Sternohyoid or sternocleidomastoid muscle flap for tracheoesophageal puncture closure in irradiated patients: A CARE case series.

INTRODUCTION: A novel technique for tracheoesophageal puncture (TEP) closure is described in which the sternohyoid muscles are rotated and interposed between the tracheal and esophageal walls. The results of this technique are reported, following CARE guidelines, and compared with those obtained using the sternocleidomastoid flap. A literature review on the techniques previously described for TEP closure in irradiated patients is presented. CASE SERIES: The novel technique was performed in six patients in whom the infrahyoid muscles were preserved during total laryngectomy. All received adjuvant radiotherapy. Successful closure was achieved in three cases; in one case a small leak was noted after initial closure and was successfully managed with simple sutures; and the other two failures occurred in patients with diabetes. The sternocleidomastoid flap was performed in five patients (only one with previous radiation) and success was achieved in two patients. In another patient a micro-fistular orifice appeared six months after the operation. DISCUSSION: The sternohyoid muscles pose a low morbidity alternative to be considered in surgical TEP closure. Patient selection is a key factor to surgical success, and this technique should be reserved for small to moderate size fistulas and in the absence of multiple impaired wound healing conditions.

Bioecological aspects of triatomines and marsupials as wild Trypanosoma cruzi reservoirs in urban, peri-urban and rural areas in the Western Brazilian Amazon.

In the Amazon region, Trypanosoma cruzi transmission cycles involve a great diversity of Triatominae vectors and mammal reservoirs. Some Rhodnius spp. mainly inhabit palm trees that act as microhabitats for hosts and vectors. The current study aimed to describe aspects of the bio-ecology of the vectors and reservoirs of T. cruzi in relation to human populations resident near areas with large quantities of palm trees, in rural, peri-urban and urban collection environments, located in the Western Brazilian Amazon. Rhodnius pictipes and Didelphis marsupialis were respectively the most predominant vector and reservoir, with rates of 71% for R. pictipes and 96.5% for D. marsupialis. The vast majority of T. cruzi isolates clustered with TcI. The most prevalent haplotype was TcI COII1 (69.7%). Mauritia flexuosa and Attalea phalerata were the main ecological indicators of infestation by triatomines. Birds were the most common food source (27,71%). T. cruzi isolated from R. robustus has the haplotype HUM-13, previously detected in a chronic Chagas patient living in the same area. Our results demonstrate the relevance of this study, with the occurrence of elevated infection rates in animals, and suggest the importance of the Amazon zones where there is a risk of infection in humans.

IgG4-positive plasma cells are more often detected in chronic periapical lesions arising from permanent rather than primary teeth.

AIM: To characterize plasma cell subsets in chronic periapical lesions affecting permanent and primary teeth. METHODOLOGY: Only chronic periapical lesions without root canal treatment were selected. Twenty-one radicular cysts and 7 periapical granulomas affecting permanent teeth and 19 radicular cysts and 4 periapical granulomas affecting primary teeth were assessed for immunoglobulin (Ig) light chain (kappa and lambda), Ig heavy chain (IgG, IgG4, IgA, IgM and IgD) and plasma cell immunohistochemical markers (MUM1/IRF4, EMA and CD138). The data acquired were analysed by Student's t test, Mann-Whitney U, Friedman test followed by Dunn's multiple comparison test and Spearman's rank correlation. RESULTS: All cases were polyclonal (having similar kappa/lambda light chain ratios). IgG was most abundant compared to other Ig heavy chains (all, P < 0.001); like Ig light chains, but unlike IgA, there was greater expression of IgG in the primary compared to the permanent dentition, for both radicular cysts (P < 0.001) and periapical granulomas (P = 0.53). Notably, IgG4 expression was greater in the permanent than the primary dentition, for both radicular cyst (P < 0.05) and periapical granuloma (P = 0.65). IgM and IgD expression was scarce and variable, whereas plasma cell populations were detected efficiently through EMA, CD138 and MUM1/IRF4 markers, the latter being more sensitive in both dentitions. CONCLUSIONS: There were slight variations in the Ig light and heavy chain profiles in chronic periapical lesions when comparing the permanent and primary dentitions. The ability of IgG4+ plasma cell infiltration to modulate inflammatory responses in chronic periapical lesions arising from permanent as opposed to primary teeth should be considered in future studies.

