Infrared Imaging of the Brain-Eyelid Thermal Tunnel: A Promising Method for Measuring Body Temperature in Afebrile Children.

(1) Infrared thermography of the inner canthus of the eye has emerged as a promising tool for temperature screening and fever diagnosis. Its non-invasive nature lends itself well to mass screening in diverse settings such as schools, public transport, and healthcare facilities. Swift and accurate temperature assessment plays a pivotal role in the early identification of potential fever cases, facilitating timely isolation, testing, and treatment, thereby mitigating the risk of disease transmission. Nonetheless, the reliability of this approach in the pediatric population, especially when compared to conventional thermometry methods, remains unexplored. This preliminary study aimed to evaluate the concordance between the temperature of the inner canthus of the eye (Tic,eye), referred to as the brain-eyelid thermal tunnel (BTT°), with axillary and tympanic methods in afebrile children. (2) Methods: A cohort of 36 children, matched in a 1:1 ratio for gender and age, underwent comprehensive assessments encompassing anthropometric data, blood pressure evaluations, axillary (Tax) and tympanic (Tty) temperature measurements, as well as BTT° infrared thermography. (3) Results: The findings revealed a high level of concordance among the tympanic, axillary, and BTT° measurement methods. Bland-Altman plots showed that the bias was minimal, and no statistically significant differences were observed when comparing BTT° with axillary (p = 0.136) and tympanic (p = 0.268) measurements. Passing-Bablok regression scatter plots further confirmed the agreement, aligning the fitted regression line closely with the identity line for both axillary versus BTT° and tympanic (Tty) versus BTT° comparisons. (4) Conclusions: This study holds significant implications for public health, especially in the context of infectious disease outbreaks such as COVID-19. BTT° infrared thermography of the inner canthus of the eye (Tic,eye) reliably measures body temperature in afebrile children in controlled settings; nevertheless, its practical application necessitates the adaptation of biothermodynamic parameters to accommodate diverse environmental conditions.

The endocannabinoid system and orofacial pains: updates and perspectives / O sistema endocanabinoide e as dores orofaciais: atualidades e perspectivas

ABSTRACT BACKGROUND AND OBJECTIVES: Since the relatively recent discovery of the endocannabinoid system (ECS) and its fundamental role in regulating other systems, the subject has aroused interest in all areas of health, including Dentistry. Among the possible uses and benefits of cannabinoids are their performance in pain and its predisposing or perpetuating factors, such as bruxism and sleep disorders. Although the literature is still scarce, the mechanisms of action and satisfactory results of cannabinoids and other cannabis derivatives in these situations already allow their safe prescription. The objective of this study was to verify the current evidence on the use of cannabis derivatives in orofacial pain (OFP), reviewing what is known, to date, about the ECS and the prospects for its use with support and criteria. CONTENTS: This research carried out a brief review of the cannabis plant history, addressing issues such as prejudice, prohibitions and interests, as well as its therapeutic use. Then, a review on ECS and its mechanisms of interest in OFP was presented. Next, the products derived from the plant and their effects, indications, contraindications, adverse effects, drug interactions, peculiarities and perspectives were discussed. CONCLUSION: The more knowledge is gained about the ECS and the therapeutic benefits of cannabis components and derivatives, the greater the conviction that a new therapeutic frontier has indeed emerged. The growing number of good outcomes, including cases of OFP, obtained through well-conducted studies, brings a mixture of satisfaction and excitement. No therapy will achieve good results if it does not start from an accurate diagnosis. Thus, it is of the utmost importance to know the ECS, the products and derivatives of the plant, the synthetic cannabinoids, their indications and effects. New studies are necessary and, at this moment, it can be said that the perspectives are very good and a new and challenging horizon is emerging.

