Magnetic resonance imaging assessment of juvenile idiopathic arthritis using OMERACT and EuroTMjoint classifications.

This retrospective case-control study compared inflammatory and structural damage in the temporomandibular joint of patients with juvenile idiopathic arthritis (JIA) and its subtypes and healthy patients using the Outcome Measures in Rheumatology Clinical Trials (OMERACT) and EuroTMjoint classifications. Correlations between the scores of the two classifications and time of diagnosis were evaluated. Twenty-nine JIA patients and 48 age-matched healthy participants were examined. TMJ images on each side were considered individually. Oligoarticular and polyarticular subtypes were present in 44.8% and 55.2% of patients, respectively. The JIA group presented a higher frequency and more severe signs of inflammatory and structural changes (P < 0.05), except for effusion (P = 0.83). The polyarticular subtype showed a higher change intensity. The time of JIA diagnosis was not correlated with inflammatory and structural changes. Positive correlations between inflammation and bone deformity scores were observed for the EuroTMjoint classification (r = 0.462, P < 0.001; low correlation) and OMERACT classification (r = 0.737, P < 0.001; high correlation). Positive correlations between the OMERACT and EuroTMjoint classifications were found for inflammation score (r = 0.907, P < 0.001; very high correlation) and bone deformity score (r = 0.854, P < 0.001; high correlation). Both classifications showed a higher frequency and intensity of inflammation and bone deformity in JIA patients. The results of this study suggest that the appropriate management of inflammation may reduce the potential for structural damage to the TMJ.

Texture analysis of cone beam computed tomography images reveals dental implant stability.

The aim of this study was to characterize the alveolar bone of edentulous maxillary sites using texture analysis (TA) of cone beam computed tomography (CBCT) images and to correlate the results to the insertion torque, thus verifying whether TA is a predictive tool of final implant treatment. This study was conducted on patients who had received single implants in the maxilla (46 implants) 1year earlier and whose torque values were properly recorded. Three cross-sections of the sites were selected on CBCT scans. Two regions of interest (ROIs) corresponding to the implant bone site and peri-implant bone were also outlined, according to virtual planning. The CBCT scans were exported to MaZda software, where the two ROIs were delimited following the previously demarcated contours. Values for the co-occurrence matrix were calculated for TA. With regard to the insertion torque value, there was a direct correlation with the contrast of the peri-implant bone (P<0.001) and an inverse correlation with the entropy of the implant bone site (P=0.006). A greater contrast indicates a greater torque value for insertion of the implants, and there is a possible association with a lower entropy value of the implant-bone interface.

Oral health in children with acute lymphoblastic leukaemia: before and after chemotherapy treatment.

AIM: To evaluate changes in the oral health status of children under the age of 14 years with acute lymphoblastic leukaemia (ALL) attending a cancer centre before and after chemotherapy treatment. MATERIALS AND METHODS: A total of 32 children with ALL without distinction of gender were selected for study. The oral cavity of the patients was evaluated before the induction stage and 17 days later. Clinical evaluation of the submandibular, submental, and cervical lymph nodes was performed. Saliva samples were collected during the early morning hours. Bacterial plaque was assessed by using the Silness and Löe plaque index (SLPI) and gingiva status was evaluated with the gingival Löe and Silness index (GLSI). The WHO toxicity oral scale was used to record the degree of oral mucositis. The resulting data were analysed with McNemar's test, t test (for related samples), and Wilcoxon test. RESULTS: There were statistically significant differences for palpable lymph nodes, paleness of oral mucosa, and ecchymoseis, respectively, P ≤ 0.000, P = 0.03, and P = 0.01, with these manifestations decreasing significantly after treatment. Incipient gingivitis had frequencies of 71.9% and 75% before and after treatment, respectively. The mean SLPI score declined significantly from 1.16 ± 0.52 (before treatment) to 0.56 ± 0.36 (after treatment) (P < 0.000); salivary flow increased significantly from 0.54 ± 0.34 to 1.22 ± 1.07 after chemotherapy treatment (P < 0.00). Oral mucositis was present in 24 children (75%) with a 1-2 severity level. CONCLUSIONS: After chemotherapy treatment, there were changes in the oral conditions of children with ALL. Some manifestations decreased after treatment, whereas in others increased.

Clinical and MRI investigation of temporomandibular joint in major depressed patients.

OBJECTIVE: The aim of the present study was to describe the clinical and MRI findings of the temporomandibular joint (TMJ) in patients with major depressive disorders (MDDs) of the non-psychotic type. METHODS: 40 patients (80 TMJs) who were diagnosed as having MDDs were selected for this study. The clinical examination of the TMJs was conducted according to the research diagnostic criteria and temporomandibular disorders (TMDs). The MRIs were obtained bilaterally in each patient with axial, parasagittal and paracoronal sections within a real-time dynamic sequence. Two trained oral radiologists assessed all images. For statistical analyses, Fisher's exact test and χ(2) test were applied (α = 0.05). RESULTS: Migraine was reported in 52.5% of subjects. Considering disc position, statistically significant differences between opening patterns with and without alteration (p = 0.00) and between present and absent joint noises (p = 0.00) were found. Regarding muscular pain, patients with and without abnormalities in disc function and patients with and without abnormalities in disc position were not statistically significant (p = 0.42 and p = 0.40, respectively). Significant differences between mandibular pathway with and without abnormalities (p = 0.00) and between present and absent joint noises (p = 0.00) were observed. CONCLUSION: Based on the preliminary results observed by clinical and MRI examination of the TMJ, no direct relationship could be determined between MDDs and TMDs.

Relationship between environmental factors and gray matter atrophy in refractory MTLE.

OBJECTIVE: To investigate clinical, neuropsychological, and MRI abnormalities (gray matter atrophy [GMA] and white matter atrophy [WMA]) in surgical mesial temporal lobe epilepsy (MTLE) patients with and without familial antecedent for epilepsy. METHODS: A cohort study including 69 operated patients with unilateral MTLE, divided into a group of 29 patients (mean age 35.8 +/- 10.4 years) with a negative family history (FH) of epilepsy and a group of 40 patients (32.8 +/- 10 years) with a positive FH. We performed voxel-based morphometry (VBM) on preoperative MRIs and investigated possible clinical and neuropsychological differences between the 2 groups. We also performed VBM and t tests to compare the patients' groups with normal controls. RESULTS: The negative-FH group had lower IQ scores (p = 0.004), performed poorer on the Boston Naming Test (p = 0.02) and on delayed recall (p = 0.03), and presented a more prominent asymmetry index of hippocampal volume (p = 0.04) and more frequent initial precipitating injuries (p = 0.023). VBM showed a more restricted pattern of GMA in the positive-FH group and a more bilateral and widespread pattern of GMA in the negative-FH group, involving thalami, temporal, frontal, parietal, and occipital lobes. WMA was widespread and bilateral in both groups. CONCLUSIONS: The more widespread structural voxel-based morphometry abnormalities and worse IQ performance identified in the negative-family history (FH) group may result from a stronger environmental influence, including initial precipitating injuries. This is further support for the hypothesis that hippocampal sclerosis in mesial temporal lobe epilepsy with positive FH is determined by a stronger genetic predisposition with less influence of environmental factors compared with patients in the negative-FH group.