Prevalence and distribution of dental anomalies in a paediatric population based on panoramic radiographs analysis.

AIM: To evaluate the frequency and distribution of dental anomalies (DA) in a paediatric population. MATERIALS AND METHODS: Panoramic digital radiographs of children between 6 and 12 years old performed at a reference centre for radiographic exams were accessed. Two calibrated examiners evaluated the radiographs. The association between variables and outcomes was assessed using non-parametric tests. The significance level was set at 5%. RESULTS: Five hundred and twelve individuals were included and 61.3% presented at least one DA. The mean age of patients with DA (9.35±1.60) was significantly higher compared to patients with no anomalies (7.90±1.58). Patients with supernumerary tooth, however, were significantly younger. The most frequent DA were permanent tooth radicular dilacerations (38.1%), permanent tooth agenesis (29.3%), supernumerary tooth (6.4%) and impacted tooth (6.4%). Anterior teeth and female patients were more affected by radicular dilacerations. Dental agenesis was more frequent in the third molars followed by the upper lateral incisor. CONCLUSION: DA are quite frequent in the paediatric population and the most common DA observed herein could only be identified through imaging exams. The most appropriate timing to perform an investigation for the detection of dental anomalies appears to be between 9 and 10 years old.

Efeito da suplementação de suínos em terminação com diferentes associações entre minerais sobre o desempenho, as características de carcaça e a viabilidade econômica / Effect of supplementation of finishing swines with different associations between minerals on performance, carcass characteristics and economic viability

Objetivou-se, com este estudo, verificar a influência da suplementação com diferentes associações entre minerais orgânicos sobre o desempenho e as características de carcaça, bem como avaliar sua viabilidade econômica, para suínos em terminação. Foram utilizados 88 machos castrados, divididos entre quatro tratamentos: controle com dieta basal e suplementação com CrFe, MgSe e CrFeMgSe, durante os 28 dias que antecederam o abate. O delineamento experimental foi em blocos ao acaso, com parcela experimental representada por dois animais. Os animais suplementados com CrFeMgSe apresentaram piores índices de peso final, ganho de peso diário e consumo durante todo o período, com consequente redução no peso de carcaça, menor profundidade de lombo, área de olho-de-lombo e menor quantidade de carne magra na carcaça. Houve um aumento no custo da dieta para os grupos CrFe, MgSe e CrFeMgSe, respectivamente. O uso de cromo mais ferro e magnésio mais selênio, associados dois a dois, não altera os parâmetros de desempenho e as características de carcaça. A associação dos quatro minerais, no entanto, promove piora nessas características e aumenta o custo da dieta.(AU)

This study aimed to verify the influence of supplementation with different associations between organic minerals on performance, carcass characteristics and economic viability for finishing swine. 88 castrated males were divided in four treatments: control with basal diet and supplementation with CrFe, MgSe and CrFeMgSe during the 28 days prior to slaughter. The experimental design was randomized blocks with an experimental plot represented by two animals. The animals supplemented with CrFeMgSe had worse final weight, daily weight gain and consumption throughout the period, with consequent reduction in carcass weight, lower loin depth, loin eye area and amount of lean meat. There was an increase in the effective operational cost of diet with CrFe, MgSe and CrFeMgSe groups, respectively. The use of chromium plus iron and magnesium plus selenium, associated two by two, did not alter the performance parameters and carcass. However, the four minerals association promote a worsening in these characteristics and increase the cost of production.(AU)

Anatomical study of length and branching pattern of main trunk of the left coronary artery.

The left coronary artery is responsible for the irrigation of important heart structures. The objective of this study was to analyze the morphological characteristics of the main trunk of left coronary artery in the Brazilian population and its clinical implications. The study was carried out by using 63 adult human hearts of the human anatomy laboratory of the Federal university of Ceará, Brazil. The hearts were dissected for exposure and analysis of the left coronary artery and its branches. The data collected were statistically analyzed. The main trunk arose from the left aortic sinus under the left atrial auricle in all the 63 hearts. The mean length of the main trunk was 8.53±4.03mm. According to the criteria for the classification of the main trunk length, about 78% were medium-sized. The majority of the hearts (52.38%) showed trifurcation of the main trunk. Anova test followed by the Tukey's post hoc test showed that the main trunk length of hearts with trifurcation was significantly longer when compared with hearts with bifurcation (9.77±4.31mm vs. 6.44±3.01mm; P=0.0029). Similar findings were observed in the main trunk length of the hearts with tetrafurcation in comparison with hearts with bifurcation (10.78±1.4mm vs. 6.44±3.01mm; P=0.0387). This study showed that there is a correlation between the branching pattern and the length of the main trunk. Additionally, we showed that the most common branching pattern of the main trunk is the trifurcation, differing from other Brazilian studies and providing additional information to professionals of cardiology, cardiovascular surgery, and radiology.

