Comparative evaluation of four treatments for postorthodontic white spot lesions: a randomized controlled trial.

OBJECTIVES: To evaluate the treatment efficacy of fluoride toothpaste alone and those of adjunctive use of resin infiltration, sodium fluoride varnish, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on white spot lesions (WSLs). MATERIALS AND METHODS: Seventy-nine patients (356 teeth) with WSLs after orthodontic treatment were randomly allocated into four groups. The WSLs of the participants received resin infiltration only at baseline, and the other groups received fluoride varnish, CPP-ACP mousse, and placebo treatment every 6 months, respectively. A toothpaste containing 1400 ppm fluoride and toothbrushes were distributed to all participants, and oral hygiene instructions were provided. Photos of the teeth with WSL were taken to compare the change between groups which was measured by ImageJ software. RESULTS: Twelve months later, different degrees of reduction in the area of WSLs were observed in all groups. The percentage of lesion area reduction in WSLs in the resin infiltration group was 46.6%, which was significantly higher than that in fluoride varnish group (26.6%), CPP-ACP group (28.6%), and control group (29.8%), and the differences were statistically significant (p < 0.001). CONCLUSIONS: This study shows that after 1-year follow-up, the use of fluoride toothpaste, with or without the use of fluoride varnish or CPP-ACP, can reduce the area of WSLs. While resin infiltration can immediately improve dental aesthetics and continuously improved in 12 months, resin infiltration group showed much better results than other groups. TRIAL REGISTRATION: Clinical Trials Registration Number: ChiCTR2000032516. CLINICAL SIGNIFICANCE: The use of fluoride toothpaste, with or without adjunctive use of fluoride varnish and CPP-ACP, can reduce the area of WSLs, while resin infiltration treatment has additional effect and can immediately improve dental aesthetics.

User perceptions of COVID-19 telemedicine testing services, disease risk, and pandemic preparedness: findings from a private clinic in Hong Kong.

INTRODUCTION: During the coronavirus disease 2019 (COVID-19) pandemic, telemedicine has been regarded as a method for providing safe access to healthcare. Here, we explored the experiences of individuals using telemedicine in Hong Kong during the COVID-19 pandemic to understand their risk perceptions and preparedness measures. METHODS: We conducted a cross-sectional online survey of telemedicine users of private clinic-based COVID-19 testing services from 6 April to 11 May 2020. All users were invited to complete an anonymous online survey regarding COVID-19 risk perception and preparedness measures. The results of the survey were compared with the findings of a previous territory-wide survey. RESULTS: In total, 141 of 187 telemedicine users agreed to participate; the response rate was 75.4%. Of the participants, 95.1% (116/122) believed that telemedicine consultations were useful. Nearly half of the participants (49.0%) agreed or strongly agreed that telemedicine consultations were appropriate during the COVID-19 pandemic. Most participants believed that telemedicine consultations could perform the functions of 'health protection, promotion and disease prevention' (73.6%) and 'diagnosis' (64.0%). Concerning the choice of telemedicine provider, almost all participants (99.2%) were willing to consult medical doctors; more than half of the participants (54.1%) were willing to consult registered nurses, but only 13.1% were willing to consult non-clinical staff who had been trained to provide telemedicine services. CONCLUSION: The use of telemedicine for screening and patient education can be encouraged during the COVID-19 pandemic in Hong Kong.

Managing Carious Lesions: Consensus Recommendations on Terminology.

Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current words used in the literature for caries removal techniques, and 2) agreed terms and definitions, explaining how these were decided.Dental cariesis the name of the disease, and thecarious lesionis the consequence and manifestation of the disease-the signs or symptoms of the disease. The termdental caries managementshould be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereascarious lesion managementcontrols the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions' clinical manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1)selective removal of carious tissue-includingselective removal to soft dentineandselective removal to firm dentine; 2)stepwise removal-including stage 1,selective removal to soft dentine, and stage 2,selective removal to firm dentine6 to 12 mo later; and 3)nonselective removal to hard dentine-formerly known ascomplete caries removal(technique no longer recommended). Adoption of these terms, around managing dental caries and its sequelae, will facilitate improved understanding and communication among researchers and within dental educators and the wider clinical dentistry community.

