Efficacy of digital radiography for detecting a second mesiobuccal canal adjacent to unfilled or filled canals.

The aim of this study was to assess the diagnostic accuracy of digital periapical radiography for the detection of the second mesiobuccal (MB2) canal when the adjacent canals are unfilled or filled with gutta percha. Forty human maxillary first molars were selected, 20 of which had an MB2 canal. The presence or absence of the MB2 canal was confirmed using microcomputed tomography. Digital periapical radiographs of each tooth were obtained from 3 horizontal angles before and after the adjacent root canals were filled with gutta percha. Three experienced oral radiologists evaluated all images and indicated the presence or absence of the MB2 canal using a confidence scale of 5 points. To assess intraobserver and interobserver agreement, weighted kappa coefficients were calculated. The diagnostic test (sensitivity, specificity, and accuracy) and area under the receiver operating characteristic curve (Az) values were calculated and compared between groups (n = 40): radiographs of the first molars with unfilled adjacent canals and radiographs of the same teeth with filled adjacent canals. For all observers, intraobserver reproducibility ranged from substantial (0.70) to almost perfect (0.86), and interobserver reproducibility ranged from fair (0.39) to substantial (0.67). Similar values of specificity and Az for the detection of the MB2 canal were observed with unfilled and filled adjacent canals. The sensitivity and accuracy were slightly greater when the adjacent root canals were filled with gutta percha. Detection of the MB2 canal on digital periapical radiographs can be challenging even when obtained at varying horizontal angles, and the presence of gutta percha does not influence the detection.

Probability of oral complications of radiotherapy and chemotherapy for head and neck cancer.

The objective of this study was to investigate the relationship between antineoplastic treatments and oral complications in patients with head and neck cancer. Medical records from 400 patients treated at a cancer center were analyzed. Univariable analysis was initially performed to verify the association between the variables and the presence of oral complications. Multivariable analysis was performed using multiple linear regression to assess the association between the type of treatment performed and the presence and types of oral complications. The medical records of 290 patients included information about the presence or absence of oral complications of therapy, and 199 of these patients experienced oral complications. An average of 1 oral complication per patient was found; 104 patients experienced 1 complication, 74 patients experienced 2 complications, and 21 patients experienced 3 or 4 complications. Oral complications were correlated with tobacco use (P = 0.01), alcohol use (P = 0.006), radiotherapy (P = 0.000), and chemotherapy (P = 0.028). The association between oral complications and radiotherapy was greater than the association between oral complications and chemotherapy, but the risk increased when both therapies were performed (odds ratio [OR] = 4.41; P = 0.004). Mucositis was associated with both radiotherapy and chemotherapy, and the incidence increased when both types of treatment were combined (OR = 5.28; P = 0.001). Oral complications of antineoplastic therapy are related to lifestyle habits and treatment modalities. Clinicians should educate patients with head and neck cancer about the role of lifestyle habits in possible adverse treatment effects and consider a more careful approach to follow-up care of patients who are undergoing both radiotherapy and chemotherapy.