Clinical and genetic analysis of patients with cherubism.

OBJECTIVE: To describe the clinical and genetic features of patients with cherubism. MATERIAL AND METHODS: A descriptive analysis of 14 cases from nine different families was carried out. Clinicopathological, imaging, and follow-up data were retrieved from patients' medical files and correlated with the genetic profile of each patient. Genomic DNA isolated from buccal mucosa cells was subjected to direct sequencing analysis of the SH3BP2 gene. RESULTS: Females were more affected than males (8:6), and the mean age at diagnosis was 8.6 years (range 3-30 years). Eleven patients exhibited simultaneous bilateral involvement of the maxilla and mandible. Two patients did not have a familial history of cherubism. Progressive growth pattern was found in six patients and stable lesions were observed in other seven patients, whereas in one patient, complete spontaneous remission was documented during the follow-up (31 years). Mutations were found in 13 cases and included the typical heterozygous missense mutations R415Q, P418T, and P418H at exon 9 of SH3BP2. No correlation between the mutations and the clinical manifestations was observed. CONCLUSION: Three different point mutations in the SH3BP2 gene were detected with variable clinical involvement. Genotype-phenotype association studies in larger population with cherubism are necessary to provide important knowledge about molecular mechanisms related to the disease.

Intestinal alkaline phosphatase and sodium butyrate may be beneficial in attenuating LPS-induced intestinal inflammation.

In this study, we evaluated the effect of intestinal alkaline phosphatase (IAP) and sodium butyrate (NaBu) on lipopolysaccharide (LPS)-induced intestinal inflammation. Intestinal alkaline phosphatase and RelA/p65 (NF-κB) gene expressions in porcine jejunum explants were evaluated following exposure to sodium butyrate (NaBu) and essential oil from Brazilian red pepper (EO), alone or in combination with NaBu, as well as exogenous IAP with or without LPS challenge. Five piglets weighing approximately 20 kg each were sacrificed, and their jejunum were extracted. The tissues were segmented into 10 parts, which were exposed to 10 treatments. Gene expressions of IAP and RelA/p65 (NF-κB) in jejunal explants were evaluated via RT-PCR. We found that EO, NaBu, and exogenous IAP were able to up-regulate endogenous IAP and enhance RelA/p65 (NF-κB) gene expression. However, only NaBu and exogenous IAP down-regulated LPS-induced inflammatory response via RelA/p65 (NF-κB). In conclusion, we demonstrated that exogenous IAP and NaBu may be beneficial in attenuating LPS-induced intestinal inflammation.

MicroRNA profiling in human breast cancer cell lines exposed to the anti-neoplastic drug cediranib.

Cediranib, a pan-tyrosine kinase inhibitor is showing promising results for the treatment of several solid tumours. In breast cancer, its effects remain unclear, and there are no predictive biomarkers. Several studies have examined the expression profiles of microRNAs (miRNAs) in response to different chemotherapy treatments and found that the expression patterns may be associated with the treatment response. Therefore, our aim was to evaluate the cellular behaviour and differential expression profiles of miRNAs in breast cancer cell lines exposed to cediranib. The biological effect of this drug was measured by viability, migration, invasion and cell death in in vitro assays. Signaling pathways were assessed using a human phospho-receptor tyrosine kinase array. Furthermore, using a miRNA array and quantitative real-time PCR (qRT­PCR), we assessed the relative expression of miRNAs following cediranib treatment. The breast cancer cell lines exhibited a distinct cytotoxic response to cediranib treatment. Cediranib exposure resulted in a decrease in the cell migration and invasion of all the breast cancer cell lines. Treatment with cediranib appeared to be able to modulate the activation of several RTKs that are targets of cediranib such as EGFR and a new potential target ROR2. Furthermore, this drug was able to modulate the expression profile of different microRNAs such as miR-494, miR-923, miR-449a, miR-449b and miR-886-3 in breast cancer cell lines. These miRNAs are reported to regulate genes involved in important molecular processes, according to bioinformatics prediction tools.