RESUMO JUSTIFICATIVA E OBJETIVOS: Desde a descoberta relativamente recente do sistema endocanabinoide (SEC) e seu papel fundamental da regulação de outros sistemas, o assunto tem despertado interesse de todas as áreas da saúde, incluindo-se a Odontologia. Dentre as possíveis utilizações e benefícios dos canabinoides, está sua atuação na dor e seus fatores predisponentes ou perpetuadores, como o bruxismo e os distúrbios do sono. Embora a literatura seja ainda escassa, os mecanismos de ação e resultados satisfatórios dos canabinoides e demais derivados da cannabis nessas situações já permitem sua prescrição com segurança. O objetivo deste estudo foi verificar as atuais evidências sobre a utilização de derivados da cannabis nas dores orofaciais (DOFs), revisando o que se sabe, até o momento, sobre o SEC e as perspectivas de sua utilização com respaldo e critério. CONTEÚDO: Esta pesquisa realizou uma breve revisão da história da planta cannabis, abordando temas como preconceito, proibições e interesses, além de sua utilização terapêutica. Em seguida, foi apresentada uma revisão sobre o SEC e seus mecanismos de interesse na DOF. Na sequência, foram discutidos os produtos derivados da planta e seus efeitos, indicações, contraindicações, efeitos adversos, interações farmacológicas, peculiaridades e perspectivas. CONCLUSÃO: Quanto mais são adquiridos conhecimentos sobre o SEC e os benefícios terapêuticos dos componentes e derivados da cannabis, mais há um convencimento de que surgiu, de fato, uma nova fronteira terapêutica. O número crescente de bons desfechos, incluindo casos de DOF, obtidos através de estudos bem conduzidos, traz um misto de satisfação e empolgação. Nenhuma terapia obterá bons resultados se não partir de um diagnóstico preciso. Assim, é de suma importância que se conheça o SEC, os produtos e derivados da planta, os canabinoides sintéticos, suas indicações e efeitos. Novos estudos são necessários e, nesse momento, pode-se afirmar que as perspectivas são muito boas e um novo e desafiador horizonte está despontando.

Proposal of a protocol for thermographic assessment of the orbicularis oris muscle.

BACKGROUND: The orbicularis oris muscle is extremely important to performing various oral functions, including mastication, swallowing and speech. Infrared thermography is a non-invasive painless technique that does not require either contrast or ionisation. It has been increasingly used in speech-language-hearing therapy in the last years. OBJECTIVE: The objective of the study was to propose a thermographic analysis method for the orbicularis oris muscle. METHODS: This is an observational, analytical, cross-sectional study. The area of the orbicularis oris muscle was defined based on its anatomy with thermographic images of 11 children and 13 adults. Then, this area was divided into four quadrants, each of which was analysed considering four different shapes: a triangle; a rectangle; a triangle with a rounded side, including the vermilion zone; and a customised shape encompassing only the region of the orbicularis oris muscle, not including the vermilion zone. Data were collected and analysed with the coefficient of variation and interrater agreement. RESULTS: Data variability for the four shapes had similar dispersions per region of the orbicularis oris muscle, in both maximum and mean temperatures and in both children and adults. The rectangle was the shape with the lowest coefficient of variation in more regions of both adults and children. Interrater agreement was excellent for all shapes, in both children and adults. CONCLUSION: Currently, the best way to analyse the orbicularis oris muscle's quadrants is to use the maximum temperature and the rectangle, based on an initial ellipsis encompassing the whole muscle.

Congenital heart disease in children: Orofacial myofunctional aspects, eating behavior and facial temperature

OBJECTIVE: To characterize the eating behavior, orofacial, speech myofunctional conditions, and facial temperature of children with congenital heart disease. METHOD: This is a cross-sectional and analytical study. The sample consisted of 30 children with heart disease (cyanotic or acyanotic; mean of 5.48 ± 0.84 years old) and 28 healthy children (4.98 ± 0.64 years old). Parents were given a questionnaire to assess eating behaviors (Montreal Children's Hospital Feeding Scale). The orofacial myofunctional assessment protocol (OMES-E), the Child Language Test (ABFW), and thermography infrared of facial temperature were used. Data analysis was conducted by student's t-tests, Chi-square, logistic regression, and correlation analysis. RESULTS: Eating behavior in Parents did not perceive eating behavior differences between the heart disease and control groups. However, the percentage of children with some feeding difficulty was higher in the heart disease group. There was a difference between groups regarding the appearance and posture of structures, the mobility of the mandibular and cheek, swallowing function, and the total function score. Thermographic variables did not differ between the groups, but better performance in orofacial functions correlated with the temperature of the labial commissure and lower lip points. CONCLUSIONS: The frequency of children with eating difficulties was higher among those with congenital heart disease, as was the increased facial temperature at the medial eyelid commission point when submitted to interventional procedures. The orofacial myofunctional aspects showed changes in posture and position, mobility, and orofacial functions among children with heart disease as compared to the control group. There was a correlation between the temperature of the thermo-anatomical points of the labial commissure and the lower lip as well as the OMES-E function score. (AU)

Congenital heart disease in children: Orofacial myofunctional aspects, eating behavior and facial temperature.

