Prediction of Radiation-Related Dental Caries Through PyRadiomics Features and Artificial Neural Network on Panoramic Radiography.

The prediction and detection of radiation-related caries (RRC) are crucial to manage the side effects of the head and the neck cancer (HNC) radiotherapy (RT). Despite the demands for the prediction of RRC, no study proposes and evaluates a prediction method. This study introduces a method based on artificial intelligence neural network to predict and detect either regular caries or RRC in HNC patients under RT using features extracted from panoramic radiograph. We selected fifteen HNC patients (13 men and 2 women) to analyze, retrospectively, their panoramic dental images, including 420 teeth. Two dentists manually labeled the teeth to separate healthy and teeth with either type caries. They also labeled the teeth by resistant and vulnerable, as predictive labels telling about RT aftermath caries. We extracted 105 statistical/morphological image features of the teeth using PyRadiomics. Then, we used an artificial neural network classifier (ANN), firstly, to select the best features (using maximum weights) and then label the teeth: in caries and non-caries while detecting RRC, and resistant and vulnerable while predicting RRC. To evaluate the method, we calculated the confusion matrix, receiver operating characteristic (ROC), and area under curve (AUC), as well as a comparison with recent methods. The proposed method showed a sensibility to detect RRC of 98.8% (AUC = 0.9869) and to predict RRC achieved 99.2% (AUC = 0.9886). The proposed method to predict and detect RRC using neural network and PyRadiomics features showed a reliable accuracy able to perform before starting RT to decrease the side effects on susceptible teeth.

Idiopathic exostosis: rarity on maxillary sinus

Introduction: Exostoses in the paranasal sinuses have been reported in a greater number in the dental radiological literature, despite the extensive citation in the otorhinolaryngology literature. Objective: This case report was a rare idiopathic expression that grew in the maxillary sinus. Case report: A 68-year-old black patient, BGS, followed up by the Odontology Service of Cancer Hospital for treating oral lesions (Mucositis) and other conditions resulting from radiation therapy and hormone therapy (Tamoxifen), presented malignant neoplasm at the right breast in 2015; an exostosis biopsy was not performed, since the patient is being treated and followed up by the hospital service. Panoramic radiography and clinical examination were performed. By analyzing the tests, it was possible to notice an image with double radiodensity, more radiopaque in the external portion and less radiopaque in the internal portion, with an aspect of trabecular bone, circumscribed, unilocular, in the region of pedunculated premolar, inside the left maxillary sinus. In order to have a better assessment and diagnostic hypothesis of the case, a CT scan was performed, a tool was applied to measure the density of the profile of the lesion, thus evidencing that the supposed injury invaginates to the interior of the maxillary sinus and had bone density similar to the alveolar crest bone. Conclusion: Simultaneously to other lesions, exostoses are benign lesions, present low aggression and rare symptomatology; exeresis is indicated only when it prevents functioning, or for aesthetics reasons, or when it is not possible to make prostheses. Many cases are incidentally diagnosed from routine radiographic review in medical or dental offices and should be followed up for analysis and verification of their growth.

Introdução: Exostoses nos seios paranasais têm sido muito mais relatados na literatura radiológica odontológica, apesar da extensa citação na literatura otorrinolaringológica. Objetivo: Neste relato de caso, encontramos uma exostose idiopática rara, que cresceu no seio maxilar. Relato de caso: Paciente negra de 68 anos, BGS, acompanhada pelo Serviço de Odontologia do Hospital do Câncer para tratamento de lesões orais (mucosite) e outras condições decorrentes da radioterapia e terapia hormonal (Tamoxifeno), apresentou neoplasia maligna da mama direita em 2015. Não foi realizada biopsia da exostose, pois a paciente está em tratamento e está sendo acompanhada pelo serviço do hospital. Realizaram-se radiografia panorâmica e exame clínico. Ao examinar os exames, foi possível notar uma imagem com dupla radiodensidade, mais radiopaca numa parte externa e menos radiopaca na parte interna, com aspecto de osso trabecular, circunscrito, unilocular, na região do ré-molar pediculado, no interior do seio maxilar esquerdo. Para melhor avaliação e hipótese diagnóstica, foi realizada uma tomografia computadorizada, aplicou-se uma ferramenta para mensuração da densidade do perfil da lesão, evidenciando-se que a suposta lesão invagina para o interior do seio maxilar e tinha densidade óssea semelhante ao osso da crista alveolar. Conclusão: Simultaneamente a outras lesões, as exostoses são lesões benignas, apresentam baixa agressividade e rara sintomatologia, sendo indicada exérese somente quando acomete a função, ou por motivos estéticos, ou quando não é possível a confecção de próteses. Muitos dos casos são diagnosticados de modo incidental e a partir de exames radiográficos de rotina em consultórios médicos ou odontológicos e devem ser acompanhados para análise e verificação de seu crescimento.

Literature Review: Dental Aspects in Gaucher Disease / Revisión de la Literatura: Aspectos Dentales en la Enfermedad de Gaucher

SUMMARY: Knowledge about Gaucher disease, characteristics, clinical and radiographic alterations, demonstrate the importance of using anamnesis, laboratory tests and radiological images, among these dental analysis and images, making possible the early detection in the oral manifestations and the success in the control and treatment of the disease.

RESUMEN: El conocimiento sobre la enfermedad de Gaucher, características, alteraciones clínicas y radiográficas, demuestra la importancia de utilizar la anamnesis, los exámenes de laboratorio e imágenes radiológicas, entre ellas las odontológicas, posibilitando la detección precoz de las manifestaciones orales, y el éxito en el control y tratamiento de la enfermedad.