RESUMO
The longitudinal course of temporomandibular joint (TMJ) disc displacement (DD) and degenerative joint disease (DJD) has never been conclusively described with magnetic resonance imaging and computed tomography, respectively. This 8-y observational study's objective was to assess the longitudinal stability of DD and DJD among 401 subjects. The Validation Project provided baseline measures; follow-up was performed in the TMJ Impact Project. With magnetic resonance imaging, 2 radiologists rendered a consensus diagnosis of normal/indeterminate, DD with reduction, or DD without reduction. Computed tomography consensus diagnoses included normal/indeterminate, grade 1 DJD, or grade 2 DJD. Radiologist reliability was assessed by kappa; a Hui-Walter model was used to estimate, after accounting for diagnostic disagreement, the frequency of diagnostic progression and reversal. Permutation tests were used to test the statistical influence of concurrent baseline diagnoses on diagnostic changes at follow-up. Of 789 baseline joint-specific soft tissue diagnoses of DD, 598 (76%) joints showed no change; 109 (14%) demonstrated progression; and 82 (10%) had reversal. Of 794 joints with baseline joint-specific hard tissue diagnoses of DJD, progression was observed in 122 (15%) joints, no change in 564 (71%), and reversal in 108 (14%). Radiologist reliability (kappa) was 0.73 (95% CI, 0.64 to 0.83) for DD and 0.76 (95% CI, 0.68 to 0.83) for DJD. After accounting for the influence of diagnostic disagreement, progression of hard tissue diagnoses in the right TMJ occurred in 15.2% of subjects (95% CI, 10.5% to 20.8%) and reversal in 8.3% (95% CI, 4.9% to 12.3%); results were similar for soft tissue diagnoses and the left TMJ. Concurrent baseline soft tissue diagnoses were associated with hard tissue diagnostic changes at follow-up ( P < 0.0001). Baseline hard tissue diagnoses showed no statistical association with soft tissue changes at follow-up ( P = 0.11). Longitudinally, 76% of baseline TMJ soft tissue diagnoses and 71% of the baseline hard tissue diagnoses remained stable. Diagnostic reversal and progression were confirmed for both soft and hard tissues.
Assuntos
Imageamento por Ressonância Magnética , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/fisiopatologia , Tomografia Computadorizada por Raios X , Progressão da Doença , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Estados UnidosRESUMO
OBJECTIVES: Research diagnostic criteria for temporomandibular disorders (RDC/TMDs) were proposed in 1992 with the aim of standardizing and testing methods for diagnosing TMDs. RDC/TMDs have so far been lacking standardized methods for imaging and criteria for imaging diagnosis of disorders of the temporomandibular joint (TMJ). Criteria for disorders of the TMJ have recently been proposed for MRI. The aim of this study was to publish MR images of the TMJ on the web and to test the agreement of five observers using the criteria. METHODS: 20 cases of MRI of the TMJ were published on the web together with the criteria. The MR images were taken in closed and open mouth positions, and sagittal and coronal views. Five observers diagnosed disc position, disc shape, joint effusion and loose calcified bodies in the TMJ. RESULTS: In all cases except one, three or more observers agreed upon the diagnosis. All agreed on whether a loose calcified body was present or not. The second best agreement was obtained for disc position in the sagittal view, where all observers agreed in 16 of the 20 cases. For disc position in the coronal view and the evaluation of the disc shape, observer agreement was lower. CONCLUSION: Criteria were useful in order to standardize and simplify evaluation and thereby probably increase the diagnostic outcome among different observers for MRI of the TMJ. We recommend that the criteria be used internationally to facilitate comparisons between different studies.
