In vivo study of cone beam computed tomography texture analysis of mandibular condyle and its correlation with gender and age.

OBJECTIVE: Texture analysis is an image processing method that aims to assess the distribution of gray-level intensity and spatial organization of the pixels in the image. The purpose of this study was to investigate whether the texture analysis applied to cone beam computed tomography (CBCT) images could detect variation in the condyle trabecular bone of individuals from different age groups and genders. METHODS: The sample consisted of imaging exams from 63 individuals divided into three groups according to age groups of 03-13, 14-24 and 25-34. For texture analysis, the MaZda® software was used to extract the following parameters: second angular momentum, contrast, correlation, sum of squares, inverse difference moment, sum entropy and entropy. Statistical analysis was performed using Mann-Whitney test for gender and Kruskal-Wallis test for age (P = 5%). RESULTS: No statistically significant differences were found between age groups for any of the parameters. Males had lower values for the parameter correlation than those of females (P < 0.05). CONCLUSION: Texture analysis proved to be useful to discriminate mandibular condyle trabecular bone between genders.

Three-Dimensional Volumetric Analysis of Frontal Ethmoidal Cells and Evaluation of Influential Factors: A Helical Computed Tomography Study.

In the present study, we aimed to assess frontal ethmoidal cells by using segmentation 3D software to establish a possible correlation between volume variation and both gender and age, as well as a relationship with Keros classification. Helical computed tomography images were obtained from 71 patients for analysis, in which the agger nasi cell, supra agger cell, supra agger frontal cell, supra bulla frontal cell, supraorbital ethmoidal cell, supra bulla cell, and frontal septal cell were identified and segmented to obtain their volume. Significant differences in volume were found for age and gender regarding agger nasi cells (p-value = 0.017), supra agger cells (p-value < 0.001), and frontal septal cells (p-value = 0.049). In the frontal septal cells, an increase of one year in age reduced the volume by 0.309, on average. According to Keros classification, the mean volumes were 10.07 and 25.64, respectively, for types II and III, both being greater than that of type I. Extracting volumetric data by using segmentation software in agger nasi cells, supra agger cells, and frontal septal cells may be useful for obtaining additional information related to age, in addition to possibly contributing to elucidating the anatomical variations in the region and an identification forensic tool.

Magnetic resonance imaging texture analysis to differentiate ameloblastoma from odontogenic keratocyst.

The differentiation between ameloblastoma (AB) and odontogenic keratocyst (OKC) is essential for the formulation of the surgical plan, especially considering the biological behavior of these two pathological entities. Therefore, developing means to increase the accuracy of the diagnostic process is extremely important for a safe treatment. The aim of this study was to use magnetic resonance imaging (MRI) based on texture analysis (TA) as an aid in differentiating AB from OKC. This study comprised 18 patients; eight patients with AB and ten with OKC. All diagnoses were determined through incisional biopsy and later through histological examination of the surgical specimen. MRI was performed using a 3 T scanner with a neurovascular coil according to a specific protocol. All images were exported to segmentation software in which the volume of interest (VOI) was determined by a radiologist, who was blind to the histopathological results. Next, the textural parameters were computed by using the MATLAB software. Spearman's correlation coefficient was used to assess the correlation between texture parameters and the selected variables. Differences in TA parameters were compared between AB and OKC by using the Mann-Whitney test. Mann-Whitney test showed a statistically significant difference between AB and OKC for the parameters entropy (P = 0.033) and sum average (P = 0.033). MRI texture analysis has the potential to discriminate between AB and OKC as a noninvasive method. MRI texture analysis can be an additional tool to differentiate ameloblastoma from odontogenic keratocyst.

Differentiation of periapical granuloma from radicular cyst using cone beam computed tomography images texture analysis.

OBJECTIVE: This study aimed to investigate the use of texture analysis for characterization of radicular cysts and periapical granulomas and to assess its efficacy to differentiate between both lesions with histological diagnosis. METHODS: Cone beam computed tomography (CBCT) images were obtained from 19 patients with 25 periapical lesions (14 radicular cysts and 11 periapical granulomas) confirmed by biopsy. Regions of interest were created in the lesions from which 11 texture parameters were calculated. Spearman's correlation analysis was performed and adjusted with Benjamini-Hochberg false discovery rate procedure (FDR <0.005). RESULTS: The texture parameters used to differentiate the lesions were assessed by using a receiver operating characteristic analysis. Five texture parameters were predictive of lesion differentiation for eight positions: angular second moment; sum of squares; sum of average; contrast; correlation. CONCLUSION: Texture analysis of CBCT scans distinguishes radicular cysts from periapical granulomas and can be a promising diagnostic tool for periapical lesions. CLINICAL SIGNIFICANCE: Texture analysis can be used in diagnostic and treatment monitoring to provide supplementary information.