Managing Carious Lesions: Consensus Recommendations on Carious Tissue Removal.

The International Caries Consensus Collaboration undertook a consensus process and here presents clinical recommendations for carious tissue removal and managing cavitated carious lesions, including restoration, based on texture of demineralized dentine. Dentists should manage the disease dental caries and control activity of existing cavitated lesions to preserve hard tissues and retain teeth long-term. Entering the restorative cycle should be avoided as far as possible. Controlling the disease in cavitated carious lesions should be attempted using methods which are aimed at biofilm removal or control first. Only when cavitated carious lesions either are noncleansable or can no longer be sealed are restorative interventions indicated. When a restoration is indicated, the priorities are as follows: preserving healthy and remineralizable tissue, achieving a restorative seal, maintaining pulpal health, and maximizing restoration success. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralized tissues close to the pulp do not need to be removed. In deeper lesions in teeth with sensible (vital) pulps, preserving pulpal health should be prioritized, while in shallow or moderately deep lesions, restoration longevity becomes more important. For teeth with shallow or moderately deep cavitated lesions, carious tissue removal is performed according toselective removal to firm dentine.In deep cavitated lesions in primary or permanent teeth,selective removal to soft dentineshould be performed, although in permanent teeth,stepwise removalis an option. The evidence and, therefore, these recommendations support less invasive carious lesion management, delaying entry to, and slowing down, the restorative cycle by preserving tooth tissue and retaining teeth long-term.

Restorative approaches to treat dentin caries in preschool children: systematic review.

AIM: Dental restorations have long been used for the management of early childhood caries, but there is a need to have an evidence based approach when selecting the most appropriate restorative intervention to treat dentin caries in preschool children. This systematic review aimed to assess the effectiveness of restorative treatments of dentin caries in primary teeth in preschool children. DESIGN: A systematic search of the main electronic databases (Pubmed, Cochrane Collaboration, EMBASE) was conducted to identify peer reviewed papers published in English in the years 1947-2014. Search keywords and MeSH headings were "dental caries", "primary dentition" and "dental restoration". The inclusion criteria were clinical studies conducted in children under 6 years old, and reported findings on the longevity or failure of restorations in primary teeth. Retrieved papers were read by two reviewers independently to assess suitability for inclusion, and the final decision was made by consensus. The quality of the included studies was assessed and data were extracted for analysis. RESULTS: The search identified 348 papers for screening. Among these, 218 papers did not satisfy the study inclusion criteria. Consequently, 130 full papers were retrieved and reviewed. Finally, 9 papers were included. Most of the trials were assessed as having high risk of bias. Five included studies that compared the success rates of restorations with different filling materials and liner materials. Two studies showed clinical advantages of using minimally invasive approaches in caries removal and cavity preparation. The other two trials showed low success rates of interim GI restorations done in a field setting, compared to the high caries arrest rates of silver diammine fluoride application. CONCLUSION: Within the limitation of this systematic review, there is insufficient evidence to make recommendations regarding which material and technique is the most appropriate for restorative treatment in young children. Minimally invasive approaches are advantageous in operative caries management in primary teeth in preschool children. More well-designed randomised controlled trials are required to confirm these findings.

Orofacial functional impairments among patients following stroke: a systematic review.

OBJECTIVES: The objective of this study was to review orofacial functional impairments among patients following stroke, including objective and subjective assessment. METHODS: A structured search strategy was applied to three electronic databases (Pubmed, Embase, and Web of Science) to identify effective papers. Relevant data regarding subjects, method, outcomes, and key findings were extracted from the effective papers and the results were summarized. RESULTS: The initial search yielded 5227 papers, and 18 effective papers (Kappa: 0.971) were in accordance with the inclusion criteria. The patients with stroke consistently showed a decreased lip force, salivary flow rate, and chewing performance compared with the healthy controls. Due to equivocal results gained from the effective papers, the qualitative assessments regarding whether there was any change in masticatory force on the affected side and oral health-related quality of life were inconclusive. CONCLUSIONS: Existing evidence highlights a number of compromised orofacial functions experienced by patients following stroke. These impairments appear to be sustained, with spontaneous recovery unlikely to occur. While rehabilitative approaches may have the potential to improve orofacial function and quality of life following stroke, there is currently a lack of evidence-based interventions available to inform the development of comprehensive rehabilitation protocols.