Assuntos
Internet , Imageamento por Ressonância Magnética/normas , Transtornos da Articulação Temporomandibular/diagnóstico , Articulação Temporomandibular/patologia , Calcinose/diagnóstico , Calibragem , Humanos , Corpos Livres Articulares/diagnóstico , Côndilo Mandibular/patologia , Variações Dependentes do Observador , Intensificação de Imagem Radiográfica/métodos , Amplitude de Movimento Articular/fisiologia , Padrões de Referência , Líquido Sinovial , Disco da Articulação Temporomandibular/patologiaRESUMO
OBJECTIVES: The aim of this study was to (1) evaluate the fractal dimension (FD) in regions of the mandible on cone beam CT (CBCT) images of patients with bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) and (2) to select the most suitable region of interest (ROI) for further study on detection of bone alterations associated with bisphosphonates. METHODS: CBCT images of patients with BP-ONJ were included with matched controls. Values of FD were compared between groups. Selected ROIs were: ROI-1 - below the mandibular foramen; ROI-2 - above the mandibular foramen; ROI-3 - anterior to the mental foramen; ROI-4 - above the mandibular canal. The area of bone exposure was included as ROI-5. The results were analysed using generalized estimating equations and conditional logistic regression. RESULTS: There were 36 patients (67% female) with a mean age of 60.7 years. The mean FDs were: ROI-1 - 1.678 for controls and 1.673 for patients (P = 0.81); ROI-2 - 1.657 for controls and 1.653 for patients (P = 0.78); ROI-3 - 1.661 for controls and 1.684 for patients (P = 0.17); and ROI-4 - 1.670 for controls and 1.698 for patients (P = 0.03). The value of the FD in the area of exposed bone was the highest (1.729). The odds of being a BP-ONJ patient vs being a control was six times as high for individuals with a higher FD score at ROI-4, although the confidence interval was quite wide owing to the small sample size. CONCLUSION: In this preliminary study, BP-ONJ patients had higher FD values than controls at regions close to the alveolar process. The results suggest that FD is a promising tool for detection of bone alterations associated with BP-ONJ.
Assuntos
Conservadores da Densidade Óssea/efeitos adversos , Tomografia Computadorizada de Feixe Cônico/métodos , Difosfonatos/efeitos adversos , Fractais , Doenças Mandibulares/induzido quimicamente , Doenças Mandibulares/diagnóstico por imagem , Osteonecrose/induzido quimicamente , Osteonecrose/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Análise de Regressão , Estudos Retrospectivos , Método Simples-CegoRESUMO
Following up on a letter received from the Mrs. Nicole Fontaine, the Delegate Minister of Industry, requesting recommendations concerning the "serious threats" to the French drug industry, the Academy of Medicine auditioned the five leading French pharmaceutical firms and two foreign firms. Their complains led to proposals for six recommendations: recognize the strategic importance of the drug industry, conclude several years of contracts between the Economic committee on health products and the drug industry, facilitate clinical trails of drugs in France, favor relations between the national drug industry and university research centers, Inserm, Cnrs and the administration, encourage the development of biotechnology firms which represent one of the most promising areas of therapeutic research, propose the creation of an interministerial drug counsel presided by the Prime Minister to establish and implement a common national strategy.
Assuntos
Indústria Farmacêutica/tendências , Centros Médicos Acadêmicos , Biotecnologia , Ensaios Clínicos como Assunto , França , PesquisaRESUMO
BACKGROUND: Depression and periodontitis are common conditions in older adults. There is some evidence that these two conditions may be related. AIMS: To study a population of dentate elders and assess the prevalence of depression, self-assessment of risk for periodontitis and tooth loss, in relation to periodontal disease status. MATERIAL AND METHODS: Data were obtained from 701 older subjects (mean age 67.2 years (SD+/-4.6), of whom 59.5% were women. Self-reports of a diagnosis of depression, scores of the Geriatric Depression Scale (GDS), and self-assessment of risk for future tooth loss and periodontitis were compared with a diagnosis of periodontitis based on probing depth, and bone loss assessed from panoramic radiographs. Other systemic diseases and smoking habits were also determined and studied in relation to depression. RESULTS: A history of depression was reported by 20% of the subjects. GDS scores >/=8 were reported by 9.8% of the elders. Periodontitis was identified in 48.5% of the subjects. Depression was associated with heart attack (p<0.05), stroke (p<0.01), high blood pressure (p<0.02), all combined cardiovascular diseases (p<0.001), chronic pain (p<0.01), osteoarthritis (p<0.001), and osteoporosis (p< 0.001) but not with periodontitis (p=0.73). Subjects with depression had a higher self-reported risk score for future tooth loss (p<0.02). No group difference emerged for self-perceived risk for periodontitis. Logistic regression analysis demonstrated that a past history of tooth loss (p<0.001), self-perceived risk for periodontitis (p<0.02), the number of years with a smoking habit (p<0.02), and male gender (p<0.02) were associated with a diagnosis of periodontitis but neither measure of depression could be included in an explanatory model for periodontitis. CONCLUSIONS: Evidence of depression (self-report or by GDS) is not associated with risk for periodontitis in older subjects but is associated with tooth loss and chronic conditions associated with pain.
