Brazil. Two different examiners carried out the analysis in two distinct moments. The panoramic radiographs were analyzed according to Winter, Félez-Gutierrez, and Koong classifications. The CBTC was considered the gold standard for the evaluation. Data were analyzed descriptively by using the Microsoft Excel 2013 program, through graphs, charts, and percentages. Results: According to the Winter classification, the most frequent position of the lower third molars was Mesio Angular. The most prevalent radiographic signs were narrowed channel and islet-shaped apex in the Félez-Gutiérrez classification, while in the Koong classification, the signs of narrowed channel and superimposed apexes were the most frequent. In the CBCT scans, the most frequent relationship was the channel passing below the third molars. In the comparison of the radiographic signs with the gold standard, 45% of false positives were found in both the Félez-Gutiérrez and Koong classifications. Conclusion: The CBTC is the best choice for the surgical plan, especially in the cases in which there is intimate contact between the lower third molars and the mandibular canal