Radiopacity of 28 Composite Resins for Teeth Restorations.

AIM: Radiopacity is a fundamental requisite to check marginal adaptation of restorations. Our objective was to assess the radiopacity of 28 brands of light-cured composite resins and compare their radiopacity with that of enamel, dentin, and aluminum of equivalent thickness. MATERIALS AND METHODS: Composite resin disks (0.2, 0.5, and 1 mm) were radiographed by the digital method, together with an aluminum penetrometer and a human tooth equivalent tooth section. The degree of radiopacity of each image was quantified using digital image processing. Wilcoxon nonparametric test was used for comparison of the mean thickness of each material. RESULTS: All of the materials tested had an equal or greater radiopacity than that of aluminum of equivalent thickness. Similar results for enamel were found with the exception of Durafill, which was less radiopaque than enamel (p < 0.05). All the specimens were more radiopaque than dentin, except for P90 (which was equally radiopaque) and Durafill (which was less radiopaque). The thickness of the specimens may influence the similarity to the enamel's radiopacity. All of the composite resins comply with specification #27 of the American Dental Association. The radiopacity of Amelogen Plus, Aph, Brilhiante, Charisma, Concept Advanced, Evolux X, Exthet X, Inten S, Llis, Master Fill, Natural Look, Opallis, P60, Tetric, Tph, Z100, and Z250 was significantly higher than that of enamel (p < 0.05). CONCLUSION: With these composites, it is possible to observe the boundaries between restoration and tooth structure, thus allowing clinicians to establish the presence of microleakage or restoration gap. CLINICAL SIGNIFICANCE: Suitable radiopacity is an essential requisite for good-quality esthetic restorative materials. We demonstrate that only some composites have the sufficient radiopacity to observe the boundaries between restoration and tooth structure, which is the main cause of restoration failure.

Perception of professionals in the assessment of coronoid hyperplasia by computed tomography.

Coronoid Hyperplasia (CH) is a non-neoplastic and relatively rare enlargement of the coronoid process that may limit mandibular movement as a consequence of the close association between the hyperplastic coronoid process and the anterior region of the zygomatic bone. Computed tomography (CT) is extremely useful for the observation of this association and plays an important role in diagnosing and planning surgical treatment. Once the CT scan is performed, the data can be viewed in many different arrangements, including multiplanar (MPR) and 3D rendering, although the resolution of the latter may not be as good as that of the former. Our aim is to analyze the importance of and preference for multiplanar and 3D reconstruction images for diagnosing and interpreting Coronoid Hyperplasia (CH), by comparing the opinions of oral surgeons and oral radiologists who analyzed both temporomandibular joints (TMJ) in 20 patients. Three images of each TMJ comprised the set of scans (MPR, 3D reconstructions with maximum intercuspation and 3D reconstructions with maximum mouth opening). After each analysis, the members of the two groups answered a questionnaire about the usefulness of each examination and classified the association between the head of mandible and mandibular fossa. Hypomotility was present in 55.2%. Both groups stated that both MPR and 3D reconstructions, particularly the latter, were fundamental for diagnosing CH and that they would request them in order to interpret CH correctly. The examiners were found to differ significantly regarding their opinion of MPR; only radiologists considered MPR to be less elucidative for the diagnosis of CH.

Perception of professionals in the assessment of coronoid hyperplasia by computed tomography

Coronoid Hyperplasia (CH) is a non-neoplastic and relatively rare enlargement of the coronoid process that may limit mandibular movement as a consequence of the close association between the hyperplastic coronoid process and the anterior region of the zygomatic bone. Computed tomography (CT) is extremely useful for the observation of this association and plays an important role in diagnosing and planning surgical treatment. Once the CT scan is performed, the data can be viewed in many different arrangements, including multiplanar (MPR) and 3D rendering, although the resolution of the latter may not be as good as that of the former. Our aim is to analyze the importance of and preference for multiplanar and 3D reconstruction images for diagnosing and interpreting Coronoid Hyperplasia (CH), by comparing the opinions of oral surgeons and oral radiologists who analyzed both temporomandibular joints (TMJ) in 20 patients. Three images of each TMJ comprised the set of scans (MPR, 3D reconstructions with maximum intercuspation and 3D reconstructions with maximum mouth opening). After each analysis, the members of the two groups answered a questionnaire about the usefulness of each examination and classified the association between the head of mandible and mandibular fossa. Hypomotility was present in 55.2%. Both groups stated that both MPR and 3D reconstructions, particularly the latter, were fundamental for diagnosing CH and that they would request them in order to interpret CH correctly. The examiners were found to differ significantly regarding their opinion of MPR; only radiologists considered MPR to be less elucidative for the diagnosis of CH.