Assuntos
Depressão/complicações , Periodontite/complicações , Idoso , Assistência Odontológica para Idosos , Feminino , Avaliação Geriátrica , Humanos , Modelos Logísticos , Masculino , Probabilidade , Fatores de Risco , Autorrevelação , Estatísticas não Paramétricas , Perda de Dente/complicaçõesRESUMO
BACKGROUND: An increased risk for periodontitis has been associated both with type-1 or insulin dependent diabetes (IDDM) and with type-2 or non-insulin dependent diabetes (NIDDM). AIMS: 1) To describe and analyze periodontal conditions in older low-income ethnic diverse subjects with or without a diagnosis of diabetes. 2) To assess to what extent diabetes mellitus is associated with periodontal status, and 3) how periodontitis ranks as a coexisting disease among other diseases in subjects with diabetes mellitus. MATERIAL AND METHODS: Radiographic signs of alveolar bone loss were studied in 1101 older subjects 60-75 years old (mean age 67.6, SD+/-4.7). The number of periodontal sites and the proportions of teeth with probing depth (PD) > or =5 mm, clinical attachment levels (CAL) > or =4 mm were studied in a subset of 701 of the subjects. RESULTS: IDDM was reported by 2.9% and NIDDM by 9.2% of the subjects. The number of remaining teeth did not differ by diabetic status. The number of sites with PD > or =5 mm and the proportion of PD with > or =5 mm was significantly smaller in the non-diabetic group (chi2=46.8, p<0.01, and chi2=171.1, p<0.001, respectively). Statistical analysis failed to demonstrate group differences for the number and proportions of sites with CAL > or =4 mm and for radiographic findings of alveolar bone loss. Combining all periodontal parameters revealed that the Mantel-Haenszel common odds of having IDDM/NIDDM and periodontitis was 1.8 : 1 (95% CI: 1.1-3.1, p<0.03). The common odds ratio estimate of an association between heart disease and diabetes was 3.6 : 1 (95% CI: 2.1-2.6, p<0.001). CONCLUSIONS: Probing depth differences between IDDM/NIDDM vs. non-diabetic subjects may reflect the presences of pseudo-pockets and not progressive periodontitis in many subjects with diabetes mellitus. Periodontitis is not a predominant coexisting disease in older subjects with diabetes mellitus.
Assuntos
Complicações do Diabetes , Doenças Periodontais/complicações , Fatores Etários , Idoso , Perda do Osso Alveolar/classificação , Perda do Osso Alveolar/complicações , Distribuição de Qui-Quadrado , Intervalos de Confiança , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Etnicidade , Humanos , Arcada Parcialmente Edêntula/complicações , Pessoa de Meia-Idade , Razão de Chances , Perda da Inserção Periodontal/classificação , Perda da Inserção Periodontal/complicações , Bolsa Periodontal/classificação , Bolsa Periodontal/complicações , Periodontite/classificação , Periodontite/complicações , Pobreza , Fatores de Risco , Estatísticas não ParamétricasRESUMO
BACKGROUND: Osteoporosis (OPOR) is a common chronic disease, especially in older women. Patients are often unaware of the condition until they experience bone fractures. Studies have suggested that OPOR and periodontitis are associated diseases and exaggerated by cytokine activity. Panoramic radiography (PMX) allows studies of mandibular cortical index (MCI), which is potentially diagnostic for OPOR. AIMS: i). To study the prevalence of self-reported history of OPOR in an older, ethnically diverse population, ii). to assess the agreement between PMX/MCI findings and self-reported OPOR, and iii). to assess the likelihood of having both a self-reported history of OPOR and a diagnosis of periodontitis. MATERIALS AND METHODS: PMX and medical history were obtained from 1084 subjects aged 60-75 (mean age 67.6, SD +/- 4.7). Of the films, 90.3% were useful for analysis. PMXs were studied using MCI. The PMXs were used to grade subjects as not having periodontitis or with one of three grades of periodontitis severity. RESULTS: A positive MCI was found in 38.9% of the subjects, in contrast to 8.2% self-reported OPOR. The intraclass correlation between MCI and self-reported OPOR was 0.20 (P < 0.01). The likelihood of an association between OPOR and MCI was 2.6 (95%CI: 1.6, 4.1, P < 0.001). Subjects with self-reported OPOR and a positive MCI had worse periodontal conditions (P < 0.01). The Mantel-Haentzel odds ratio for OPOR and periodontitis was 1.8 (95%CI: 1.2, 2.5, P < 0.001). CONCLUSIONS: The prevalence of positive MCI was high and consistent with epidemiological studies, but only partly consistent with a self-reported history of osteoporosis with a higher prevalence of positive MCI in Chinese women. Horizontal alveolar bone loss is associated with both positive self-reported OPOR and MCI.