Intestinal Alkaline Phosphatase: Potential Roles in Promoting Gut Health in Weanling Piglets and Its Modulation by Feed Additives - A Review.

The intestinal environment plays a critical role in maintaining swine health. Many factors such as diet, microbiota, and host intestinal immune response influence the intestinal environment. Intestinal alkaline phosphatase (IAP) is an important apical brush border enzyme that is influenced by these factors. IAP dephosphorylates bacterial lipopolysaccharides (LPS), unmethylated cytosine-guanosine dinucleotides, and flagellin, reducing bacterial toxicity and consequently regulating toll-like receptors (TLRs) activation and inflammation. It also desphosphorylates extracellular nucleotides such as uridine diphosphate and adenosine triphosphate, consequently reducing inflammation, modulating, and preserving the homeostasis of the intestinal microbiota. The apical localization of IAP on the epithelial surface reveals its role on LPS (from luminal bacteria) detoxification. As the expression of IAP is reported to be downregulated in piglets at weaning, LPS from commensal and pathogenic gram-negative bacteria could increase inflammatory processes by TLR-4 activation, increasing diarrhea events during this phase. Although some studies had reported potential IAP roles to promote gut health, investigations about exogenous IAP effects or feed additives modulating IAP expression and activity yet are necessary. However, we discussed in this paper that the critical assessment reported can suggest that exogenous IAP or feed additives that could increase its expression could show beneficial effects to reduce diarrhea events during the post weaning phase. Therefore, the main goals of this review are to discuss IAP's role in intestinal inflammatory processes and present feed additives used as growth promoters that may modulate IAP expression and activity to promote gut health in piglets.

Landscape structure in the Pirapó, Paranapanema 3 and 4 Hydrographic Unit, in the state of Paraná, Brazil.

The aim of this study is to characterize the Pirapó, Paranapanema 3 and 4 Hydrographic Unit, emphasizing its physical attributes and processes of use and occupation, responsible for the structure of the current landscape and the state of its water resources. The recognition of the landscape's spatial structure in the hydrographic unit and its drainage basins was obtained by integrated analysis of the main elements that compose it: geology, landforms (hypsometric and slope), soils, climate and land use. Analysis revealed that within each drainage basin several variations in the spatial structure of the landscape occur which produce an internal compartmentalization. Each compartment is defined by its own geo-ecological structure, physiognomic standards and dynamics, reflected in its potentialities and vulnerabilities and in the conditions of water resources in the wake of occupation and use over time.

Landscape structure in the Pirapó, Paranapanema 3 and 4 Hydrographic Unit, in the state of Paraná, Brazil / Estrutura da paisagem na Unidade Hidrográfica Pirapó, Paranapanema 3 e 4, no estado do Paraná, Brasil

The aim of this study is to characterize the Pirapó, Paranapanema 3 and 4 Hydrographic Unit, emphasizing its physical attributes and processes of use and occupation, responsible for the structure of the current landscape and the state of its water resources. The recognition of the landscape’s spatial structure in the hydrographic unit and its drainage basins was obtained by integrated analysis of the main elements that compose it: geology, landforms (hypsometric and slope), soils, climate and land use. Analysis revealed that within each drainage basin several variations in the spatial structure of the landscape occur which produce an internal compartmentalization. Each compartment is defined by its own geo-ecological structure, physiognomic standards and dynamics, reflected in its potentialities and vulnerabilities and in the conditions of water resources in the wake of occupation and use over time.