A Hiperplasia Coronoide (HC) e um aumento nao-neoplasico e relativamente raro do processo coronoide que pode limitar o movimento mandibular, como consequencia da intima relacao entre o processo coronoide hiperplasico e a regiao anterior do osso zigomatico. A tomografia computadorizada (TC) e extremamente util para a observacao dessa relacao, desempenhando assim um papel importante no diagnostico e planejamento do tratamento cirurgico. Uma vez que a TC e realizada, os dados podem ser vistos em muitos arranjos diferentes, incluindo o multiplanar (MPR) e a reconstrucao em 3D, no entanto, a resolucao desta ultima pode nao ser tao boa quanto a primeira. Nosso objetivo e analisar a importancia e a preferencia por reconstrucoes de imagens multiplanares (MPR) e 3D para diagnosticar e interpretar a Hiperplasia Coronoide (HC), comparando cirurgioes buco-maxilo-faciais com radiologistas orais. Ambas as articulacoes temporomandibulares (ATM) de 20 pacientes foram analisadas pelos 2 grupos. Tres imagens de cada ATM compreenderam o conjunto de exames (MPR, reconstrucoes 3D em maxima intercuspidacao e reconstrucoes 3D com abertura maxima da boca). Apos cada analise, os grupos responderam a um questionario sobre a utilidade de cada exame e classificou a relacao entre a cabeca da mandibula e da fossa mandibular. A Hipomobilidade esteve presente em 55,2%. Ambos os grupos afirmaram que tanto MPR e as reconstrucoes em 3D, especialmente a ultima, foram fundamentais para diagnosticar CH e as requisitariam para interpretar a HC corretamente. Foi encontrada uma diferenca significativa entre os examinadores sobre a MPR; apenas o grupo de radiologistas considerou que este exame nao e tao elucidativo para o diagnostico da CH.

Assessment of the mandibular incisive canal by panoramic radiograph and cone-beam computed tomography.

Objectives. The region between mental foramens is considered as a zone of choice for implants. However, complications may arise due to an extension anterior to the mental foramen that forms the mandible incisive canal [MIC]. Our goal is to evaluate identification of MIC by both panoramic radiograph [PAN] and cone-beam computed tomography [CBCT]. Methods. 150 cases with bilateral MIC were analyzed. Images of a radiolucent canal, within the trabecular bone, surrounded by a radiopaque cortical bone representing the canal walls, and extending to the anterior portion beyond the mental foramen, were considered by two independent radiologists as being images of MIC. PAN and CBCT of these cases were evaluated by 2 other radiologists at different times. Agreement between results of examination methods was assessed by the Kappa coefficient. The interexaminer and intramethod rates for detection of MIC were analyzed by the McNemar test. Gender, mandible side, examiner, and type of method were analyzed by the generalized estimating equations [GEE] model. Results. significant difference between examiners [PAN: P = 0.146; CBCT: P = 0.749] was not observed. Analysis by GEE model showed no significant difference between genders [P = 0.411] and examiners [P = 0.183]. However, significant difference was observed for identification in both mandible right side [P = 0.001], where the identification frequency was higher, and CBCT method [P < 0.001]. Conclusions. PAN was not shown to be a safe examination to identify MIC. CBCT should always be used in preoperative planning and to reduce the number of complications in implant surgeries.

Digital radiographic evaluation of the midpalatal suture in patients submitted to rapid maxillary expansion.