Assuntos
Perda do Osso Alveolar/complicações , Perda do Osso Alveolar/etnologia , Avaliação Geriátrica , Osteoporose/complicações , Periodontite/complicações , Idoso , Perda do Osso Alveolar/diagnóstico por imagem , Análise de Variância , Colúmbia Britânica/epidemiologia , Distribuição de Qui-Quadrado , China/etnologia , Etnicidade , Feminino , Humanos , Masculino , Doenças Mandibulares/complicações , Doenças Mandibulares/diagnóstico por imagem , Doenças Mandibulares/etnologia , Anamnese , Pessoa de Meia-Idade , Razão de Chances , Osteoporose/diagnóstico por imagem , Osteoporose/etnologia , Periodontite/diagnóstico por imagem , Periodontite/etnologia , Prevalência , Curva ROC , Radiografia Panorâmica , Fumar , Estatísticas não Paramétricas , Washington/epidemiologiaRESUMO
BACKGROUND: Panoramic radiographs (PMX)s may provide information about systemic health conditions. AIMS: i). To study clinical periodontal conditions and collect self-reported health status in a cohort of 1084 older subjects; ii). to study signs of alveolar bone loss and carotid calcification from panoramic radiographs obtained from these subjects; and iii). to study associations between study parameters. MATERIAL AND METHODS: PMXs from 1064 adults aged 60-75 (mean age 67.6, SD +/- 4.7) were studied. Signs of alveolar bone loss, vertical defects, and molar furcation radiolucencies defined periodontal status. Medical health histories were obtained via self-reports. Signs of carotid calcification were identified from panoramic radiographs. RESULTS: The PMX allowed assessment of 53% of the films (Seattle 64.5% and Vancouver 48.4%). A self-reported history of a stroke was reported by 8.1% of men in Seattle and 2.9% of men in Vancouver (P < 0.01). Heart attacks were reported by 12% of men in Seattle and 7.2% in Vancouver (N.S.). PMX evidence of periodontitis was found in 48.5% of the subjects, with carotid calcification in 18.6%. The intraclass correlation score for PMX findings of carotid calcification and stroke was 0.24 (95% CI: 0.10-0.35, P < 0.001). The odds ratio for PMX carotid calcification and periodontitis was 2.1 (95% CI: 1.3-3.2, P < 0.001), and for PMX carotid calcification and stroke 4.2 (95% CI: 1.9-9.1, P < 0.001). The associations disappeared when smoking was accounted for. A history of a heart attack was associated with stroke, gender, age, and PMX scores of alveolar bone loss. CONCLUSIONS: PMXs may provide valuable information about both oral conditions and signs of carotid calcification, data that are consistent with self-reported health conditions. Alveolar bone loss as assessed from PMXs is associated with cardiovascular diseases.
Assuntos
Perda do Osso Alveolar/complicações , Doenças das Artérias Carótidas/complicações , Avaliação Geriátrica , Infarto do Miocárdio/complicações , Periodontite/complicações , Acidente Vascular Cerebral/complicações , Idoso , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/epidemiologia , Colúmbia Britânica/epidemiologia , Calcinose/diagnóstico por imagem , Doenças das Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/epidemiologia , Artéria Carótida Interna/diagnóstico por imagem , Distribuição de Qui-Quadrado , Etnicidade , Feminino , Humanos , Modelos Lineares , Masculino , Anamnese , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Razão de Chances , Periodontite/diagnóstico por imagem , Periodontite/epidemiologia , Prevalência , Radiografia Panorâmica , Estatísticas não Paramétricas , Acidente Vascular Cerebral/epidemiologia , Washington/epidemiologiaRESUMO
Several obstacles of different types seem to be a barrier to the promotion of "same day surgery": seizures of misinformed patients, local mentalities, reticence coming from different administrations, from control organizations also from general practitioners, as even a kind of reserve revealed by hospitals doctors. All these arguments are discussed and disproved.
