Age determination on panoramic radiographs using the Kvaal method with the aid of artificial intelligence.

OBJECTIVES: This study aimed to assess and compare age estimation on panoramic radiography using the Kvaal method and machine learning (ML). METHODS AND MATERIALS: 554 panoramic radiographs were selected from a Brazilian practice. To estimate age using the Kvaal method, the following measurements were performed on the upper left central incisors and canines: tooth, pulp and root length; root and pulp width at three different levels: at the enamel-cementum junction (ECJ); midpoint between the enamel-cementum junction and; at the mid root level. For ML age estimation, radiomic, semantic and the radiomic-semantic attribute extractions were assessed. Nineteen semantic and 14 radiomic attributes and a single set of 33 semantic-radiomic attributes were extracted. Logistic Regression, Linear Regression, KNN, SVR, Decision Tree Reg, Random Forest Reg, Gradient Boost Reg e XG Boosting Reg were used for ML classification. For the Kvaal method, Mann-Whitney test, Spearman correlation coefficient, Student's t-test and linear regression with its respective coefficient of determination were used to estimate age and to assess data variability. RESULTS: Mean absolute error (MAE) and standard error estimate (SEE) were assessed. For the Kvaal method, upper incisors presented higher precision than canines (R²: 0.335, SSE: 7.108). Males presented better MAE and SEE values (5.29,6.96) than females (5.69,7.37). The radiomic-semantic attributes presented superior precision (MAE: 4.77) than the radiomic and semantic (MAE: 5.23) attributes. The XG Boosting Reg classifier performed better than the other six assessed classifiers (MAE: 4.65). ML (MAE: 4.77 presented higher age estimation precision than the Kvaal method (MAE: 5.68). CONCLUSION: The use of ML on panoramic radiographs can improve age estimation.

Assessment of the anterior loop of the mandibular canal: A study using cone-beam computed tomography.

PURPOSE: Sufficient area in the interforaminal region is required for dental implant placement, and the anterior loop of the mandibular canal is located within the limits of this area. The aim of this study was to evaluate the prevalence and extent of the anterior loop in a Brazilian sample population using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: CBCT images from 250 patients (500 hemimandibles) obtained for various clinical indications were randomly selected and evaluated to determine the presence and length of the anterior loop. The length of the anterior loop was then compared based on gender, age, and the side of the mandible. The data were analyzed using the Pearson chi-square test and linear regression analysis. RESULTS: An anterior loop was identified in 41.6% of the cases, and its length ranged from 0.25 mm to 4.00 mm (mean, 1.1±0.8 mm). The loop had a greater mean length and was significantly more prevalent in males (p=0.014). No significant differences were found between the right and left sides regarding length (p=0.696) or prevalence (p=0.650). CONCLUSION: In this study, a high prevalence of the anterior loop of the mandibular canal was found, and although its length varied greatly, in most cases it was less than 1 mm long. Although this is a prevalent anatomical variation, safety limits for the placement of implants in this region cannot be established before an accurate evaluation using imaging techniques in order to identify and preserve the neurovascular bundles.

Human identification by FSS system adapted to cephalometric radiographs.

The aim of this study was to verify the applicability and reproducibility of the FSS system [8] adapted for frontal and lateral cephalometric radiographs of the frontal sinus for human identification purposes. Eighty lateral and frontal digital cephalometric radiographs from a private Dental Radiology service's database were evaluated. Evaluations were performed in a dimmed lighting room, using a 4.200 lux lightbox with mask, ultrafan paper and pencil with a 0.5 diameter tip. The sheet of paper was superimposed on the radiograph to obtain the outlines of the frontal sinus and two examiners made the drawings independently at two different times, with a minimum period interval between evaluations. To obtain the linear physical measurements of the frontal sinus, a digital pachymeter was used. Later, all the discrete variables were codded for the statistical analysis. All variables were tested by means of the Cohen's Kappa test. The intraexaminer agreement ranged from good to perfect (p<0.001), while the interexaminer agreement ranged from regular to perfect (p<0.001). The use of frontal and lateral cephalometric radiographs was found to be reproducible and reliable for human identification by an adaptation of FSS system.

Knowledge and attitudes of Brazilian dental students and dentists regarding bisphosphonate-related osteonecrosis of the jaw.