OBJECTIVE: To characterize the eating behavior, orofacial, speech myofunctional conditions, and facial temperature of children with congenital heart disease. METHOD: This is a cross-sectional and analytical study. The sample consisted of 30 children with heart disease (cyanotic or acyanotic; mean of 5.48 ± 0.84 years old) and 28 healthy children (4.98 ± 0.64 years old). Parents were given a questionnaire to assess eating behaviors (Montreal Children's Hospital Feeding Scale). The orofacial myofunctional assessment protocol (OMES-E), the Child Language Test (ABFW), and thermography infrared of facial temperature were used. Data analysis was conducted by student's t-tests, Chi-square, logistic regression, and correlation analysis. RESULTS: Eating behavior in Parents did not perceive eating behavior differences between the heart disease and control groups. However, the percentage of children with some feeding difficulty was higher in the heart disease group. There was a difference between groups regarding the appearance and posture of structures, the mobility of the mandibular and cheek, swallowing function, and the total function score. Thermographic variables did not differ between the groups, but better performance in orofacial functions correlated with the temperature of the labial commissure and lower lip points. CONCLUSIONS: The frequency of children with eating difficulties was higher among those with congenital heart disease, as was the increased facial temperature at the medial eyelid commissions point when submitted to interventional procedures. The orofacial myofunctional aspects showed changes in posture and position, mobility, and orofacial functions among children with heart disease as compared to the control group. There was a correlation between the temperature of the thermo-anatomical points of the labial commissure and the lower lip as well as the OMES-E function score.

Fragile X syndrome: panoramic radiographic evaluation of dental anomalies, dental mineralization stage, and mandibular angle.

OBJECTIVE:: The purpose of this study was to evaluate the dental radiographic characteristics as described in 40 records of patients with panoramic radiography. MATERIAL AND METHODS:: The patients were in the range of 6-17 years old, and were divided into two groups (20 subjects who were compatible with the normality standard and 20 individuals diagnosed with the FXS), which were matched for gender and age. Analysis of the panoramic radiographic examination involved the evaluation of dental mineralization stage, mandibular angle size, and presence of dental anomalies in both deciduous and permanent dentitions. RESULTS:: The results of radiographic evaluation demonstrated that the chronology of tooth eruption of all third and second lower molars is anticipated in individuals with FXS (p<0.05). In this group, supernumerary deciduous teeth (2.83%), giroversion of permanent teeth (2.31%), and partial anodontia (1.82%) were the most frequent dental anomalies. In addition, an increase was observed in the mandibular angle size in the FXS group (p<0.05). CONCLUSION:: We conclude that knowledge of dental radiographic changes is of great importance for dental surgeons to plan the treatment of these individuals.

Fragile X syndrome: panoramic radiographic evaluation of dental anomalies, dental mineralization stage, and mandibular angle

ABSTRACT Fragile X syndrome (FXS) is a disorder linked to the chromosome X long arm (Xq27.3), which is identified by a constriction named fragile site. It determines various changes, such as behavioral or emotional problems, learning difficulties, and intellectual disabilities. Craniofacial abnormalities such as elongated and narrow face, prominent forehead, broad nose, large and prominent ear pavilions, strabismus, and myopia are frequent characteristics. Regarding the oral aspects, deep and high-arched palate, mandibular prognathism, and malocclusion are also observed. Objective: The purpose of this study was to evaluate the dental radiographic characteristics as described in 40 records of patients with panoramic radiography. Material and Methods: The patients were in the range of 6–17 years old, and were divided into two groups (20 subjects who were compatible with the normality standard and 20 individuals diagnosed with the FXS), which were matched for gender and age. Analysis of the panoramic radiographic examination involved the evaluation of dental mineralization stage, mandibular angle size, and presence of dental anomalies in both deciduous and permanent dentitions. Results: The results of radiographic evaluation demonstrated that the chronology of tooth eruption of all third and second lower molars is anticipated in individuals with FXS (p<0.05). In this group, supernumerary deciduous teeth (2.83%), giroversion of permanent teeth (2.31%), and partial anodontia (1.82%) were the most frequent dental anomalies. In addition, an increase was observed in the mandibular angle size in the FXS group (p<0.05). Conclusion: We conclude that knowledge of dental radiographic changes is of great importance for dental surgeons to plan the treatment of these individuals.