Resumo O objetivo deste trabalho é caracterizar a Unidade Hidrográfica do Pirapó, Paranapanema 3 e 4, ressaltando os seus atributos físicos e os processos de uso e ocupação, responsáveis pela estrutura da paisagem atual e pelo estado dos seus recursos hídricos. O reconhecimento da estrutura espacial da paisagem na unidade hidrográfica e nas suas bacias foi obtido por meio da análise integrada dos principais elementos que a compõe: geologia, relevo, solos, clima e uso da terra. A análise mostrou que no interior de cada bacia hidrográfica ocorrem variações na estrutura espacial da paisagem que produzem uma compartimentação interna. Cada compartimento se define por uma estrutura geoecológica, padrões fisionômicos e dinâmicos próprios o que se reflete nas suas potencialidades e vulnerabilidades e nas condições dos seus recursos hídricos, em face das formas de ocupação e uso ao longo do tempo.

Landscape structure in the Pirapó, Paranapanema 3 and 4 Hydrographic Unit, in the state of Paraná, Brazil

The aim of this study is to characterize the Pirapó, Paranapanema 3 and 4 Hydrographic Unit, emphasizing its physical attributes and processes of use and occupation, responsible for the structure of the current landscape and the state of its water resources. The recognition of the landscapes spatial structure in the hydrographic unit and its drainage basins was obtained by integrated analysis of the main elements that compose it: geology, landforms (hypsometric and slope), soils, climate and land use. Analysis revealed that within each drainage basin several variations in the spatial structure of the landscape occur which produce an internal compartmentalization. Each compartment is defined by its own geo-ecological structure, physiognomic standards and dynamics, reflected in its potentialities and vulnerabilities and in the conditions of water resources in the wake of occupation and use over time.

Resumo O objetivo deste trabalho é caracterizar a Unidade Hidrográfica do Pirapó, Paranapanema 3 e 4, ressaltando os seus atributos físicos e os processos de uso e ocupação, responsáveis pela estrutura da paisagem atual e pelo estado dos seus recursos hídricos. O reconhecimento da estrutura espacial da paisagem na unidade hidrográfica e nas suas bacias foi obtido por meio da análise integrada dos principais elementos que a compõe: geologia, relevo, solos, clima e uso da terra. A análise mostrou que no interior de cada bacia hidrográfica ocorrem variações na estrutura espacial da paisagem que produzem uma compartimentação interna. Cada compartimento se define por uma estrutura geoecológica, padrões fisionômicos e dinâmicos próprios o que se reflete nas suas potencialidades e vulnerabilidades e nas condições dos seus recursos hídricos, em face das formas de ocupação e uso ao longo do tempo.

Effects of ractopamine and arginine dietary supplementation for sows on growth performance and carcass quality of their progenies.

The objective of this study was to evaluate the effects of ractopamine (Rac) and Arg fed to pregnant sows from d 25 to 53 of gestation on fetal muscle development as well as the performance and carcass characteristics of the progeny. One hundred sows were divided into 4 treatments including a control diet, the control plus 1% Arg, the control plus 20 mg/kg Rac, and the control diet supplemented with both additives at the same levels as those used separately. During the farrowing process the data evaluated were the weight of placenta to calculate the placental efficiency and the number of piglets born alive, stillborn, and mummified. To evaluate the fiber number and area, 12 male piglets from each treatment were euthanized to harvest semitendinosus muscle. During the lactation, the preweaning mortality, weaned weights, and number of piglets weaned per litter were evaluated. After weaning, the pig performance was evaluated until the slaughter following the sow treatment. At end of finishing phase, 1 male pig of each treatment replicate was selected to evaluation the carcass and pork quality. All variables measured were analyzed using the MIXED procedure of SAS and least squares means were compared using the Tukey test with P < 0.05. The control diet + supplementation of 1.0% of L-Arg + 20 mg/kg of ractopamine HCl from d 25 to 53 of gestation (Arg+Rac) treatment had a greater number of stillborn piglets (P = 0.014) than the control group. Piglet birth weights from sows fed Rac were 11% greater (P = 0.031) than those of piglets of the control treatment. The semitendinosus muscle fiber diameters of piglets at birth from sows that received Arg, Rac, and Arg+Rac were greater (P < 0.0001) than those of control piglets, and as consequence, the fiber number per square millimeter decreased (P < 0.0001). The final nursery BW of progeny from sows fed Arg and Rac individually were greater (P = 0.010) than those of progeny of the control group. At 110 d of age, in the beginning of the finisher 1 phase, pigs from Arg-fed sows were 1.9 kg heavier (P = 0.010) than pigs from the Arg+Rac-fed sows. The HCW were 2.97 and 1.64 kg heavier (P < 0.0001) for progeny of the Arg and Rac sows, respectively, compared with those of progeny of the control. In conclusion, the trial showed that the use of Rac for gestating sows increased the piglets' weight at birth. The size of muscular fiber was increased in the semitendinosus muscle of piglets originating from sows receiving Rac or Arg. However, the combination of both compounds did not have an additive effect in comparison with the control treatment but increased the stillbirth number.