PURPOSE: The aim of this study was to evaluate the knowledge of Brazilian dentists (DEN) and dental students (DS) about bisphosphonates (BP) and bisphosphonate-related osteonecrosis of the jaw (BRONJ). METHODS: A convenience sample of 104 DEN and 100 DS was randomly selected and invited to answer a questionnaire. The questionnaire was structured on the basis of the main information about BP and the risk factors associated with the development of BRONJ. The data obtained were analyzed by the chi-square and Fisher's exact tests, considering significance of 5%. RESULTS: Seventy-five (72.1%) DEN and 75 (75%) DS did not know the BP cited in the questionnaire (p < 0.0001), and their commercial brand names were not recognized by 88 (84.6%) DEN and 86 (86%) DS (p < 0.0001). In the same way, 62 (59.6%) DEN (p = 0.04) and 58 (58%) DS (p < 0.0001) did not recognize BRONJ as an oral side effect of BP or point out oral conditions that were not associated with the use of BP. CONCLUSIONS: Practical initiatives, such as free lectures and workshops, must be taken to broaden the knowledge of DEN and DS about BP and thus contribute to the prevention of BRONJ.

Displasia ectodérmica hereditária e hipótese de Lyon / Displasia ectodérmica hereditaria e hipótesis de Lyon / Hereditary ectodermal dysplasia and Lyon hypothesis

Introdução: A Displasia Ectodérmica refere-se a distúrbios que promovem displasia ou aplasia de estruturas e tecidos derivados da ectoderme. Tal condição geralmente é herdada por padrão recessivo com lincagem cruzada, tendo sua frequência e severidade mais pronunciada nos homens. Objetivo: relatar o caso clínico de Displasia Ectodérmica Hereditária. Relato de caso: paciente do sexo feminino TVLV, 25 anos, leucoderma, que procurou um serviço privado de Radiologia Odontológica no município de João Pessoa, Paraíba, Brasil. Foi relatado, pela paciente, que seu pai, já falecido, era portador dessa síndrome. Durante o exame clínico extrabucal, observou-se ressecamento dos lábios e olhos, escurecimento da pele na região periocular, cabelos e pêlos finos e esparsos. A paciente não revelou queixa de xerostomia nem episódios de hipertermia. Havia perda de dimensão vertical, região frontal proeminente e as unhas não apresentavam aspectos de anormalidade. Ao exame clínico intrabucal, verificou-se permanência de 11 dentes decíduos e ausência de 19 dentes permanentes. A oligodontia parcial foi então confirmada pelo exame radiográfico panorâmico. A expressão parcial das características sindrômicas pode ser explicada pela Hipótese de Lyon (inativação do X), com metade dos cromossomos X da paciente expressando genes normais e a outra metade os genes anormais. Conclusão: Foi recomendado aconselhamento genético e visitas periódicas ao dentista. É fundamental a importância do cirurgião dentista no diagnóstico desse distúrbio, inclusive nesses casos de amenização dos sinais e sintomas(AU)

Introducción: la displasia ectodérmica se refiere a trastornos que promueven displasia o aplasia en estructuras y tejidos derivados del ectodermo. Esta afección generalmente se hereda con patrón recesivo lincagem cruz, llevando su frecuencia y gravedad más pronunciado en los hombres. Objetivo: este trabajo tiene como objetivo presentar un caso de displasia ectodérmica hereditaria. Presentación del caso: paciente TVLV femenina, de 25 años, leucoderma, que buscaba un servicio de radiología privada en la ciudad de João Pessoa, Paraíba, Brasil. Se ha informado por parte de la paciente que su padre, ya fallecido, fue diagnosticado con este síndrome. Durante el examen extrabucal, se observó sequedad de los labios y los ojos, oscurecimiento de la piel en la región periocular, cabello fino y escaso. La paciente no reveló xerostomía o episodios de hipertermia. No hubo pérdida de dimensión vertical; se observó frente prominente y uñas de aspecto normal. Por examen clínico intraoral se constató retención de 11 dientes primarios y ausencia de 19 dientes permanentes. La oligodoncia parcial fue confirmada por el examen radiográfico panorámico. La expresión parcial de las características sindrómicas se puede explicar por la hipótesis de Lyon (inactivación X), con la mitad de los cromosomas X de los pacientes que expresan genes normales y la otra mitad genes anormales. Conclusiones: se recomienda la asesoría genética y las visitas regulares al dentista. Es fundamental el diagnóstico de este trastorno por el odontólogo aun en los casos de reblandecimiento de los signos y síntomas(AU)

Introduction: ectodermal dysplasia refers to disorders that promote dysplasia or aplasia structures and tissues derived from ectoderm. This condition is usually inherited by recessive pattern with lincagem cross, taking their frequency and severity more pronounced in men. Objective: the aim was to report a case of Hereditary Ectodermal Dysplasia. Case report: patient TVLV female, aged 25, leucoderma, which sought a private radiology service in the city of João Pessoa, Paraíba, Brazil. It was reported by the patient, his father, now deceased, was diagnosed with this syndrome. During the extraoral examination, there was dryness of the lips and eyes, skin darkening in the periocular region, hair thin and sparse. The patient did not reveal xerostomia or episodes of hyperthermia. There was loss of vertical dimension, prominent forehead and nails were normal. The clinical examination intrabucal, there was retention of 11 primary teeth and the absence of 19 permanent teeth. The partial oligodontia was then confirmed by radiographic examination. The partial expression of syndromic features can be explained by the Lyon hypothesis (X inactivation), with half of the X chromosomes of patients expressing normal genes and half the abnormal gene. Conclusions: it was recommended genetic counseling and regular visits to the dentist. It´s fundamental the diagnosis of this disorder for the odontologist even in the cases of softening of signs and symptoms(AU)

Radiopacity of restorative composites by conventional radiograph and digital images with different resolutions.