AIMS: To analyze the density of the midpalatal suture by means of digital radiographs three months after retention to evaluate if this period of retention is really sufficient for bone repair. MATERIALS AND METHODS: This prospective study consisted of 31 patients (11 girls and 20 boys) in the mixed or permanent dentition stage, treated using a tooth-tissue borne expanders (Haas). Occlusal digital radiographs were taken at three stages: prior to rapid maxillary expansion (Stage I); immediately after desired maxillary expansion (Stage II); and after three months of retention (Stage III). Radiographs were taken on a dental X-ray machine, set at 70 kVp and 7 mA with an exposure time of 0.04 s. A phosphor storage plate system, imaging plate size n. 2 (35 × 45 × 1.6 mm), was used. Three regions (A, B and C) measured 0.02 mm² were selected for optical density analysis. The difference between the measurements was evaluated with the paired t-test. RESULTS: The optical density was reduced at Stages II and III compared with Stage I. Between-stage comparison showed statistically significant changes for all variables (P < 0.05), with the highest mean optical density at Stage I and the lowest at Stage II, in all groups. Actually, there was an increase in optical density between Stages II and III, but they are reduced compared with Stage I. CONCLUSION: The results strongly suggest that bone formation did not occur as expected, and that a longer retention period for bone repair may be necessary.

How should the articular disk position be analyzed?

PURPOSE: To compare 2 methods used to determine the disk position based on sagittal magnetic resonance images. PATIENTS AND METHODS: A cross-sectional study of patients with the signs and symptoms of temporomandibular disorders was conducted. The patients' ages and gender distributions were collected. The disk position diagnosis from the clinical examination was considered the primary outcome. Three observers evaluated the presence of anterior displacement on magnetic resonance images according to 2 criteria: method 1 (12-o'clock position) and method 2 (location of the intermediate zone). To assess the intraobserver variability of the 2 methods, the examiners evaluated the same magnetic resonance images at the beginning of the study (time 1) and 40 days later (time 2). The intraobserver agreement was assessed using the observed agreement and the kappa statistic. McNemar's test was used to assess the differences between each method and the clinical examination findings (P < .05). The accuracy, sensitivity, specificity, and positive and negative predictive values were calculated by comparing the diagnosis from each method with that from the clinical examination (considered the reference standard). RESULTS: The final sample was composed of 20 subjects with a mean age of 33.0 ± 33.7 years; 3 were men (15%) and 17 were women (85%). A statistically significant difference between the 2 methods was found. Method 1 yielded a greater percentage of anterior displaced disks (52.5%). The agreement between the clinical diagnosis and method 1 was lower (70.0%) than that between the clinical diagnosis and method 2 (87.5%). No statistically significant difference was found between the clinical diagnosis and method 2. CONCLUSION: The disk position should be judged according to the intermediate zone criterion.

Comparison between cone-beam and multislice computed tomography for identification of simulated bone lesions.

There are many studies that compare the accuracy of multislice (MSCT) and cone beam (CBCT) computed tomography for evaluations in the maxillofacial region. However, further studies comparing both acquisition techniques for the evaluation of simulated mandibular bone lesions are needed. The aim of this study was to compare the accuracy of MSCT and CBCT in the diagnosis of simulated mandibular bone lesions by means of cross sectional images and axial/MPR slices. Lesions with different dimensions, shape and locularity were produced in 15 dry mandibles. The images were obtained following the cross sectional and axial/MPR (Multiplanar Reconstruction) imaging protocols and were interpreted independently. CBCT and MSCT showed similar results in depicting the percentage of cortical bone involvement, with great sensitivity and specificity (p < 0.005). There were no significant intra- or inter-examiner differences between axial/MPR images and cross sectional images with regard to sensitivity and specificity. CBCT showed results similar to those of MSCT for the identification of the number of simulated bone lesions. Cross sectional slices and axial/MPR images presented high accuracy, proving useful for bone lesion diagnosis.

Comparison between cone-beam and multislice computed tomography for identification of simulated bone lesions

There are many studies that compare the accuracy of multislice (MSCT) and cone beam (CBCT) computed tomography for evaluations in the maxillofacial region. However, further studies comparing both acquisition techniques for the evaluation of simulated mandibular bone lesions are needed. The aim of this study was to compare the accuracy of MSCT and CBCT in the diagnosis of simulated mandibular bone lesions by means of cross sectional images and axial/MPR slices. Lesions with different dimensions, shape and locularity were produced in 15 dry mandibles. The images were obtained following the cross sectional and axial/MPR (Multiplanar Reconstruction) imaging protocols and were interpreted independently. CBCT and MSCT showed similar results in depicting the percentage of cortical bone involvement, with great sensitivity and specificity (p < 0.005). There were no significant intra- or inter-examiner differences between axial/MPR images and cross sectional images with regard to sensitivity and specificity. CBCT showed results similar to those of MSCT for the identification of the number of simulated bone lesions. Cross sectional slices and axial/MPR images presented high accuracy, proving useful for bone lesion diagnosis.