Estudo da distribuição térmica da superfície cutânea facial por meio de termografia infravermelha: termoanatomia da face / Study of the facial surface skin thermal distribution by infrared thermography: facial thermoanatomy

Pelo fato da face ser uma estrutura que envolve multissistemas, ela é considerada anatomica e funcionalmente muito complexa em sua avaliação clínica. Muitos diagnósticos de doenças que afetam a região facial são realizados por meio de métodos de imagem, entretanto, as técnicas convencionais são incompletas, pois apresentam um déficit de informações em relação aos aspectos funcionais, relativos à microcirculação regional e o sistema nervoso autônomo. Para documentação objetiva destas alterações, a termografia por imagem infravermelha tem sido proposta como método auxiliar diagnóstico. O objetivo deste estudo foi identificar, mapear e quantificar pontos de referência baseados na termoanatomia da face, a partir de gradientes térmicos, em uma população adulta. A amostra constituiu-se por 161 voluntários, ambos os gêneros, entre 26 e 84 anos (63 ±15 anos). Foram identificados 28 pontos de referência termoanatômicos fixos em 94,6% da amostra. A temperatura média desses pontos de referência termoanatômicos variou entre 33,3°C a 35,6°C, sendo que o melhor valor de corte para sua correta identificação na face foi acima de 34,5ºC. Não houve diferença estatística quando os comparou entre as hemifaces correspondentes e nem quanto à idade dos voluntários (?T = 0,11°C), exceto entre os gêneros e grupo racial (p<0,05). Concluiu-se que a face apresenta pontos termoanatômicos fixos e confiáveis em adultos, a qual a termografia tem o potencial de auxiliar na identificação de alterações a partir destes pontos...

Anatomical and functional information of the structures of interest are the basis for interpretation of imaging exams. For recognizing diseases it is necessary to understand and identify the anatomical structures and its variations. Diagnosis of some facial diseases may be done through medical imaging techniques; however, the most conventional methods present lack of information regarding physiological and functional aspects such as microcirculation and autonomous nervous system. The aim of this study was to identify, map and quantify the facial thermal gradients (thermo-anatomical points) in healthy adult population. A hundred sixty-one volunteers of both gender and mean age of 63 ±15 years were included. The results showed that twenty eight thermo-anatomical points have been identified in 94.6% of the sample, with a significant difference of the temperature in gender and racial groups (p<0.05). Moreover, there was no statistically significant difference between ages and sides in healthy individuals (?T = 0.11°C). The average temperature of the points ranged from 33.3°C to 35.6°C. When the maximum temperature reached to detect a facial thermal gradient is higher than 34.5°C, the thermo-anatomical point is meant to be correctly delineated. For detection of functional changes from thermoanatomical points on the face, thermography may be used as an auxiliary diagnostic imaging method...

Correlação clínica e termográfica do ponto-gatilho miofascial nos músculos da mastigação / Thermographic and clinical correlation of myofascial trigger points in the masticatory muscles

A síndrome dolorosa miofascial (SDM) é uma disfunção musculoesquelética não articular caracterizada por pontos-gatilho miofasciais. Estes pontos, identificados por meio da palpação, são descritos como bandas tensas na fibra muscular, podendo apresentar dor referida à compressão. Sabe-se que os pontos-gatilho miofasciais provocam hiperatividade simpática regional de temperatura local devido à atividade vasoconstritora cutânea. Para documentação objetiva por imagem desta alteração funcional, a termografia tem sido proposta como método auxiliar diagnóstico. O objetivo deste estudo foi correlacionar os exames clínico e termográfico dos pontosgatilho nos músculos da mastigação masseter e temporal parte anterior. A amostra constituiu-se por 26 mulheres voluntárias com 41 ± 15 anos. Os resultados demonstraram correlação diretamente proporcional entre algometria e termografia na avaliação do ponto-gatilho miofascial, onde, quanto menor a força aplicada, menor a temperatura local (p<0,001). As áreas com dor referida apresentaram níveis de limiar de dor à pressão (1.28±0.45 kgf) menores quando comparados às áreas de dor local (1.73±0,59 kgf; p<0.001). Sendo assim, a imagem termográfica de um ponto-gatilho apresentou-se hiporradiante quando comparada à região de ausência de pontogatilho (T>0,4ºC; p<0.001). Além disso, a avaliação termográfica dos pontos-gatilho nos músculos masseter e temporal pelo gradiente térmico (T e ) apresentou maior sensibilidade e especificidade em comparação com a temperatura absoluta (T), mesmo quando corrigidos estes valores para a temperatura ambiente e temperatura timpânica da voluntária durante o exame (). A termografia isoladamente identificou pontos-gatilho com sensibilidade de 62,5% e especificidade de 71,31%. Os autores concluíram que a termografia é um método de imagem não invasivo, com potencial de identificação de pontos-gatilho miofasciais na região facial.