Autologous blood injection for the treatment of recurrent mandibular dislocation.

The purpose of the present study was to evaluate the effectiveness of autologous blood injection in the treatment of recurrent temporomandibular joint dislocation. Eleven patients diagnosed with recurrent dislocation of the joint that could not be self-reduced, received bilateral injections of autologous blood in the superior joint compartment and pericapsular region. During a follow-up period ranging from 24 to 35 months (average 29.6 months), eight patients (72.7%) did not show new episodes of dislocation. The most advocated treatment for recurrent dislocation is eminectomy, which involves a skin incision, with the risk of damaging the facial nerve, requires general anaesthesia, and presents an average success rate of 85% according to the literature. Autologous blood injection is a simple, rapid, minimally invasive, and cost-effective technique, with a low possibility of complications, and is a feasible alternative treatment before surgical intervention.

CBCT-based volume of simulated root resorption - influence of FOV and voxel size.

AIM: To examine the influence of the field of view (FOV) and voxel size on the measurement of the volume of simulated internal root resorption (IRR) lesions through cone-beam computed tomography (CBCT). METHODOLOGY: Eleven single-rooted teeth with IRR simulated by acid demineralization were studied. CBCT images were acquired using large FOV (voxel sizes of 0.200, 0.250 and 0.300 mm) and limited FOV (voxel sizes of 0.076, 0.100 and 0.200 mm). The IRR volumes were calculated using the Dolphin(®) software. Volumetric measurements were validated using IRR silicone putty casts. The analysis of variance (anova) for randomized block design complemented with the Tukey's test was employed. RESULTS: IRR volumes obtained using voxel sizes of 0.200 and 0.250 mm were similar (P > 0.05). However, both these values were significantly different from that obtained using the 0.300-mm voxel (P < 0.05). There was no significant difference between IRR volumes measured through voxel sizes of 0.076 and 0.100 mm (P > 0.05), but both differed significantly from that obtained through the 0.200-mm voxel (P < 0.05). There was no significant difference between the volumetric measurements of the 0.200-mm voxel images of the restricted and large FOV protocols. The mean volumes of the silicone casts were smaller than those calculated using a 0.200-mm voxel, but were similar to those obtained using voxel sizes of 0.076 and 0.300 mm. CONCLUSIONS: Despite the FOV protocol, voxel size can influence measurement of simulated IRR volumes. The importance of standardization of CBCT image acquisition protocols is emphasized, especially during follow-up of an IRR lesion, to prevent misinterpretation of its extent, which can create a bias in clinical decisions.

Evaluation of a digital learning object (DLO) to support the learning process in radiographic dental diagnosis.

AIMS: Studies have shown that inappropriate therapeutic strategies may be adopted if crown and root changes are misdiagnosed, potentially leading to undesirable consequences. Therefore, the aim of this study was to evaluate a digital learning object, developed to improve skills in diagnosing radiographic dental changes. MATERIALS AND METHODS: The object was developed using the Visual Basic Application (VBA) software and evaluated by 62 undergraduate students (male: 24 and female: 38) taking an imaging diagnosis course. Participants were divided in two groups: test group, which used the object and control group, which attended conventional classes. After 3 weeks, students answered a 10-question test and took a practice test to diagnose 20 changes in periapical radiographs. RESULTS: The results show that test group performed better that control group in both tests, with statistically significant difference (P = 0.004 and 0.003, respectively). In overall, female students were better than male students. Specific aspects of object usability were assessed using a structured questionnaire based on the System Usability Scale (SUS), with a score of 90.5 and 81.6 by male and female students, respectively. CONCLUSIONS: The results obtained in this study suggest that students who used the DLO performed better than those who used conventional methods. This suggests that the DLO may be a useful teaching tool for dentistry undergraduates, on distance learning courses and as a complementary tool in face-to-face teaching.

Radiographic diagnosis of dental restoration misfit: a systematic review.