Influence of dental metallic artifact from multislice CT in the assessment of simulated mandibular lesions.

OBJECTIVE: This study evaluated the influence of metallic dental artifacts on the accuracy of simulated mandibular lesion detection by using multislice technology. MATERIAL AND METHODS: Fifteen macerated mandibles were used. Perforations were done simulating bone lesions and the mandibles were subjected to axial 16 rows multislice CT images using 0.5 mm of slice thickness with 0.3 mm interval of reconstruction. Metallic dental restorations were done and the mandibles were subjected again to CT in the same protocol. The images were analyzed to detect simulated lesions in the mandibles, verifying the loci number and if there was any cortical perforation exposing medullar bone. The analysis was performed by two independent examiners using e-film software. RESULTS: The samples without artifacts presented better results compared to the gold standard (dried mandible with perforations). In the samples without artifacts, all cortical perforation were identified and 46 loci were detected (of 51) in loci number analysis. Among the samples with artifacts, 12 lesions out of 14 were recognized regarding medullar invasion, and 40 out of 51 concerning loci number. The sensitivity in samples without artifacts was 90% and 100% regarding loci number and medullar invasion, respectively. In samples with artifacts, these values dropped to 78% and 86%, respectively. The presence of metallic restorations affected the sensitivity values of the method, but the difference was not significant (p>0.05). CONCLUSIONS: Although there were differences in the results of samples with and without artifacts, the presence of metallic restoration did not lead to misinterpretation of the final diagnosis. However, the validity of multislice CT imaging in this study was established for detection of simulated mandibular bone lesions.

Influence of dental metallic artifact from multislice CT in the assessment of simulated mandibular lesions

OBJECTIVE: This study evaluated the influence of metallic dental artifacts on the accuracy of simulated mandibular lesion detection by using multislice technology. MATERIAL AND METHODS: Fifteen macerated mandibles were used. Perforations were done simulating bone lesions and the mandibles were subjected to axial 16 rows multislice CT images using 0.5 mm of slice thickness with 0.3 mm interval of reconstruction. Metallic dental restorations were done and the mandibles were subjected again to CT in the same protocol. The images were analyzed to detect simulated lesions in the mandibles, verifying the loci number and if there was any cortical perforation exposing medullar bone. The analysis was performed by two independent examiners using e-film software. RESULTS: The samples without artifacts presented better results compared to the gold standard (dried mandible with perforations). In the samples without artifacts, all cortical perforation were identified and 46 loci were detected (of 51) in loci number analysis. Among the samples with artifacts, 12 lesions out of 14 were recognized regarding medullar invasion, and 40 out of 51 concerning loci number. The sensitivity in samples without artifacts was 90 percent and 100 percent regarding loci number and medullar invasion, respectively. In samples with artifacts, these values dropped to 78 percent and 86 percent, respectively. The presence of metallic restorations affected the sensitivity values of the method, but the difference was not significant (p>0.05). CONCLUSIONS: Although there were differences in the results of samples with and without artifacts, the presence of metallic restoration did not lead to misinterpretation of the final diagnosis. However, the validity of multislice CT imaging in this study was established for detection of simulated mandibular bone lesions.

Parameters in panoramic radiography for differentiation of radiolucent lesions.

