Comparison of outcomes after total hip arthroplasty between patients with osteonecrosis of the femoral head in Association Research Circulation Osseous stage III and stage IV: a five-year follow-up study.

BACKGROUND: No large cohort study has evaluated the surgical outcomes of THA between different stages of ONFH patients. This study aimed to compare the surgical outcomes of ONFH patients who underwent THA in ARCO stage III versus IV, in terms of operative parameters, one-year hip function assessments and postoperative at least five-year complications, to inform optimized management of ONFH. METHOD: From our prospectively collected database, 876 patients undergoing THA between October 2014 and April 2017 were analyzed and divided into ARCO stage III group (n = 383) and ARCO stage IV group(n = 493). Details of demographics, medical record information, adverse events and clinical scores of both groups were collected and compared. Proper univariate analysis was used for the analysis. RESULT: There were no statistically significant differences in baseline characteristics between the two groups. Compared to ARCO stage IV patients, ARCO stage III patients showed a shorter operative time (p < 0.01), less bleeding (p < 0.01), fewer one-year readmissions (p = 0.026) and complications (p = 0.040), and significantly higher HHS (p < 0.01) one year after THA. In addition, ARCO stage IV patients seem more likely to suffer prosthesis dislocation (p = 0.031). CONCLUSION: Although ARCO stage IV patients in the study cohorts appeared to suffer more one-year complications, no significant difference was observed at long-term follow-up. Enhanced clinical guidance on preventing early prosthesis dislocation may help improve the prognosis of final-stage ONFH patients.

Tratamiento endovascular exitoso de aneurisma del arco aórtico en un paciente pediátrico / Successful endovascular treatment of aortic arch aneurysm in a pediatric patient

Resumen Antecedentes: Los aneurismas de la aorta ascendente son patologías poco frecuentes en la infancia, sobre todo en ausencia de enfermedades previas como el síndrome de Marfan. Objetivo: Dar a conocer la posibilidad del manejo endovascular exitoso de los aneurismas de grandes vasos, usando stent y micro catéter con embolización del saco aneurismático. Método: Presentamos el caso de una paciente de 10 años y 2 meses, previamente sana, en quien se documentó un pseudoaneurisma entre el origen de la arteria carótida común izquierda y la arteria subclavia izquierda, que logró manejarse de forma endovascular, inicialmente con un stent cubriendo el cuello del aneurisma con el fin de remodelarlo y posteriormente por medio de microcatéter se realizó embolización del saco del aneurisma con coils, con resultado exitoso. Resultados: Los aneurismas de los grandes vasos, como la arteria carótida común y la arteria subclavia, tienen riesgo de ruptura con complicaciones devastadoras; el manejo endovascular se plantea como una opción poco invasiva de manejo, con resultados favorables. Conclusión: El manejo de aneurismas de grandes vasos, por vía endovascular usando stent y microcatéter con embolización del saco aneurismático, es una opción novedosa de manejo que logra resultados exitosos.

Abstract Background: Ascending aortic aneurysms are rare pathologies in childhood, especially in the absence of previous diseases such as Marfan syndrome. Objective: Present the possibility of successful endovascular management of large vessel aneurysms, using stents and microcatheters with embolization of the aneurysm sac. Method: We present the case of a previously healthy ten-year-old patient, in whom a pseudoaneurysm was documented between the origin of the left common carotid artery and left subclavian artery, successfully managed endovascularly, initially with a stent covering the neck of the aneurysm to remodel it and later with embolization of the aneurysm sac using a microcatheter. Results: Aneurysms of large vessels, such common carotid artery and subclavian artery, are at risk of rupture with devastating complications; endovascular management is considered a minimally invasive management option, with favorable results. Conclusion: The endovascular management of large vessel aneurysms using stents and microcatheters with embolization of the aneurysmal sac is a novel management option that achieves successful results.

Successful endovascular treatment of aortic arch aneurysm in a pediatric patient.

BACKGROUND: Ascending aortic aneurysms are rare pathologies in childhood, especially in the absence of previous diseases such as Marfan syndrome. OBJECTIVE: Present the possibility of successful endovascular management of large vessel aneurysms, using stents and microcatheters with embolization of the aneurysm sac. METHOD: We present the case of a previously healthy ten-year-old patient, in whom a pseudoaneurysm was documented between the origin of the left common carotid artery and left subclavian artery, successfully managed endovascularly, initially with a stent covering the neck of the aneurysm to remodel it and later with embolization of the aneurysm sac using a microcatheter. RESULTS: Aneurysms of large vessels, such common carotid artery and subclavian artery, are at risk of rupture with devastating complications; endovascular management is considered a minimally invasive management option, with favorable results. CONCLUSION: The endovascular management of large vessel aneurysms using stents and microcatheters with embolization of the aneurysmal sac is a novel management option that achieves successful results.