Silver diamine fluoride and education to prevent and arrest root caries among community-dwelling elders.

BACKGROUND/AIMS: Root caries among elderly communities is of growing public health concern globally. This controlled clinical trial investigated the effectiveness of silver diamine fluoride and oral health education in preventing and arresting root caries. METHODS: Two hundred sixty-six elderly subjects who had at least 5 teeth with exposed root surfaces and did not have serious life-threatening medical diseases were allocated to 3 groups according to a computer-generated random list: group 1 (the control group) received oral hygiene instructions (OHI) annually; group 2 received OHI and silver diamine fluoride (SDF) application annually, and group 3 was given OHI and SDF application annually, plus an oral health education (OHE) programme every 6 months. RESULTS: Two hundred twenty-seven elderly subjects were followed for 24 months. The mean numbers of new root caries surfaces in groups 1, 2 and 3 were 1.33, 1.00 and 0.70, respectively (ANOVA, p < 0.05). Group 3 had fewer root surfaces with new caries than group 1 (Scheffé multiple-comparison test, p < 0.05). The mean numbers of arrested root caries surfaces in groups 1, 2 and 3 were 0.04, 0.28 and 0.33, respectively (ANOVA, p < 0.01). Group 3 and group 2 had a greater number of active root caries surfaces which became arrested than group 1 (Scheffé multiple-comparison test, p < 0.05). CONCLUSION: Annual application of SDF together with biannual OHE was effective in preventing new root caries and arresting root caries among community-dwelling elderly subjects.

Oral health and dental care in Hong Kong.

Hong Kong, a Special Administrative Region of People's Republic of China, is a metropolitan city in Asia with a population of over 7 million people. This paper reflects the current oral health and dental care situations in Hong Kong. Water fluoridation was commenced in 1961, with a current level at 0.5 ppm. And there has continuously been lower caries prevalence thereafter. Dental care is mainly provided by private practitioners. The School Dental Care Service, run by the Department of Health, provides dental care to enrolled primary school children through treatments by dental therapists. An Oral Health Education Unit is set up to promote dental health among the public, particularly preschool children. Government dentists serve mainly civil servants and their dependents. Limited emergency dental care is available to the public at designated government clinics for pain relief, most commonly in the form of extractions. There are about 2200 registered dentists and the dentist to population ratio is about 1:3200. Amongst the dental team, dental hygienists are trained in limited numbers. There are only less than 320 dental hygienists registered, working under the supervision of dentists. The Faculty of Dentistry of the University of Hong Kong has been providing 5-year undergraduate training in dentistry since 1981, and this is lengthened to 6 years from 2012 onwards. Specialty training requires at least a further 6 years. There are 8 specialties, which are Community Dentistry, Endodontics, Family Dentistry, Oral & Maxillofacial Surgery, Oral Rehabilitation, Orthodontics, Pediatric Dentistry, and Periodontics.

Journal-based learning, a new learning experience building on PBL at HKU.

OBJECTIVE: To evaluate the effectiveness of a new journal-based learning (JBL) programme designed to equip students with skills necessary to understand dental research publications, thereby preparing them for continuing professional development. MATERIALS AND METHODS: A baseline evaluation of knowledge relating to key research terms was conducted on 52 final-year BDS students. 11 weekly seminars were conducted from 8 clinical disciplines driven by a reading list of 2-5 journal articles along with a series of 'guidance' questions relating to research terms and content knowledge aspects of each paper to focus their reading and learning. Seminars were facilitated by discipline experts with supporting notes. An exit test based on research process and terminologies for the programme was conducted with 4 repeated questions from the baseline assessment. A systematic marking scheme was used and the results analysed. A focus group was run to collect feedback regarding students' views and experiences on the JBL experience. FINDINGS: Students showed significant improvements over the baseline score. The mean score rose from 3.5 to 11.5 in the repeated questions (P < 0.001). The focus group revealed that students had learnt new information about journal classification, evidence level determination, new research terms and the structure of research papers. From the first 4 years of PBL, students recognized the importance of learning from research papers since year 1. However, JBL gave them a deeper understanding of research and the development of critical appraisal skills. IMPLICATIONS: JBL provided final-year students the opportunity to learn significantly more about dental research, terminologies, paper structure, critical analysis and content knowledge through active-learning small group seminars.