OBJECTIVE: The aims of this study were to establish parameters in panoramic radiography for interpretation of unilocular radiolucent lesions, and to compare the accuracy of diagnoses given by examiners before and after using these parameters. MATERIAL AND METHODS: In Part I, 12 specialists analyzed 24 images and the diagnostic criteria used by each examiner to make correct diagnoses were used to build a list of basic radiographic parameters for each pathology (ameloblastoma, keratocystic odontogenic tumor, dentigerous cyst, and idiopathic bone cavity). In Part II, this list was used by 6 undergraduate students (Un), 8 recently graduated dentists (D), 3 oral pathologists, 3 stomatologists, 3 oral radiologists, and 3 oral surgeons to diagnose the corresponding pathologies in the other set of 24 panoramic radiographs (T2). The same analysis occurred without using this list (T1). The method of generalized estimating equations (GEE) was used in order to estimate the probability of making a correct diagnosis depending on the specialty of the examiner, type of lesion, and moment of the evaluation, T1 or T2 (before or after they had access to the list of parameters, respectively). RESULTS: Higher values were obtained for the probability (GEE) of making a correct diagnosis on T2; the group Un presented the highest improvement (14.6 %); no differences between the probabilities were observed either between Un and D, or among the different groups of specialists. CONCLUSIONS: The use of panoramic radiographic parameters did allow improving the diagnostic accuracy for all groups of examiners.

Radiographic interpretation of unilocular radiolucent mandibular lesions.

The main goal of this study was to identify the main distinctive radiographic characteristics of different unilocular radiolucent mandibular lesions based on the criteria used by different groups of specialists during the process of radiograph interpretation to arrive at a correct diagnosis. A total of 24 panoramic radiographs were selected exhibiting the following lesions: ameloblastoma, keratocystic odontogenic tumor, dentigerous cyst and simple bone cyst. Six cases of each pathology were analyzed by 3 specialists from 4 related areas (pathologists, stomatologists, radiologists and oral surgeons). A number of important distinctive features and confounding characteristics that are liable to misinterpretation were pointed out by the specialists during the analysis. The method of generalized estimating equations (GEE) was used to estimate the probability of correct diagnosis according to the specialization of the examiner and the type of lesion and no significant relation was found (p>0.05 for all variables). The overall percentage of correct diagnosis among the specialists was around 56%, which shows that these lesions are of difficult radiographic diagnosis. Although the specialty of the examiners did not influence the results, i.e., the 4 different kinds of specialists showed the same diagnostic capacity, the criteria used for interpreting the same lesions were often different among the specialists. The compilation of these criteria enabled the identification and selection of some useful distinctive radiographic characteristics to formulate diagnostic hypothesis of unilocular radiolucent lesions. The radiographic diagnosis of the unilocular radilucent mandibular lesions is particularly difficult and the histopathological examination is essential to make the definitive diagnosis.

Parameters in panoramic radiography for differentiation of radiolucent lesions

OBJECTIVE: The aims of this study were to establish parameters in panoramic radiography for interpretation of unilocular radiolucent lesions, and to compare the accuracy of diagnoses given by examiners before and after using these parameters. MATERIAL AND METHODS: In Part I, 12 specialists analyzed 24 images and the diagnostic criteria used by each examiner to make correct diagnoses were used to build a list of basic radiographic parameters for each pathology (ameloblastoma, keratocystic odontogenic tumor, dentigerous cyst, and idiopathic bone cavity). In Part II, this list was used by 6 undergraduate students (Un), 8 recently graduated dentists (D), 3 oral pathologists, 3 stomatologists, 3 oral radiologists, and 3 oral surgeons to diagnose the corresponding pathologies in the other set of 24 panoramic radiographs (T2). The same analysis occurred without using this list (T1). The method of generalized estimating equations (GEE) was used in order to estimate the probability of making a correct diagnosis depending on the specialty of the examiner, type of lesion, and moment of the evaluation, T1 or T2 (before or after they had access to the list of parameters, respectively). RESULTS: Higher values were obtained for the probability (GEE) of making a correct diagnosis on T2; the group Un presented the highest improvement (14.6 percent); no differences between the probabilities were observed either between Un and D, or among the different groups of specialists. CONCLUSIONS: The use of panoramic radiographic parameters did allow improving the diagnostic accuracy for all groups of examiners.