ANTECEDENTES: Los aneurismas de la aorta ascendente son patologías poco frecuentes en la infancia, sobre todo en ausencia de enfermedades previas como el síndrome de Marfan. OBJETIVO: Dar a conocer la posibilidad del manejo endovascular exitoso de los aneurismas de grandes vasos, usando stent y micro catéter con embolización del saco aneurismático. MÉTODO: Presentamos el caso de una paciente de 10 años y 2 meses, previamente sana, en quien se documentó un pseudoaneurisma entre el origen de la arteria carótida común izquierda y la arteria subclavia izquierda, que logró manejarse de forma endovascular, inicialmente con un stent cubriendo el cuello del aneurisma con el fin de remodelarlo y posteriormente por medio de microcatéter se realizó embolización del saco del aneurisma con coils, con resultado exitoso. RESULTADOS: Los aneurismas de los grandes vasos, como la arteria carótida común y la arteria subclavia, tienen riesgo de ruptura con complicaciones devastadoras; el manejo endovascular se plantea como una opción poco invasiva de manejo, con resultados favorables. CONCLUSIÓN: El manejo de aneurismas de grandes vasos, por vía endovascular usando stent y microcatéter con embolización del saco aneurismático, es una opción novedosa de manejo que logra resultados exitosos.

Bone metabolism in patients with osteonecrosis of the femoral head based on etiology and Association Research Circulation Osseous staging / 中国组织工程研究

BACKGROUND:Currently,there is a lack of large sample studies to analyze the bone metabolism level of patients with femoral head necrosis of different etiologies and stages,which is not conducive to the development of better necrosis-promoting repair strategies. OBJECTIVE:To study the bone metabolism of patients with osteonecrosis of the femoral head with different etiologies and Association Research Circulation Osseous(ARCO)stages. METHODS:A retrospective study was performed on 401 patients diagnosed with osteonecrosis of the femoral head as the trial group,and 81 healthy subjects as the control group.The trial group could be divided into three groups according to different etiologies:steroid-induced osteonecrosis of the femoral head,alcoholic osteonecrosis of the femoral head and traumatic osteonecrosis of the femoral head,and were divided into stages Ⅱ/Ⅲ/Ⅳ according to different ARCO stages.Seven bone metabolism-related indicators of all subjects were collected,including bone metabolism-regulating hormone 25-hydroxyvitamin D and bone conversion markers:N-terminal propeptide of type Ⅰ procollagen,degradation product of type Ⅰ collagen,n-terminal middle molecular fragment of osteocalcin,general biochemical markers of bone metabolism:serum calcium,serum phosphorus,serum alkaline phosphatase.The bone metabolism levels of each group were compared and the independent factors associated with osteonecrosis of the femoral head were determined by binary Logistic regression analysis. RESULTS AND CONCLUSION:Compared with the control group,levels of degradation product of type Ⅰ collagen,N-terminal propeptide of type Ⅰ procollagen,n-terminal middle molecular fragment of osteocalcin,serum phosphorus and alkaline phosphatase in the trial group were significantly increased(all P＜0.05).Based on the presence or absence of the disease,according to binary Logistic regression analysis,degradation product of type Ⅰ collagen,N-terminal propeptide of type Ⅰ procollagen,and n-terminal middle molecular fragment of osteocalcin were independent factors associated with osteonecrosis of the femoral head.The levels of degradation product of type Ⅰ collagen and N-terminal propeptide of type Ⅰ procollagen in three groups of patients with different etiologies were higher than normal reference values.The bone metabolism-regulating hormone 25-hydroxyvitamin D and serum calcium in the alcoholic osteonecrosis of the femoral head group were higher than those in the other two groups(P＜0.05).The level of bone metabolism-regulating hormone 25-hydroxyvitamin D in steroid-induced and traumatic osteonecrosis of the femoral head groups was lower than the normal value.There were no significant differences in seven bone metabolism-related indicators in patients with ARCO stages Ⅱ,Ⅲ and Ⅳ osteonecrosis of the femoral head(all P＞0.05),but degradation product of type Ⅰ collagen and N-terminal propeptide of type Ⅰ procollagen in these three groups were higher than normal reference values.Bone metabolism-regulating hormone 25-hydroxyvitamin D in patients with ARCO stage Ⅱ and ARCO stage Ⅳ was lower than the normal reference value.It is concluded that the bone metabolism level of osteonecrosis of the femoral head patients was abnormal.The degradation product of type Ⅰ collagen and N-terminal propeptide of type Ⅰ procollagen of osteonecrosis of the femoral head patients with different etiologies and ARCO stages were all higher than the normal reference value,and they were in a state of high bone turnover.Degradation product of type Ⅰ collagen,N-terminal propeptide of type Ⅰ procollagen and n-terminal middle molecular fragment of osteocalcin may be risk factors for the pathogenesis of osteonecrosis of the femoral head.