Presence of langerhans cells, regulatory T cells (Treg) and mast cells in asymptomatic apical periodontitis.

Asymptomatic Apical Periodontitis is essentially an inflammatory disease of microbial aetiology. Association and function of the cell components involved, or specific inductive factors and growth mediators associated with development, maintenance and resolution of the periapical lesions are still unknown. The objective of this study was to evaluate the concentration of Regulatory T cells (FoxP3+; Treg), Langerhans cells (CD1a+; LC) and mast cells in asymptomatic apical periodontitis. 73 cases were selected: 30 periapical granulomas, 29 radicular cysts and 14 residual cysts. All groups were submitted to morphological analysis for classification of inflammatory infiltrate and thickness of the epithelial lining as well as to immunohistochemical analysis for detection of LC and Treg cells. Toluidine blue staining was used for detecting mast cells. Analysis showed higher mean numbers of LC (8.2 cells/0.2mm2), and Treg cells in radicular cysts (5.910 cells/0.2mm2). As for mast cells, it was found that radicular cysts had a higher mean number of these cells compared to other periapical lesions (12.68 cells/0.2mm2). The association between thickness of the epithelial lining and inflammatory cells showed that the presence of hypertrophic epithelium in radicular cysts presented higher density of LC. The number of LC and Treg cells play an important role in the control of the inflammatory micro-environment in periapical granulomas and radicular cysts, respectively. The presence of mast cells in radicular cysts may be associated with progression of the lesion. Knowledge regarding the inflammatory cell profile is therefore essential for a better understanding of the pathogenesis of asymptomatic periapical periodontitis.

Presence of langerhans cells, regulatory T cells (Treg) and mast cells in asymptomatic apical periodontitis

Abstract Asymptomatic Apical Periodontitis is essentially an inflammatory disease of microbial aetiology. Association and function of the cell components involved, or specific inductive factors and growth mediators associated with development, maintenance and resolution of the periapical lesions are still unknown. The objective of this study was to evaluate the concentration of Regulatory T cells (FoxP3+; Treg), Langerhans cells (CD1a+; LC) and mast cells in asymptomatic apical periodontitis. 73 cases were selected: 30 periapical granulomas, 29 radicular cysts and 14 residual cysts. All groups were submitted to morphological analysis for classification of inflammatory infiltrate and thickness of the epithelial lining as well as to immunohistochemical analysis for detection of LC and Treg cells. Toluidine blue staining was used for detecting mast cells. Analysis showed higher mean numbers of LC (8.2 cells/0.2mm2), and Treg cells in radicular cysts (5.910 cells/0.2mm2). As for mast cells, it was found that radicular cysts had a higher mean number of these cells compared to other periapical lesions (12.68 cells/0.2mm2). The association between thickness of the epithelial lining and inflammatory cells showed that the presence of hypertrophic epithelium in radicular cysts presented higher density of LC. The number of LC and Treg cells play an important role in the control of the inflammatory micro-environment in periapical granulomas and radicular cysts, respectively. The presence of mast cells in radicular cysts may be associated with progression of the lesion. Knowledge regarding the inflammatory cell profile is therefore essential for a better understanding of the pathogenesis of asymptomatic periapical periodontitis.

Inflammatory profile of chronic apical periodontitis: a literature review.

Apical periodontitis caused by root canal infection is the most frequent pathological lesion in the jaws, mainly manifested as periapical granulomas and cysts. Understanding of the formation and progression of apical periodontitis as well as the identification of inflammatory biomarkers can help increase the knowledge of pathogenic mechanisms, improve the diagnosis and provide support for different therapeutic strategies. The objective of the present article is to review inflammatory biomarkers such as cytokines, chemokines, inflammatory cells, neuropeptides, RANK/RANKL/OPG system and other inflammatory markers and to relate these systems to the development and progression of pathological conditions related to apical periodontitis.