Assuntos
Procedimentos Cirúrgicos Ambulatórios , Características CulturaisRESUMO
OBJECTIVES: (1) To compare fractal dimension (FD) from periapical radiographs with FD from panoramic radiographs; (2) to correlate FD with cortical thickness and morphology; and (3) to correlate FD with a reported history of osteoporotic fractures. METHODS: Information on fracture and smoking history was obtained by a telephone interview with 281 elderly (>60 years of age) patients who had periapical and panoramic radiographs exposed on the same date. FD was measured in several locations on both types of radiograph. Mandibular cortical thickness and morphology were obtained from the panoramic radiograph. RESULTS: FD measured in the mandible was lower than FD in the maxilla. Same-jaw measurements had a higher correlation than same-side measurements. FD measured on panoramic radiographs was lower than FD from periapical radiographs. There was a negative correlation between cortical thickness and FD. FD was higher in subjects with more mandibular cortical porosities and resorption. The mean panoramic FD from subjects with a history of osteoporotic fractures was significantly higher, after adjusting for smoking, gender, age, height and weight. CONCLUSIONS: FD measured on panoramic radiographs is lower than FD measured on periapical radiographs. FD is higher in both types of radiograph in subjects with a thinner, severely eroded mandibular cortex and a history of osteoporotic fractures. This study confirms other reports that FD increases when bone mass decreases. In addition, it suggests that panoramic radiographs can be used as a possible alternative for the measurement of FD to periapical radiographs.
Assuntos
Fractais , Radiografia Dentária/estatística & dados numéricos , Fatores Etários , Idoso , Análise de Variância , Estatura , Peso Corporal , Reabsorção Óssea/diagnóstico por imagem , Fatores de Confusão Epidemiológicos , Feminino , Fraturas Ósseas/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador , Arcada Edêntula/diagnóstico por imagem , Masculino , Mandíbula/diagnóstico por imagem , Osteoporose/diagnóstico por imagem , Radiografia Interproximal/estatística & dados numéricos , Radiografia Panorâmica/estatística & dados numéricos , Fatores Sexuais , Fumar , Estatística como AssuntoRESUMO
Eugène Koeberlé, surgeon and anatomist gained international renown due to his outstanding ability in resection of ovary cysts and in hysterectomy. He was one of the first to perform these operations successfully. He was a pioneer in asepsis and pre- and postoperative care. He also invented many surgical instruments, among them an efficient hemostatic forceps.
Assuntos
Cirurgia Geral/história , Histerectomia/história , Cistos Ovarianos/história , Feminino , França , Procedimentos Cirúrgicos em Ginecologia/história , Procedimentos Cirúrgicos em Ginecologia/métodos , História do Século XIX , História do Século XX , Humanos , Histerectomia/métodos , Cistos Ovarianos/cirurgia , Instrumentos Cirúrgicos , Infecção da Ferida Cirúrgica/prevenção & controleRESUMO
The American Academy of Oral and Maxillofacial Radiology developed these Parameters of Care to provide national guidelines for the use of radiographs prescribed for the diagnosis of disease, treatment planning, and follow-up care of patients with abnormalities of the oral and maxillofacial region. The Parameters cover radiographic techniques, imaging of the temporomandibular joint, imaging of diseases of the jaws, and imaging of dental implant sites.
Assuntos
Radiografia Dentária/normas , Radiografia/normas , Cárie Dentária/diagnóstico por imagem , Implantes Dentários , Seguimentos , Humanos , Doenças Maxilomandibulares/diagnóstico por imagem , Planejamento de Assistência ao Paciente , Doenças Periodontais/diagnóstico por imagem , Controle de Qualidade , Doses de Radiação , Proteção Radiológica , Radiologia/educação , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Tomografia por Raios X , Tomografia Computadorizada por Raios XRESUMO
A 59-year old woman was referred by her dentist to an Oral Medicine practice for evaluation of acute pain and swelling in her right temporomandibular joint (TMJ).