Natural collapse course of ARCO Ⅱ stage osteonecrosis of the femoral head based on China-Japan Friendship Hospital classification / 中国组织工程研究

BACKGROUND:Osteonecrosis of the femoral head is one of the refractory diseases in orthopedic diseases.The natural collapse course of osteonecrosis of the femoral head under different stages and types affects the progression and prognosis of the disease. OBJECTIVE:To explore the progression of natural collapse within 5 years in patients under the different classifications of China-Japan Friendship Hospital(CJFH)with stage Ⅱ osteonecrosis of the International Association for Research Circulation Osseous(ARCO),and to analyze the collapse rate and collapse risk of the femoral head under the different classifications of CJFH. METHODS:A retrospective study was performed to select patients diagnosed with ARCO Ⅱ stage osteonecrosis of the femoral head without collapse in the Honghui Hospital Affiliated to Xi'an Jiaotong University from October 2016 to October 2017.According to whether it collapsed,the number of hips was divided into the collapse group(n=82)and the non-collapsed group(n=70).The collapse risk of patients with osteonecrosis of the femoral head under different CJFH classifications,as well as the collapse time,number of collapses,and collapse rate within 5 years were counted,and then the Kaplan-Meier survival curve of the femoral head under different classification of CJFH was plotted. RESULTS AND CONCLUSION:(1)A total of 97 patients with 152 hips were enrolled,and 82 hips collapsed during the follow-up period,with a total collapse rate of 53.9%,of which the collapse rates of M type,C type,L1 type,L2 type,and L3 type were 0.0%,36.7%,51.4%,72.2%,and 77.8%,respectively,and the comparison between the groups was statistically significant(P<0.05).(2)In terms of collapse risk,the collapse risk of L1 type was 1.704 times that of C-type(P>0.05),while the collapse risks of L2 type and L3 type were 3.866 times and 6.423 times that of C type(P<0.05),respectively.(3)In terms of the Kaplan-Meier survival curve,the median survival time of the femoral head of ARCO Ⅱ stage patients was 3 years,with a 95%confidence interval of 2.885-3.471 years,and the survival rates of the femoral head at the first,third and fifth years were 65.1%(99/152),50.7%(77/152),and 46.1%(70/152),respectively.(4)These findings conclude that different CJFH classifications affect the collapse rate of ARCO Ⅱ stage osteonecrosis of the femoral head patients,among which L3 type patients have the highest collapse rate,followed by L2 type and L1 type patients;C type patients have a lower collapse rate,and M type patients do not collapse,which indicates that the preservation of the lateral column of the femoral head is of great significance for the natural collapse course of osteonecrosis of the femoral head.

Patrón de variación de la forma del arco dentario mandibular en una muestra de la Región Metropolitana de Chile

Objetivos: Describir el patrón de variación de la forma de la arcada dentaria mandibular en una muestra de la Región Metropolitana mediante un estudio observacional, transversal. Métodos: Se digitalizaron 18 puntos de referencia en 134 fotografías estandarizadas de modelos de yeso y se realizó un análisis de Procusto para obtener los componentes de variación de la forma y el tamaño (tamaño del centroide= cs). Resultados: El tamaño de centroide en hombres es significativamente mayor que en mujeres. El análisis discriminante con validación cruzada no mostró diferencias significativas en los componentes de la forma según el sexo. Las diferencias en la forma de los arcos dentales, explicada por los dos primeros componentes de la forma correspondió al 73.4% de la varianza total (PC1= 50,14%, en el eje anteroposterior y PC2= 13,31% en el eje transversal). Conclusiones: De acuerdo con los resultados del presente estudio, se debe replantear el uso de plantillas preformadas en la determinación de la forma del arco dentario, dada la continuidad morfológica que se observa al realizar un análisis estadístico del patrón de variación en forma y tamaño del arco, como queda en evidencia al utilizar herramientas de morfometría geométrica.

Objetivos : Descrever o padrão de variação da forma do arco dentário mandibular em uma amostra populacional da Região Metropolitana, através de um estudo observacional transversal. Métodos : 18 pontos anatómicos em 134 fotografias padronizadas de moldes de gesso foram digitalizados e foi realizado uma análise Procrustes. Resultados : O tamanho do centróide nos homens é significativamente maior do que nas mulheres. A análise discriminante com validação cruzada de gênero não mostrou diferenças significativas nos componentes da forma. O padrão de variação na forma das arcadas dentárias é explicado principalmente por PC1 (50,1% da variação total, variação anteroposterior) e PC2 (13,3%, variação transversal). Conclusões : Dada a continuidade morfológica que se observa ao realizar uma análise estatística do padrão de variação da forma e tamanho da arcada, aplicando ferramentas morfométricas geométricas, o uso de templates pré-formados para determinação da forma da arcada dentária deve ser reconsiderado.

Objectives: Describe the pattern of shape variation of the mandibular dental arch in a sample from the Metropolitan Region through an observational, cross-sectional study. Methods: 18 landmarks on 134 standardized photographs of dental casts were digitized, and a Procrustes analysis was performed. Results: The size of the centroid in men was significantly larger than in women. Discriminant analysis with gender cross-validation did not show significant differences in the shape components. The variation pattern in the shape of the dental arches is mainly explained by PC1 (50.1% of the total variation, anteroposterior variation) and PC2 (13.3%, transverse variation). Conclusions: Given the morphological continuity that is observed when performing a statistical analysis of the variation pattern in shape and size of the arch applying geometric morphometric tools, the use of preformed templates for determining the shape of the dental arch should be reconsidered.