The contribution of life course determinants to early childhood caries: a 2-year cohort study.

BACKGROUND: Early childhood caries (ECC) is a serious problem in China. There are few data available on the risk factors contributing to ECC in children under the age of 3 years. In this study we investigate the risk factors for ECC in the life course of a cohort of 8-month-old children. METHODS: A total of 225 children aged 8 months were recruited from a rural community in the city of Guangzhou in southern China. Information was collected at baseline and once every 6 months. The questionnaire was designed to collect socioeconomic and behavioural information. Dental caries was recorded by surface and oral hygiene was assessed using the visible plaque index. The presence of Streptococcus mutans (S. mutans) in dental plaque was determined using microbiological tests. The incidence density of ECC was calculated and generalised estimating equation analysis was performed to identify the risk factors. RESULTS: The incidence density among 8 to 14-, 14 to 20-, 20 to 26- and 26 to 32-month-old children was found to be 0, 0.02 ± 0.19, 0.05 ± 0.26 and 0.20 ± 0.59 (surfaces/100 surface-months), respectively. Multivariable analysis showed that mothers who had a low level of education, families with higher monthly income, enamel hypoplasia of the teeth, lower than average height, a high proportion of visible plaque, and the presence of S. mutans were risk predictors for ECC of the children. CONCLUSIONS: There appears to be a relationship between socioeconomic, behavioural and biological factors and ECC. Early life factors play an important role in the development of ECC.

Caries increment over 2 years in preschool children: a life course approach.

BACKGROUND: Longitudinal study to investigate how the dental caries in primary teeth progress with increasing age is still lacking. Aims. To describe the development of new caries over 2years and to identify risk factors that can predict new caries development. DESIGN: A random sample of preschool children aged 3-4years was surveyed and followed up when they reached 5-6years of age in Hong Kong. Dental caries status was assessed using the dmft index. Negative binomial regression was performed to investigate the factors collected at baseline that could predict the caries increment over 2years. RESULTS: Totally 358 children attended both examinations. The mean caries increment over 2years was 0.9. Results of the negative binomial regression showed that children who used nursing bottles during sleep when they were young (P=0.013), whose toothbrushing began after 12months (P=0.005), who took snack once or more daily (P<0.001), and whose parents had 9 or fewer years of education attainment (P=0.002) had significantly higher caries increment. CONCLUSIONS: New caries development of Hong Kong preschool children was low. Children's feeding, snaking and brushing habits, and parents' education attainment were the significant predictors for new caries development of preschool children.

Use of professionally administered topical fluorides in Asia.

Professionally applied topical fluoride varnish, gel, and solution have been shown to be effective in preventing and in arresting dental caries. Their use in different countries in Asia varies greatly and may not correlate with the dental caries situation of the populations in the countries. In the higher-income countries, use of fluoride varnish and gel is common among dental professionals. In contrast, the use of professionally administered topical fluorides is not common in the lower-income countries. Fluoride varnish, being easy to apply and safe, has been the preferred agent for the prevention of early childhood caries, which is prevalent in many developing countries in Asia. The relatively high cost of professionally administered fluoride agents and the shortage of a dental workforce, especially in lower income countries, have hampered the widespread adoption of these effective caries prevention methods in the private and public dental services. Government health policies should be pursued to lower the cost of treatment, either through incentives for local production and/or elimination of taxes and tariffs on imported fluoride products.

A Systematic Review and Meta-analysis of the Effect of Oral Exercises on Masticatory Function.