Radiographic interpretation of unilocular radiolucent mandibular lesions

The main goal of this study was to identify the main distinctive radiographic characteristics of different unilocular radiolucent mandibular lesions based on the criteria used by different groups of specialists during the process of radiograph interpretation to arrive at a correct diagnosis. A total of 24 panoramic radiographs were selected exhibiting the following lesions: ameloblastoma, keratocystic odontogenic tumor, dentigerous cyst and simple bone cyst. Six cases of each pathology were analyzed by 3 specialists from 4 related areas (pathologists, stomatologists, radiologists and oral surgeons). A number of important distinctive features and confounding characteristics that are liable to misinterpretation were pointed out by the specialists during the analysis. The method of generalized estimating equations (GEE) was used to estimate the probability of correct diagnosis according to the specialization of the examiner and the type of lesion and no significant relation was found (p>0.05 for all variables). The overall percentage of correct diagnosis among the specialists was around 56%, which shows that these lesions are of difficult radiographic diagnosis. Although the specialty of the examiners did not influence the results, i.e., the 4 different kinds of specialists showed the same diagnostic capacity, the criteria used for interpreting the same lesions were often different among the specialists. The compilation of these criteria enabled the identification and selection of some useful distinctive radiographic characteristics to formulate diagnostic hypothesis of unilocular radiolucent lesions. The radiographic diagnosis of the unilocular radilucent mandibular lesions is particularly difficult and the histopathological examination is essential to make the definitive diagnosis.

O objetivo deste estudo foi identificar as principais caracteristicas radiograficas para a diferenciacao de lesoes radiolucidas uniloculares mandibulares, por meio dos criterios utilizados por diferentes grupos de especialistas durante o processo de interpretacao radiografica para a obtencao dos diagnosticos corretos das lesoes. Vinte e quatro radiografias panoramicas foram selecionadas exibindo as seguintes lesoes: ameloblastoma, tumor odontogenico queratocistico, cisto dentigero e cisto osseo simples. Seis casos de cada entidade patologica foram analisados por 3 especialistas de 4 areas diretamente relacionadas a diagnostico (patologistas, estomatologistas, radiologistas e cirurgioes buco-maxilo-faciais). Inumeras caracteristicas importantes tanto para a correta distincao quanto para a ocorrencia de confusao entre as lesoes, foram levantadas pelos especialistas durante a analise. O metodo de equacoes de estimacao generalizada (EEG) foi utilizado para estimar a probabilidade do acerto do diagnostico segundo a especialidade do examinador e o tipo de lesao, nao sendo encontrada relacao significativa (p>0.05 para todas as variaveis). A porcentagem geral de diagnostico correto entre os especialistas ficou em torno de 56%, o que mostra que estas lesoes sao de dificil diagnostico radiografico. Embora a especialidade dos examinadores nao tenha influenciado os resultados, isto e, os 4 tipos de especialistas mostraram a mesma capacidade diagnostica, os criterios utilizados para a interpretacao das mesmas lesoes foram frequentemente diferentes entre os especialistas. A compilacao desses criterios possibilitou a identificacao e selecao de algumas caracteristicas radiograficas distintivas uteis na formulacao de hipoteses diagnosticas de lesoes radiolucidas uniloculares. O diagnostico radiografico das lesoes radiolucidas uniloculares mandibulares e particularmente dificil e a analise histopatologica e essencial para a obtencao do diagnostico definitivo.

Diagnostic agreement between panoramic radiographs and color doppler images of carotid atheroma

The aim of this study was to investigate the agreement between diagnoses of calcified atheroma seen on panoramic radiographs and color Doppler images. Our interest stems from the fact that panoramic images can show the presence of atheroma regardless of the level of obstruction detected by color Doppler images. Panoramic and color Doppler images of 16 patients obtained from the archives of the Health Department of the city of Valença, RJ, Brazil, were analyzed in this study. Both sides of each patient were observed on the images, with a total of 32 analyzed cervical regions. The level of agreement between diagnoses was analyzed using the Kappa statistics. There was a high level of agreement, with a Kappa value of 0.78. In conclusion, panoramic radiographs can help detecting calcifications in the cervical region of patients susceptible to vascular diseases predisposing to myocardial infarction and cerebrovascular accidents. If properly trained and informed, dentists can refer their patients to a physician for a cardiovascular evaluation in order to receive proper and timely medical treatment.

Diagnostic agreement between panoramic radiographs and color Doppler images of carotid atheroma.