Comparação de técnicas de montagem em articuladores virtuais: fotografia versus valores médios na determinação da posição maxilomandibular / Comparison of mounting techniques in virtual articulators: photography versus average values in determining maxillomandibular position

Os articuladores virtuais visam superar limitações dos métodos analógicos na odontologia, integrando-se ao avanço do sistema CAD/CAM para um fluxo digital crescente. Entre as tecnologias disponíveis, destacam-se os articuladores simulados matematicamente, que facilitam reproduções precisas e rápidas na rotina clínica virtual. Este estudo avaliou a eficácia desses articuladores, comparando técnicas de montagem utilizando fotografias e valores médios automáticos. A pesquisa sobre articuladores virtuais na odontologia restauradora investigou a transição dos métodos analógicos para os virtuais, focando na melhoria da precisão e eficiência dos tratamentos. Utilizando escaneamento intraoral, foram obtidos modelos digitais em Máxima Intercuspidação Habitual (MIH) e posição protusiva, processados no software DentalCad. Dois métodos de montagem foram comparados: um utilizando fotografias para montagem arbitrária e outro baseado em valores médios automáticos. Os resultados mostraram que ambas as técnicas alcançaram níveis similares de precisão na reprodução da posição protusiva da maxila. Especificamente, a média das distâncias entre os modelos protusivos e o modelo de controle não apresentou diferenças estatisticamente significantes (p > 0,05), conforme ANOVA de medições repetidas. Esses achados destacam a eficácia dos articuladores virtuais em integrar fluxos de trabalho digitais na odontologia, eliminando as limitações dos métodos analógicos. Conclui-se que a adoção de articuladores virtuais oferece uma abordagem promissora para a odontologia restauradora moderna, com potencial para melhorar significativamente a precisão dos tratamentos e otimizar a prática clínica (AU)

Virtual articulators aim to overcome limitations of analog methods in dentistry, integrating with the advancement of CAD/CAM systems for a growing digital workflow. Among the available technologies, mathematically simulated articulators stand out for enabling precise and rapid reproductions in virtual clinical routines. This study assessed the effectiveness of these articulators by comparing assembly techniques using photographs and automated average values. Research on virtual articulators in restorative dentistry investigated the transition from analog to virtual methods, focusing on enhancing treatment precision and efficiency. Through intraoral scanning, digital models in Maximum Intercuspation Habitual (MIH) and protrusive position were obtained and processed using DentalCad software. Two assembly methods were compared: one using photographs for arbitrary assembly and another based on automated average values. Results indicated that both techniques achieved similar levels of accuracy in reproducing the protrusive position of the maxilla. Specifically, the mean distances between protrusive models and the control model showed no statistically significant differences (p > 0.05), as per repeated measures ANOVA. These findings underscore the efficacy of virtual articulators in integrating digital workflows in dentistry, eliminating analog method limitations. It is concluded that adopting virtual articulators offers a promising approach for modern restorative dentistry, with potential to significantly enhance treatment precision and optimize clinical practice (AU)

Arterialização venosa superficial com veia safena magna in situ: a experiência de um único centro / Superficial venous arterialization with the great saphenous vein in situ: a single-center experience

Resumo Contexto A arterialização do arco venoso dorsal do pé é uma técnica indicada em casos de isquemia crítica de membros inferiores sem leito distal adequado que possibilite tratamento convencional, como revascularização, angioplastia ou tratamento clínico. Objetivos O propósito do trabalho foi apresentar o resultado da arterialização do arco venoso do pé em 16 pacientes submetidos a essa técnica. Métodos Tratou-se de um estudo analítico descritivo retrospectivo transversal, baseado na revisão de prontuários de 16 pacientes submetidos à arterialização do arco venoso dorsal do pé para salvamento de membro, entre janeiro de 2016 a janeiro de 2021. Resultados Dos 16 pacientes submetidos à arterialização do arco venoso do pé, 25% (4) evoluíram para amputação maior durante a mesma internação, e 6,25% (1) pacientes evoluíram para amputação maior após 6 meses. Os demais pacientes (68,75%, 11) tiveram seus membros preservados, sendo que 10 foram submetidos a amputações menores (pododáctilos e antepé), e 1 paciente não necessitou de procedimento adicional. Conclusões A técnica de arterialização do arco venoso dorsal do pé deve ser considerada em casos selecionados. Trata-se de uma alternativa válida para a preservação do membro na impossibilidade de tratamento convencional.