PURPOSE: This study was performed to evaluate and compare the radiopacity of dentin, enamel, and 8 restorative composites on conventional radiograph and digital images with different resolutions. MATERIALS AND METHODS: Specimens were fabricated from 8 materials and human molars were longitudinally sectioned 1.0 mm thick to include both enamel and dentin. The specimens and tooth sections were imaged by conventional radiograph using #4 sized intraoral film and digital images were taken in high speed and high resolution modes using a phosphor storage plate. Densitometric evaluation of the enamel, dentin, restorative materials, a lead sheet, and an aluminum step wedge was performed on the radiographic images. For the evaluation, the Al equivalent (mm) for each material was calculated. The data were analyzed using one-way ANOVA and Tukey's test (p<0.05), considering the material factor and then the radiographic method factor, individually. RESULTS: The high speed mode allowed the highest radiopacity, while the high resolution mode generated the lowest values. Furthermore, the high resolution mode was the most efficient method for radiographic differentiation between restorative composites and dentin. The conventional radiograph was the most effective in enabling differentiation between enamel and composites. The high speed mode was the least effective in enabling radiographic differentiation between the dental tissues and restorative composites. CONCLUSION: The high speed mode of digital imaging was not effective for differentiation between enamel and composites. This made it less effective than the high resolution mode and conventional radiographs. All of the composites evaluated showed radiopacity values that fit the ISO 4049 recommendations.

Eosinophilic granuloma in the jaws.

Eosinophilic granuloma is the most common expression of Langerhans cell histiocytosis and corresponds with typical bone lesions. This disease is of importance to dental professionals because early clinical signs can occur in the jaw and can cause extensive destruction of the periodontal tissues. Pathological fracture is an unusual finding. The purpose of this case report is to describe a case of eosinophilic granuloma in a 28-year-old black man who initially appeared with intense pain from a pathological mandibular fracture.

Errores en radiografias intrabucales realizadas en la Facultad de Odontología de Pernambuco-Brasil / Intrabucal radiographs errors made at Pernambuco dental school-Brazil

The quality of the radiographic image is essential for the diagnosis and conservation of x-rays in archive. However, there are some Dental specialties that, for force of the execution, require the attainment of x-rays with bigger brevity, being common professionals and students exist to appeal the procedures that cause the damage of its quality with the justification of time profit. Because of this, this work had the intention to emphasize the optimization importance of the radiographic image through the analysis of imperfections in x-rays taken by students. For such, 572 x-rays, proceeding from archives of patients taken care by the students of the ninth period of the 1999 first semester at the Polyclinic of Pernambuco Dental School -UPE, were analyzed simultaneously by two observers and out of these, 75% presented imperfections. Related to the type of imperfection, the execution of the technique had prevalence in the referring errors (58%), followed by the processing errors (19%). Framing of the exposed region (35%) and elongation of the image (35,7%) were the most prevalent errors in the phase of execution of the technique, while yellowish images (33%) and lacerated x-rays (23%) demonstrated to be the occurred imperfections most frequent during processing.

La calidad de la imagen radiográfica es esencial para el diagnóstico y conservación de radiografías en archivo. Así mismo, hay especialidades odontológicas que, por fuerza de la ejecución, necesitan obtener radiografías con mayor brevedad, siendo común que profesionales y alumnos recurran a procedimientos que perjudican su calidad con la justificación de ganar tiempo. De esta forma, este trabajo tuvo el propósito de enfatizar la importancia de optimizar la imagen radiográfica a través del análisis de errores en radiografías obtenidas por alumnos. Con este propósito fueron analizadas 572 radiografías provenientes de archivos de pacientes atendidos por los alumnos del 9º semestre de 1999, de la Clínica Integrada de la Facultad de Odontología de Pernambuco-UPE. Las radiografías fueron analizadas simultáneamente por dos observadores y de esas, 75% presentaron errores. Los errores asociados a la técnica radiográfica correspondieron a 58%, siendo de mayor prevalencia los errores de elongación de la imagen (35,7%) y encuadramiento de la región radiografiada (35%). Los errores que más ocurrieron durante el procesamiento fueron imágenes "amarillentas" (33%) y radiografías rasguñada (23%).