Myofascial pain syndrome is a myalgic dysfunction characterized by myofascial trigger points (MTP). The taut band is a constant feature of a trigger point characterized by referred pain when stimulated. It is known that the myofascial trigger points cause regional sympathetic hyperactivity in local temperature due to the cutaneous vasoconstrictor activity. For detection of functional changes, thermography may be used as an auxiliary diagnostic imaging. The aim of this study was to correlate clinical and thermographic myofascial trigger points in the masticatory muscles masseter and temporalis. Twenty six women volunteers were included, having a mean age of 41 ± 15 years. The results showed directly proportional relationship by algometry and thermography in the assessment of MTP, where smaller the force applied, lower the local temperature will be (p<0.001). Moreover, when the soreness was evaluated and local vasomotor response, the temperature decreases as the worst local situation. PPT (pressure pain threshold) levels measured at the points of referred pain in MTP (1.28±0.45 kgf) were significantly lower than the areas of local pain in MTP (1.73±0,59 kgf; p<0.001). Thus, the thermographic image of a MTP presented colder than the area without trigger point (T>0,4ºC; p<0.001). In the thermographic assessment of MTP in the masseter and temporalis muscles, the results suggest that the parameters of thermal asymmetry (T and ) show greater sensitivity and specificity in comparison to local absolute temperature values (T), even when corrected for the volunteer's core temperature and the temperature of the room during the exam (). Thermography can identify trigger points (referred pain) with sensitivity of 62,50% and specificity of 71,31%. The authors concluded that thermography is a noninvasive imaging method with potential for screening patients with MTP in the facial region.

Estudo da correlação entre a sensibilidade de filmes radiográficos e a variação no tempo de exposição / Study of corelation between radiographic films sensitivity and exposition time variation

Introdução - O objetivo deste trabalho é comparar a densidade em níveis de cinza de quatro filmes radiográficos: Ultraspeed, D, E e Insight (Eastman Kodak Company, Rochester, EUA) utilizando processadora automática com roletes. Material e Métodos - Gráfico foi construído para os quatro filmes aplicando-se diferentes tempos de exposição. Um escaner foi usado para adquirir imagens de cada filme e um programa computadorizado forneceu os valores de densidade em níveis de cinza para cada um. Resultados - O filme Insight apresentou maior sensibilidade do que os outros, obtendo um aumento na densidade em níveis de cinza com tempo de exposição curto. Não houve diferença entre os quatro filmes radiográficos com tempo de exposição superior a 0,6 segundo. Conclusões - O uso do filme Insight (velocidade F) pelos clínicos deve ser seguido de uma drástica redução no tempo de exposição e em conseqüencia na redução da dose de radiação absorvida pelo paciente

Estudo in vitro da infiltração marginal em restaurações de resina composta aplicadas sobre superfícies dentinárias tratadas com proteína BMP associada ao laser de Nd: YAG / In vitro study of microleakage composite restoration in dentin surface treated with bone morphogenetic protein associated with Nd: YAG laser

Introdução - A proteína BMP tem sido encontrada nos processos de reparação óssea após fraturas, agindo como indutora de neoformação óssea. O objetivo deste estudo foi de avaliar a infiltração marginal em restaurações de resina composta aplicadas sobre dentina tratada com BMP associada à aplicação de irradiação com laser de Nd:YAG. Material e Método: Cinquenta e dois dentes bovinos foram divididos em três grupos. Todos os dentes receberam preparo de Classe V, padronizados em largura e profundidade e a restauração com resina composta também seguiu o mesmo protocolo para todos os dentes. O Grupo I foi o controle, onde os procedimentos foram realizados de forma convencional. No Grupo II a dentina recebeu tratamento com BMP associada a hidroxiapatita + colágeno seguida de irradiação com laser de Nd:YAG, técnica adesiva e restauração com RC. No Grupo III foi aplicada BMP (+hidroxiapatita +colágeno) + irradiação com laser de Nd:YAG + técnica adesiva + nova irradiação + restauração com RC. Após restaurações, as amostras foram termocicladas e submetidas à teste de microinfiltração. Resultados - Após a avaliação de três examinadores, foi realizada análise do teste exato de Fisher. A associação da irradiação com laser de Nd:YAG antes e após a aplicação da proteína BMP, mostrou resultados melhores que o grupo controle. Conclusão - A associação de irradiação com laser de Nd:YAG e proteína de BMP promoveu menor microinfiltração nos preparos de Classe V restaurados com resina composta