Abstract Background Arterialization of the dorsal venous arch of the foot is a technique indicated in cases of critical lower limb ischemia that do not have a distal bed that is adequate to enable conventional treatment such as revascularization, angioplasty, or clinical treatment. Objectives The purpose of this study is to present the result of arterialization of the venous arch of the foot in 16 patients who underwent treatment with this technique. Methods This is a cross-sectional retrospective descriptive analytical study based on a review of the medical records of 16 patients who underwent arterialization of the dorsal venous arch of the foot for limb salvage from January 2016 to January 2021. Results Four (25%) of the 16 patients who underwent arterialization of the venous arch of the foot underwent a major amputation during the same hospital stay and one patient (6.25%) had a major amputation within 6 months. The other 11 patients (68.75%) had their limbs preserved, with 10 undergoing minor amputations (toes and forefoot) and one patient having no additional procedures. Conclusions We conclude that the technique of arterialization of the dorsal venous arch of the foot should be considered in selected cases. It is a valid alternative for limb salvage when conventional treatment is impossible.

Tratamiento endovascular de aneurisma subclavio derecho en arco aórtico bovino / Endovascular treatment of right subclavian aneurysm in bovine aortic arch

Aneurisma subclavio derecho superior a 50 mm de diámetro en un paciente con arco aórtico bovino. Como método complementario al angio taC se realizó una angiografía digital selectiva que confirmó el diagnóstico y complementó las mediciones necesarias. Se realizó tratamiento endovascular exitoso mediante punciones de ambas arterias femorales comunes y de la arteria humeral izquierda, con introductores de 7 Fr, con lo que se logró el control angiográfico total del tronco común. La progresión del cuello aneurismático solo fue posible a través del abordaje humeral. Se resolvió de modo satisfactorio mediante el implante de dos stents graft VBX de 7 × 39 y 6 × 29. Control agiográfico sin signos de endoleak. Se realizó control en UCI a las 24 horas, cuando se trasladó al paciente a la sala general con alta de internación y control por consultas externos. Hasta el momento permanece libre de síntomas.(AU)

Right subclavian aneurysm greater than 50mm in diameter in a patient with a bovine aortic arch. a selective digitalangiography was performed as a complementary method to the Ct angi-ography, confi rming the diagnosis andcomplementing the necessary measurements. Successful endovascular treatment was performed by puncture ofboth common femoral arteries and left brachial artery, with 7 fr introducers achieving total angiographic controlof the common trunk, making it possible to progress the aneurysmal neck only through the humeral approach. itwas resolved satisfactorily by implanting two 7 × 39 and 6 × 29 VBX stent grafts. agiographic control without signsof endoleak. monitoring was carried out in the iCu 24 hours a day, transfer to the general ward 24 hours a day, withhospital discharge and control by outpatient clinics. Currently symptom free.(AU)

Revascularización del arco plantar en pacientes con isquemia crónica amenazante de miembros inferiores / Plantar arch revascularization in patients with chronic limb threatening ischemia

La isquemia crónica amenazante de miembros inferiores (iCami) es una de las principales causas de morbilidad yde mortalidad a nivel mundial y se encuentra en aumento por la creciente prevalencia de la diabetes mellitus. enlas dos últimas décadas se ha demostrado la factibilidad y la seguridad de revascularizar el arco plantar (aP) y laimportancia de un aP intacto para la cicatrización de las heridas.Reportamos dos casos de pacientes con iCami que requirieron de revascularización endovascular del aP paraobtener la cicatrización de las heridas y evitar amputaciones mayores.(AU)

Chronic limb threatening ischemia (CLti) is a major cause of morbidity and mortality worldwide, and it is on the risedue to the increasing prevalence of diabetes mellitus (dm). in the last two decades, the feasibility and safety of revas-cularization of the plantar arch (Pa) and the importance of an intact Pa for wound healing have been demonstrated.We report two cases of patients with CLti who required endovascular revascularization of the Pa to obtain woundhealing and avoid major amputations.(AU)

Femoral Head Osteonecrosis: Computed Tomography Not Needed to Identify Collapse When Using the Association Research Circulation Osseous Staging System.

Background: The 2019 Revised Association Research Circulation Osseous (ARCO) Staging Criteria for Osteonecrosis of the Femoral Head (ONFH) only requires plain radiographs and magnetic resonance imaging (MRI) to diagnose and stage ONFH; however, the effectiveness of the 2019 ARCO criteria in the absence of computed tomography (CT) scans has not been investigated. Therefore, the purpose of this study was to evaluate whether CT scanning is a necessary modality for diagnosing/staging ONFH using the ARCO staging system. More specifically, do CT scans help differentiate pre- and post-collapse lesions more than MRI scans? Methods: A study was conducted on 228 ONFH patients diagnosed between January 1, 2008, and December 31, 2018, at a single academic medical center. CT and MRI scans were reviewed by the senior author and other contributors. The ONFH classification was compared between the 2 scans to determine if CT scans were able to further differentiate staging of collapsed lesions vs MRI scans. Results: A diagnosis of ONFH was made by MRI first in 57% (129/228) while 21% (48/228) used MRI and CT simultaneously. Only 22% (51/228) of cases were diagnosed by CT scans first. There were no cases where collapse was found by a CT scan that were not diagnosed by standard x-rays and/or MRIs. Conclusions: CT scans are not a useful adjunct for diagnosing or treating ONFH and are not necessary if MRI is ordered when using the Revised ARCO Staging System for ONFH diagnosis.