The aim of the current systematic review was to summarize and to evaluate the available information on the effectiveness of oral exercise in improving the masticatory function of people ≥18 y. Electronic databases (Medline, Embase, CENTRAL) and gray literatures were searched (up to December 2020) for relevant randomized and nonrandomized controlled clinical trials. Two reviewers independently conducted the study selection, data extraction, and quality assessments. Meta-analysis was conducted for the comparison of bite force and masticatory performance using mean difference (MD) and standardized mean difference (SMD), respectively. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) assessment was adopted for collective grading of the overall body of evidence. Of the 1,576 records identified, 18 studies (21 articles) were included in the analysis. Results of meta-analysis indicated that oral exercise could significantly improve the mean bite force of the participants (parallel comparison: MD, 41.2; 95% CI, 11.6-70.7, P = 0.006; longitudinal comparison: MD, 126.5; 95% CI, 105.2-144.9, P < 0.001). However, the improvement in masticatory performance was not significant (parallel comparison: SMD, 0.11; 95% CI, -0.20 to 0.42, P = 0.48; longitudinal comparison: SMD, 0.4; 95% CI, -0.11 to 0.91, P = 0.13). Results of meta-regression showed that greater improvements in bite force can be achieved among younger adults and with more intensive exercise. Chewing exercise is the most effective oral exercise, followed by clenching exercise, while simple oral exercise may not have a significant effect. Based on the results of the meta-analysis and GRADE assessment, a weak recommendation for people with declined masticatory function to practice oral exercise is made.

Effectiveness of Family-Centered Oral Health Promotion on Toddler Oral Health in Hong Kong.

Early childhood caries is common in Hong Kong, and parental practices on maintaining good oral health of their young children are far from satisfactory. This article reports on the effectiveness of a randomized controlled trial on family-centered oral health promotion to new parents in establishing proper feeding habits and oral hygiene practices and in reducing caries risk among 3-y-old toddlers. At baseline, pregnant mothers and their husbands were recruited and randomly allocated into 2 groups. The test group received individualized oral health education (OHE) via a behavioral and educational counseling approach while the control group received the OHE pamphlets only. Information related to the feeding habits, oral hygiene practices, and oral health of the toddlers was collected by parent-completed questionnaires and oral examination annually via home visits. A total of 580 families were recruited at baseline, and 436 toddlers were followed up when they reached 3 y old (test, n = 228; control, n = 208; follow-up rate, 75.2%). The proportions of toddlers who held food in the mouth, fell asleep when milk feeding, had prolonged use of the nursing bottle, ate before bed, and consumed a sweet snack daily were significantly lower in the test group than in the control group (all P < 0.05). Significantly higher proportions of toddlers brushed their own teeth twice daily, were brushed by their parents twice daily, and used fluoride toothpaste than in the control group (all P < 0.001). Toddlers in the test group had better oral health status with a lower level of visible plaque, Streptococcus mutans, white spot lesion, and cavitated lesion (all P < 0.05). Family-centered oral health promotion and individualized OHE for parents via a behavioral and educational counseling approach are more effective in establishing good feeding habits and parental toothbrushing practices and in decreasing the caries risk of their toddlers than the distribution of OHE pamphlets alone (ClinicalTrials.gov NCT02937194).

Painful stimulation suppresses joint inflammation by inducing shedding of L-selectin from neutrophils.

Although the inflammatory response is essential for protecting tissues from injury and infection, unrestrained inflammation can cause chronic inflammatory diseases such as arthritis, colitis and asthma. Physiological mechanisms that downregulate inflammation are poorly understood. Potent control might be achieved by regulating early stages in the inflammatory response, such as accumulation of neutrophils at the site of injury, where these cells release chemical mediators that promote inflammatory processes including plasma extravasation, bacteriocide and proteolysis. To access an inflammatory site, neutrophils must first adhere to the vascular endothelium in a process mediated in part by the leukocyte adhesion molecule L-selectin. This adhesion is prevented when L-selectin is shed from the neutrophil membrane. Although shedding of L-selectin is recognized as a potentially important mechanism for regulating neutrophils, its physiological function has not been demonstrated. Shedding of L-selectin may mediate endogenous downregulation of inflammation by limiting neutrophil accumulation at inflammatory sites. Here we show that activation of nociceptive neurons induces shedding of L-selectin from circulating neutrophils in vivo and that this shedding suppresses an ongoing inflammatory response by inhibiting neutrophil accumulation. These findings indicate a previously unknown mechanism for endogenous feedback control of inflammation. Failure of this mechanism could contribute to the etiology of chronic inflammatory disease.

Oral health-related quality of life in Hong Kong preschool children.