The aim of this study was to investigate the agreement between diagnoses of calcified atheroma seen on panoramic radiographs and color Doppler images. Our interest stems from the fact that panoramic images can show the presence of atheroma regardless of the level of obstruction detected by color Doppler images. Panoramic and color Doppler images of 16 patients obtained from the archives of the Health Department of the city of Valença, RJ, Brazil, were analyzed in this study. Both sides of each patient were observed on the images, with a total of 32 analyzed cervical regions. The level of agreement between diagnoses was analyzed using the Kappa statistics. There was a high level of agreement, with a Kappa value of 0.78. In conclusion, panoramic radiographs can help detecting calcifications in the cervical region of patients susceptible to vascular diseases predisposing to myocardial infarction and cerebrovascular accidents. If properly trained and informed, dentists can refer their patients to a physician for a cardiovascular evaluation in order to receive proper and timely medical treatment.

Avaliação da hiperplasia do processo coronoide em radiografias panorâmicas / Evaluation of hyperplasia in the coronoid process by panoramic radiograph

Introdução: A hiperplasia do processo coronoide é uma variação morfológica que causa limitação na aberturade boca. O paciente procura tratamento quando há dor ou problemas funcionais causados pela compressão do processo coronoide no osso zigomático. Muitos clínicos desconhecem esta sintomatologia confundindo com disfunção da articulação temporomandibular. A proposta nesse trabalho é demonstrar que a hiperplasia do processo coronoide pode ser observada em radiografias panorâmicas alertando o profissional para a associação com sinais e sintomas clínicos e encaminhando o paciente para exames mais complexos com os quais se conclua o diagnóstico. Métodos: A amostra constituiu-se de 620 radiografias panorâmicas das quais foram selecionadas 150 dentre as quais incluíam-se radiografias de pacientes compossível diagnóstico inicial de HPC, determinado pela relação do processo coronoide com a altura da cabeça da mandíbula. Resultados: Essas radiografias foram analisadas por 3 Radiologistas e ficou concluído que, uma vez que se trata de um exame corriqueiramente utilizado pelo cirurgião-dentista, a radiografia panorâmica é um meio auxiliar para o diagnóstico inicial dessa alteração, principalmente quando puder se associar a imagem suspeita com os sinais e sintomas clínicos correspondentes

Introduction: Hyperplasia of the coronoid process (HCP) is a morphologic variation that causes restriction in mouth opening compression in the coronoid process of the zygomatic bone causes pain or functional problem, leading patients to seek treatment. Many dental practitioners ignore these symptoms, confusing them with dysfunction in the temporomandibular joint. In the present study, our proposal is to demonstrate that HPC can be observed in panoramic radiographs. If this observation alerts the professional for association with clinical signals and symptoms The patient can be referred to perform more complex examinations with which diagnosis is concluded. Methods: Three radiologists analyzed and selected 150 (of a sample of 620) panoramic radiographs including those of patients with possible initial diagnosis of HCP as determined by the relationship of the size of the coronoid process with height of the mandible head sincepanoramic is currently used by dental practitioners. Conclusion: It was concluded that this examinationis an auxiliary way in the initial diagnosis of this condition, mostly when association between suspicion image and the corresponding clinical signals and symptoms is possible

Ateromoas calcificados: aspecto na radiografia panorâmica / Aspects of calcified atheromas in panoramic radiographs

A placa ateromatosa é constituída de depósitos circunscritos de lipídios na íntima do vaso e é a causa mais comum de AVC (Acidente Vascular Cerebral). Os depósitos calcificados na parede das artérias podem ocorrer em todas as formas de aterosclerose, com deposição de sais de cálcio na túnica média do vaso. Essas calcificações podem ser visualizadas em radiografias panorâmicas, como massa radiopaca na região de tecido mole do pescoço, no espaço intervertebral C3 e C4, acima ou abaixo do osso hióide. Com isso os profissionais devem estar aptos a diferenciar os aspectos radiográficos anatômicos e patológicos facilitando a identificação de todas as estruturas que estão localizadas na região pré-vertebral. Nesse trabalho, ressalta-se a importância do cirurgião-dentista no diagnóstico holístico dos pacientes.