Anesthetic management of a child with Loeys-Dietz syndrome undergoing complete aortic arch replacement.

Loeys-Dietz syndrome (LDS) is a connective tissue disease related to ß-transforming growth factor mutations, which causes aneurysms formation, vascular tortuosity and skeletal manifestations. The prognosis is very poor, and mortality occurs at the age of 27 in patients without surgical treatment. Despite being diagnosed in childhood, is not usual surgical aortic replacement in children. We report a case of 12 years old child with LDS and multiple aneurysms in thoracic aorta, undergoing complete aortic arch replacement and our proposal for the anesthetic management, due to surgical complexity and implications in pediatric population.

El síndrome de Loeys-Dietz (SDL) es una enfermedad del tejido conectivo debida a mutaciones del factor de crecimiento transformador beta que provocan formación de aneurismas, malformaciones vasculares y esqueléticas. Tiene mal pronóstico y el fallecimiento sobreviene de media a los 27 años sin tratamiento quirúrgico. A pesar de diagnosticarse en la infancia, es infrecuente la cirugía en niños. Presentamos el caso de una niña de 12 años con SDL y aneurisma múltiple en aorta torácica, programada para recambio completo de arco aórtico, proponiendo estrategias para el manejo anestésico, dada la complejidad y las implicaciones de esta cirugía en la población pediátrica.

Reliability and repeatability of 2021 ARCO classification and its guiding significance in treatment of nontraumatic osteonecrosis of the femoral head.

BACKGROUND: The study was designed to evaluate the interobserver reliability and intraobserver repeatability of the 2021 Association Research Circulation Osseous (ARCO) classification and explore its guiding significance in the treatment of nontraumatic osteonecrosis of the femoral head (ONFH). METHODS: In this retrospective study, we randomly selected and investigated 50 sets of preoperative computed tomography or magnetic resonance imaging scans from 96 patients (139 hips) to validate the reliability and repeatability of the 2021 ARCO classification. Patients with a nano-hydroxyapatite/polyamide-66 support rod were included in the clinical efficacy study. The Harris hip score (HHS) was used to assess hip function. Femoral head collapse of > 2 mm was considered radiological failure. Total hip arthroplasty (THA) was performed for clinical failure, and follow-up was discontinued. RESULTS: The average kappa value of interobserver consistency was 0.652. The average rate of consistency was 90.25%, and the average kappa value of intraobserver consistency was 0.836. Eighty-two patients (122 hips) were enrolled and followed up for a mean of 43.57 ± 9.64 months. There was no significant difference in the HHS among the three groups before surgery, but the difference was statistically significant at the last follow-up. Among them, types 1 and 2 had significantly higher scores at the last follow-up than preoperatively (P < 0.05), whereas type 3 had a lower score at the last follow-up than preoperatively, although the difference was not statistically significant (P > 0.05).According to the imaging evaluation, the failure rate of type 1, 2, and 3 at the last follow-up was 0%, 19%, and 87%, respectively. Univariate analysis showed that the femoral head survival rate of radiography was significantly affected by the new classification system (P = 0.00). At the last follow-up, the incidence rate of THA in type 1, 2, and 3 was 5%, 7%, and 31%, respectively. Univariate analysis showed that the femoral head survival rate was significantly affected by the new classification system (P = 0.001). CONCLUSIONS: The 2021 ARCO classification for early-stage ONFH shows substantial consistency and repeatability. We do not recommend femoral head-preserving surgery for patients with type 3 ONFH.

A Clinical and Anatomical Study on the Localization of the Temporal Branch of the Facial Nerve Crossing the Zygomatic Arch / Estudio Clínico y Anatómico sobre la Localización del Ramo Temporal del Nervio Facial que Cruza el Arco Cigomático

SUMMARY: To clarify the path of the temporal branch of facial nerve (TB) crossing the zygomatic arch (ZA). Eighteen fresh adult heads specimens were carefully dissected in the zygomatic region, with the location of TB as well as its number documented. The hierarchical relationship between the temporal branch and the soft tissue in this region was observed on 64 P45 plastinated slices. 1. TB crosses the ZA as type I (21.8 %), type II (50.0 %,), and type III (28.1 %) twigs. 2. At the level of the superior edge of the ZA, the average distance between the anterior trunk of TB and the anterior part of the auricle is 36.36±6.56 mm, for the posterior trunk is 25.59±5.29 mm. At the level of the inferior edge of the ZA, the average distance between the anterior trunk of TB and the anterior part of the auricle is 25.77±6.19 mm, for the posterior trunk is 19.16±4.71 mm. 3. The average length of ZA is 62.06±5.36 mm. TB crosses the inferior edge of the ZA at an average of 14.67±6.45 mm. TB crosses the superior edge of the ZA at an average of 9.08±4.54 mm. 4. At the level of the ZA, TB passes on the surface of the pericranium while below the SMAS. The TB obliquely crosses the middle 1/3 part of the superior margin of the ZA and the junction of the middle 1/3 part and the posterior 1/3 part of the inferior margin of the ZA below the SMAS while beyond the periosteum. It is suggested that this area should be avoided in clinical operation to avoid the injury of TB.