OBJECTIVES: To assess the impact of early childhood caries (ECC) on the quality of life in a population of preschool children and their families in Hong Kong. METHODS: A random sample of 1,296 Chinese preschool children participated in the survey and were subjected to an oral examination for their ECC status by 2 trained examiners. The parents were asked to respond to the Early Childhood Oral Health Impact Scale (ECOHIS) and an extra set of questions concerning their sociodemographic background. RESULTS: The final data analysis included 1,261 children with a mean (±SD) age of 3.9 ± 0.66 years. The prevalence figures for ECC and severe ECC were 19.9 and 15.2%, respectively. Decayed teeth were found in 34.3% of the children while only 5.2% had filled teeth. The mean (±SD) dmft in this group of children was 1.5 ± 2.98. Higher ECOHIS scores were found in parents with lower education or income level, or with children who were born in mainland China (p < 0.05), or with children who had decayed, missing, or filled teeth (p < 0.001). In multiple regression analyses, decayed teeth and filled teeth in primary dentition were the better predictors (p < 0.001) of the ECOHIS score among the various parent and child characteristics collected in this survey. CONCLUSIONS: The findings of this study showed that parents of young children with dental caries experience perceived that both the children and other family members had poorer quality of life.

Clinical and socio-demographic factors influencing the oral health-related quality of life of Chinese elders.

OBJECTIVES: The objective of this study was to explore the clinical and socio-demographic factors influencing oral health-related quality of life (OHRQoL) of the Chinese elderly. METHODS: Two urban districts in Binzhou, Shandong Province, Eastern China were selected and 300 elders aged 60-80 years were recruited. The study subjects completed a structured questionnaire in an interview and underwent a clinical examination. The questionnaire included questions on socio-economic information and a Putonghua version of the General Oral Health Assessment Index (GOHAI) which had been validated for use in Chinese elders to evaluate their OHRQoL. Clinical examination was performed using the criteria recommended by the World Health Organization. Tooth status, periodontal health status, loss of attachment (LOA), and number of occluding tooth pairs were recorded. Duplicate examinations were conducted on 10% of the subjects. RESULTS: The mean GOHAI score of the subjects was 46.0 (SD 8.5). Result of an ANCOVA showed that subjects who were older, had no root caries, had no tooth with LOA > or = 6mm, or had more occluding pairs had higher GOHAI scores indicating better OHRQoL. CONCLUSION: The OHRQoL of the study elders was fair and was influenced by age and a number of clinical factors. With limited resources and dental manpower in China, higher priority should be given to the elders who are relatively younger, who have or are at high risk of developing root caries and advanced periodontal diseases, and who have few occluding tooth pairs.

Topographical distribution and radiographic pattern of lung lesions in canine eosinophilic bronchopneumopathy.

OBJECTIVES: To evaluate the radiographic lung pattern and topographical distribution in canine eosinophilic bronchopneumopathy. MATERIALS AND METHODS: Medical records were retrospectively reviewed for dogs diagnosed with eosinophilic bronchopneumopathy. Lateral thoracic radiographs were examined for the presence of increased radiopacity, classification of pattern, topography of lung changes (cranioventral, perihilar, caudodorsal, caudoventral) and severity of pulmonary lesions. RESULTS: Forty-four cases were identified with the Labrador retriever being the most commonly affected breed; there was a mean age of 5 years and an equal gender distribution. Coughing was the most common clinical sign. Circulating eosinophilia was present in 39% of dogs, with a mean peripheral eosinophilia of 5.1×109 cells/L and a mean bronchoalveolar lavage fluid eosinophilia of 40%. Eighty percent of dogs had an abnormal lung pattern in at least one of the four lung fields; the remaining had normal thoracic radiographs. The most common patterns were a bronchial and a bronchointerstitial pattern, with 41 and 89% distribution to the caudodorsal lung field, respectively. CLINICAL SIGNIFICANCE: A bronchial and bronchointerstitial pattern are the most common radiographic lung patterns seen in canine eosinophilic bronchopneumopathy with these patterns most frequently topographically distributed to at least the caudodorsal lung field. Furthermore, within the caudodorsal lung field, a bronchointerstitial pattern predominates. This radiographic and topographical finding may allow eosinophilic bronchopneumopathy to take precedence on a differential diagnoses list before confirmatory bronchoalveolar lavage fluid sampling.