Assuntos
Adenocarcinoma/secundário , Neoplasias de Cabeça e Pescoço/secundário , Neoplasias Hepáticas/patologia , Transtornos da Articulação Temporomandibular/diagnóstico , Adenocarcinoma/complicações , Diagnóstico Diferencial , Dor Facial/etiologia , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Humanos , Neoplasias Hepáticas/complicações , Pessoa de Meia-Idade , Transtornos da Articulação Temporomandibular/etiologiaRESUMO
OBJECTIVES: The purpose of this case-control study was to determine whether the radiographic appearance of the mandibular cortical bone in patients who were elderly and noninstitutionalized was related to a self-reported history of osteoporotic fractures. STUDY DESIGN: Patients who had a billing statement at the School of Dentistry dated between 1993 and 1996, who were older than 60, and who had a panoramic radiograph were invited to be interviewed regarding fracture history (circumstances and year of fracture) and risk factors for osteoporosis. Cases (n = 93) were individuals reporting osteoporotic fractures (fractures occurring after minor impact). Controls (n = 394) were individuals reporting traumatic fractures (n = 105) or no fractures (n = 289). Blinded to case-control status, we evaluated the mandibular cortex on a panoramic radiograph and classified them as normal (even and sharp endosteal margin), moderately eroded (evidence of lacunar resorption or endosteal cortical residues), or severely eroded (unequivocal porosity). In addition, cortical thickness was measured below the mental foramen. RESULTS: After adjustment for potentially confounding factors, the odds ratio for an osteoporotic fracture associated with moderately eroded and severely eroded mandibular cortices was 2.0 (95% CI, 1.2 to 3.3) and 8.0 (95% CI, 2.0 to 28.9), respectively. After adjusting for all potentially confounding factors, we found that the cortex was 0.54 mm (or 12%) thinner in subjects with an osteoporotic fracture compared with controls (95% CI, 0.25 to 0.84 mm). CONCLUSIONS: Subjects with a self-reported history of osteoporotic fractures tend to have increased resorption and thinning of the mandibular lower cortex.
Assuntos
Doenças Mandibulares/diagnóstico por imagem , Fraturas Mandibulares/etiologia , Osteoporose/complicações , Osteoporose/diagnóstico por imagem , Idoso , Análise de Variância , Densidade Óssea , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Doenças Mandibulares/complicações , Razão de Chances , Porosidade , Radiografia Panorâmica , Estudos Retrospectivos , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: To determine interobserver agreement in interpretation of magnetic resonance images of the temporomandibular joint by independent observers and to evaluate interobserver agreement within each subjectively assigned category. STUDY DESIGN: Sixty magnetic resonance images of adolescent temporomandibular joints were randomly drawn for evaluation by 4 observers who had not previously worked together. All observers independently classified disk position on sagittal magnetic resonance images according to written classification criteria consisting of 6 categories. RESULTS: Kappa statistics of agreement show moderate agreement among all observers for both medial (95% CI, 0.486-0.622) and lateral (95% CI, 0.450-0.566) components of the joint. Disk displacement without reduction was the category with the greatest agreement among all observers (kappa = 0.914). CONCLUSION: Moderate to substantial observer agreement across all defined categories of disk status may be achieved among a number of observers when standardized classification criteria are used. Interobserver agreement is, however, not uniform across all categories of disk position described.
Assuntos
Luxações Articulares/patologia , Imageamento por Ressonância Magnética , Disco da Articulação Temporomandibular/patologia , Transtornos da Articulação Temporomandibular/patologia , Adolescente , Criança , Feminino , Humanos , Masculino , Variações Dependentes do Observador , Reprodutibilidade dos TestesRESUMO
OBJECTIVE: To evaluate the relationship between vertebral bone mass and tooth loss and jaw bone mass in elderly Japanese women. METHODS: Mandibular cortical bone mass, alveolar bone height and number of teeth present (total, anterior, and posterior) were compared with the 3rd lumbar vertebral bone mineral density (L3BMD), measured by dual energy computed tomography (DEQCT), in 90 Japanese women by means of multiple regression analysis, controlling for body mass index, menopausal status, years since menopause and self-reported periodontal condition. RESULTS: Mandibular cortical bone mass and number of posterior teeth were associated with both alveolar bone height and L3BMD, but there was no association between alveolar bone height, number of anterior teeth present and L3BMD. CONCLUSION: Our results suggest that the loss of posterior teeth may be associated with a decrease not only in alveolar bone height, but also alveolar bone mineral density (BMD). The latter may be related to a decrease of lumbar vertebral BMD.