The objective of this study was to perform a systematic review on the use of radiographic methods for the diagnosis of misfit in dental prostheses and restorations. The MEDLINE bibliographic database was searched from 1950 to February 2014 for reports on the radiographic diagnosis of misfits. The search strategy was limited to English-language publications using the following combined MeSH terms in the search strategy: (Dental Restoration OR Dental Prosthesis OR Crown OR Inlays OR Dental Abutments) and (Dental Leakage OR Prosthesis Fitting OR Dental Marginal Adaptation OR Surface Properties) and (Radiography, Dental OR Radiography, Dental, Digital OR Cone-Beam Computed Tomography). Twenty-eight publications were identified and read in full text, and 14 studies fulfilled criteria for inclusion. Information regarding the use of radiographic methods for the diagnosis of misfits in dental prosthesis and restorations, and in which the methodology/results comprised information regarding how the sample was collected/prepared, the method, imaging protocol, presence of a reference test and the outcomes were evaluated. QUADAS criteria was used to rate the studies in high, moderate or low quality. The evidence supporting the use of radiographic methods for the diagnosis of misfits in dental prosthesis and restorations is limited to low-/moderate-quality studies. The well-established intra-oral orthogonal projection is still under investigation and considered the most appropriate method, both when evaluating the relation between dental restoration to tooth and abutment to implant. Studies using digital radiographs have not evaluated the effect of image post-processing, and tomography has not been evaluated.

CBCT for the assessment of second mesiobuccal (MB2) canals in maxillary molar teeth: effect of voxel size and presence of root filling.

AIM: To compare detection of the second mesiobuccal (MB2) canal in maxillary molar teeth using cone-beam computed tomography (CBCT) with different voxel sizes against conventional radiographic examination when the MB1 was unprepared, prepared and filled. METHODOLOGY: Radiographic examination and 0.2-, 0.25- and 0.3-mm CBCT (n = 89) were performed in 3 stages: S1, no first mesiobuccal (MB1) canal preparation or filling; S2, after MB1 preparation and filling; and S3, after MB1 root canal filling removal and canal repreparation. Images were analysed using the i-Cat software. After RE and CBCT acquisition in S3, all the samples were clarified to directly visualize the presence of the MB2 canal. All images were analysed by a blinded, previously calibrated examiner. Accuracy, specificity and sensitivity were compared using analysis of variance (P < 0.05 level of significance). RESULTS: MB2 root canals were detected in 67% of the samples. Overall, radiographic examination was associated with lower mean accuracy values for detecting MB2 than CBCT regardless of the MB1 condition. The MB1 root canal condition did not influence MB2 detection in 0.2-mm voxel images. The presence of root fillings in the MB1 canals reduced the detection of MB2 canals, especially in the 0.3- and 0.25-mm voxel-size images (P < 0.05). CONCLUSION: CBCT was associated with higher mean values of specificity and sensibility than radiographic examination for the detection of MB2 canals. When endodontic retreatment is necessary removal of the root filling prior to the CBCT examination eliminates artefacts, thereby permitting the use of the 0.3-mm voxel protocol that has good diagnostic performance and lower radiation dose.

Alveolar bone height in primary dentition a radiographic evaluation related to caries lesions.

AIM: This was to evaluate the CEJ-ABC distance in sound and unsound deciduous teeth, according to subject's age and the presence of caries. STUDY DESIGN: cross-sectional study. The study sample comprised 334 radiographs, the teeth were divided in two groups, according to the interproximal surface characteristics. The distal surface of the mandibular first deciduous molar and/or the mesial surface of the second mandibular deciduous molar were analysed. RESULTS: The average for the CEJ-ABC distance in the distal surface of the mandibular first molar was different between sound and carious teeth. The same behaviour was observed in the mesial surface of the mandibular second molar. Both the presence of lesion on the interproximal surface and the subject age exherted influence over the mean CEJ- ABC distance. No interaction between these factors was statistically observed. STATISTICS: data were analyzed with SPSS. Two- way ANOVA was used to assess the distance of CEJ-ABC considering the interproximal surface status and age. CONCLUSION: Although the observation that both the interproximal surface status and the age had influence on the CEJ- ABC distance values, in the present study the interaction between these variables was not a determinant for the increase CEJ- ABC distances.