The atheromatous plaque is composed of peripheral deposits of lipid on intima of blood vessels, and is the most common cause of cerebrovascular accidents (CVA). Calcified deposits formed within the artery wall may occur in all forms of atherosclerosis, and calcium salt is deposited on the tunica media of vessels. These calcifications can be observed in panoramic radiographs as radiopaque mass in the soft tissue region of the neck, at the C3-C4 intervertebral space, above or below the hyoid bone. Professionals must be able to differentiate anatomical radiographic aspects from pathological ones, making the identification of all structures in the prevertebral region easier. ln this study, we stress the importance of dentists to the holistic diagnosis of patients.

Comparação das ferramentas de medidas com e sem calibração de três sistemas de radiografia digital / Assessment of calibration tools of three digital radiography systems

O objetivo foi validar e comprovar a eficácia das ferramentas de medidas com e sem calibração de três sistemas de radiografias digitais (RVG, Visualix e Digora). Para tanto utilizamos 20 dentes humanos secos provindos do Banco de Dentes Permanentes da FOUSP, os quais foram radiografados com o auxílio de três sistemas de radiografia digital dos tipos direto e semidireto. O padrão ouro das medidas dos dentes foi a verificação das dimensões dos dentes por meio de um paquímetro digital e posteriormente comparados os seus padrões de medidas com os softwares dos respectivos sistemas. Os resultados foram analisados estatisticamente pelo teste ANOVA (métodos de Tukey e Dunnett), chegando às seguintes conclusões: existiu diferença significante entre as ferramentas de medição dos aparelhos avaliados (p<0,001); a média das medidas obtidas com o aparelho Digora foi menor do que as médias obtidas pelos outros aparelhos e quando comparado ao padrão ouro; as médias das medidas obtidas com os aparelhos Visualix e RVG não apresentaram diferença estatisticamente entre eles e quando comparadas com padrão ouro.

Estudo da prevalência das anomalias dentárias de desenvolvimento em dada população, com o uso de radiografias panorâmicas / Study of the prevalence of dental development anomalies in a population sample through panoramic x-ray

Introdução: O estudo das anomalias dentárias de desenvolvimento tem apresentado resultados nem sempre convergentes. Os índices de prevalência, distribuição por sexo, arcada, lado e dentes envolvidos têm variado na literatura, segundo a população pesquisada. Métodos: Neste trabalho foram avaliadas 533 radiografias panorâmicas, de pacientes dos sexos feminino e masculino, buscando-se identificar e caracterizar a sua ocorrência. Resultados: Alguns dos resultados encontrados foram: a) macrodontia – prevalência de 0,75%, dente mais envolvido o terceiro molar superior; b) microdontia – prevalência de 2,81%, dente mais envolvido o incisivo lateral superior direito; c) taurodontia – prevalência de 1,5% e dente mais envolvido o segundo molar inferior; d) anodontia – prevalência de 6,57%, dente mais envolvido o terceiro molar inferior; e) dentes supra-numerários – prevalência de 1,5% e região mais envolvida a região de molares superiores; f) dentes não irrompidos – prevalência de 31,52% e o dente mais envolvido foram os terceiros molares inferiores; g) transposição – prevalência de 0,38%, não foi considerado o elemento mais envolvido por constarem apenas 2 casos da amostra. Conclusão: Constituiu-se do objetivo, neste trabalho, traçar o perfil da população estudada, no que se refere às anomalias pesquisadas. A análise dos resultados permite inferir que a amostra populacional avaliada apresenta traços característicos e peculiares.

Several studies concerning dental development abnormalities have not shown accordant results. The data about prevalence, sex distribution, dental arch, side and involved tooth have been different, depending on the author, due to the specific population researched. In this report, 533 panoramic radiographs of both gender were studied, in order to establish the occurrence of the following abnormalities: a) macrodontia – prevalence: 0,75% and the most involved tooth the upper third molar; b) microdontia – prevalence: 2,81% and the most involved tooth the right upper lateral incisor; c) taurodontism – prevalence: 1,5% and the most involved tooth the lower second molar; d) fused roots – prevalence: 9,9% and the most involved tooth the upper second molar; e) anodontia – prevalence: 6,57% and the most involved tooth the lower third molar; f) supernumerary tooth – prevalence: 1,5% and the most involved area the upper molars; g) impacted tooth – prevalence: 31,52% and the most involved tooth the lower third molar; h) transposition – prevalence: 0,38%. The aim was to delineate the population concerning the researched abnormalities. The analysis of the results showed that the studied population has its own features.