El objetivo de estudio fue esclarecer el trayecto del ramo temporal del nervio facial (RT) que cruza el arco cigomático (AC). Se disecaron la región cigomática de 18 especímenes de cabezas sin fijar de individuos adultas y se documentó la ubicación del RT y su número de ramos. La relación jerárquica entre el ramo temporal y el tejido blando en esta región se observó en 64 cortes plastinados o P45. 1º El RT cruza el AC como tipo I (21,8 %), tipo II (50,0 %) y tipo III (28,1 %). 2º A nivel del margen superior del AC, la distancia promedio entre el tronco anterior de RT y la parte anterior de la aurícula fue de 36,36±6,56 mm, para el tronco posterior fue de 25,59±5,29 mm. A nivel del margen inferior del AC, la distancia promedio entre el tronco anterior del RT y la parte anterior de la aurícula era de 25,77±6,19 mm, para el tronco posterior era de 19,16±4,71 mm. 3º La longitud media de RT fue de 62,06±5,36 mm. EL RT cruzaba el margen inferior del AC a una distancia media de 14,67±6,45 mm. El RT cruzaba el margen superior del AC a una distancia media de 9,08±4,54 mm. 4º Anivel del AC, el RT pasaba por la superficie del pericráneo mientras se encuentra por debajo del SMAS. El RT cruza oblicuamente el tercio medio del margen superior del AC y la unión del tercio medio y el tercio posterior del margen inferior del AC por debajo del SMAS, más allá del periostio. Se sugiere que esta área debe evitarse en la operación clínica para evitar la lesión de la RT.

A Truncus Bicaroticus and an Aberrant Right Subclavian Artery. A Rare Case and Literature Review / Un Tronco Bicarótico y una Arteria Subclavia Derecha Aberrante. Un Caso Raro y Revisión de la Literatura

SUMMARY: An aberrant right subclavian artery described by David Bayford, is rare and one of the aortic arch anomalies. It gives usually incidental findings. We present the case of a 57-year-old woman who was admitted to a neurology outpatient clinic due to a headache and no obvious pathology was detected during a physical examination. In consequence of the brain and chest CT angiography, incidental anomalies of the aortic arch branches were found and asymptomatic aberrant right subclavian artery and bicarotid trunk was diagnosed. The presence of this anomaly is becoming increasingly important in avoiding vascular injuries and cerebral complications in patients undergoing endovascular intervention on the aorta aortic arch surgery, thyroidectomy, or cervicothoracic surgery. So, detailed knowledge of variations of the subclavian artery and bicarotid trunk is paramount for radiologists and surgeons operating on the region of the anterior neck.

Una arteria subclavia derecha aberrante descrita por David Bayford, es rara y es una de las anomalías del arco aórtico. Además, suele ser hallazgos accidentales. Presentamos el caso de una mujer de 57 años que ingresó a una consulta de neurología por dolor de cabeza, sin embargo, no se le detectó patología evidente al examen físico. En el angio-TC de cerebro y tórax, se encontraron anomalías incidentales de las ramas del arco aórtico y se diagnosticó arteria subclavia derecha aberrante asintomática y tronco bicarotídeo. Determinar la presencia de esta anomalía es cada vez más importante, para así evitar lesiones vasculares y complicaciones cerebrales en pacientes sometidos a intervención endovascular de la aorta, cirugía del arco aórtico, tiroidectomía o cirugía cervicotorácica. Por lo tanto, el conocimiento detallado de las variaciones de la arteria subclavia y el tronco bicarotídeo es primordial para los radiólogos y cirujanos que operan en la región anterior del cuello.

Artéria vertebral esquerda anômala ­ relato de caso / Anomalous left vertebral artery ­ case report

Introdução: Os procedimentos cirúrgicos e radiológicos das regiões do tórax e pescoço são frequentes e a identificação precoce de variantes do arco da aorta e especificamente da artéria vertebral ajudam a identificar possíveis obstáculos nesses procedimentos, antes que se tornem um problema. Objetivo: Relatar um caso de variação da artéria vertebral esquerda. Método: Estudo descritivo, retrospectivo de um relato de caso sobre artéria vertebral anômala identificada por meio de uma dissecção de rotina. Resultados: Durante o procedimento se observou que o arco da artéria aorta apresentava um ramo arterial emergindo entre a artéria carótida comum esquerda e a artéria subclávia esquerda. Posteriormente, avançando a dissecção para a região cervical, identificou-se que o ramo variável do arco aórtico se tratava da artéria vertebral esquerda, confirmando seu trajeto pelo forame do processo transverso das vértebras cervicais. Conclusão: Dessa forma, torna-se importante apresentar o presente relato de caso da artéria vertebral anômala, bem como discutir as possíveis implicações cirúrgicas, hemodinâmicas e radiológicas do achado. É fundamental o conhecimento das variações anatômicas da artéria vertebral, as quais, possuem relevância cirúrgica, radiológica e hemodinâmica, já que processos patológicos podem ser observados ou negligenciados por métodos de imagem. Assim, podem-se evitar eventuais lesões iatrogênicas baseadas no conhecimento prévio dessa variação

Introduction: Surgical and radiological procedures of the thorax and neck regions are frequent and early identification of variants of the aortic arch and specifically the vertebral artery help to identify possible obstacles in these procedures, before they become a problem. Objective: To report a case of variation of the left vertebral artery. Methods: Descriptive, retrospective study of a case report on anomalous vertebral artery identified by routine dissection. Results: During the procedure it was observed that the arch of the aortic artery had an arterial branch emerging between the left common carotid artery and the left subclavian artery. Subsequently, advancing the dissection to the cervical region, it was identified that the variable branch of the aortic arch was the left vertebral artery, confirming its path through the foramen of the transverse process of the cervical vertebrae. Conclusion: Thus, it is important to present the present case report of the anomalous vertebral artery, as well as to discuss the possible surgical, hemodynamic and radiological implications of the finding. It is essential to know the anatomical variations of the vertebral artery, which have surgical, radiological and hemodynamic relevance, since pathological processes can be observed or neglected by imaging methods. Thus, one can avoid eventual iatrogenic lesions based on prior knowledge of this variation.

Introducción: Los procedimientos quirúrgicos y radiológicos en las regiones de tórax y cuello son frecuentes y la identificación temprana de variantes del arco aórtico y específicamente de la arteria vertebral ayuda a identificar posibles obstáculos en estos procedimientos, antes de que se conviertan en un problema. Objetivo: Reportar un caso de variación de la arteria vertebral izquierda. Métodos: Estudio descriptivo retrospectivo de un reporte de caso sobre una arteria vertebral anómala identificada a través de una disección de rutina. Resultados: Durante el procedimiento se observó que el arco aórtico presentaba una rama arterial que emergía entre la arteria carótida común izquierda y la arteria subclavia izquierda. Posteriormente, avanzando la disección a la región cervical, se identificó que la rama variable del arco aórtico era la arteria vertebral izquierda, confirmándose su trayecto por el foramen de la apófisis transversa de las vértebras cervicales. Conclusión: Por lo tanto, es importante presentar el presente caso clínico de arteria vertebral anómala, así como discutir las posibles implicaciones quirúrgicas, hemodinámicas y radiológicas del hallazgo. Es fundamental conocer las variaciones anatómicas de la arteria vertebral, las cuales tienen relevancia quirúrgica, radiológica y hemodinámica, ya que los procesos patológicos pueden ser observados o despreciados por métodos de imagen. Así, se pueden evitar posibles lesiones iatrogénicas en base al conocimiento previo de esta variación

Use of antioxidants and time of cold storage: effects over viability parameters and enzymatic levels in semen of rainbow trout (Oncorhynchus mykiss, Walbaum, 1792) / Uso de antioxidantes e tempo de armazenamento a frio: efeitos sobre parâmetros de viabilidade e níveis enzimáticos no sêmen da truta arco-íris (Oncorhynchus mykiss, Walbaum, 1792)

The cold storage of milt implies potentials alterations in its quality because the storage generates as main process, free radicals that produce spermatozoa membrane lipids damage with the consequent motility and fertilising capacity disruptions. To decrease the damage generated by free radicals the cells have antioxidant defences (proteins, enzymes, and low molecular weight substances). The objective of the present study evaluated the time storage effect and different antioxidants prepared in spermatic diluents on sperm viability of O. mykiss milt stored at 4°C. The two-way ANOVA denoted that the time storage and antioxidant influence have significant effects separated or combined on viability parameters (sperm motility and viability, proteins concentrations and superoxide dismutase enzymatic activity in seminal plasma). In contrast, only the storage time affected the fertilising capacity and catalase enzymatic activity in seminal plasma. The resulting analysis can conclude that the antioxidant presence improves the viability of cold stored milt, especially the transport conditions and the antioxidants allow the fecundity despite motility decrease.

O armazenamento a frio de leite implica potenciais alterações em sua qualidade, pois gera como processo principal radicais livres que provocam danos aos lipídios da membrana dos espermatozoides, com as consequentes alterações na motilidade e na capacidade de fertilização. Para diminuir os danos causados pelos radicais livres, as células têm defesas antioxidantes (proteínas, enzimas e substâncias de baixo peso molecular). O presente estudo avaliou o efeito do tempo de armazenamento e diferentes antioxidantes preparados em diluentes espermáticos no armazenamento de viabilidade de O. mykiss milt a 4°C. A ANOVA de duas vias denotou que o armazenamento no tempo e a influência antioxidante têm efeitos significativos separados ou combinados nos parâmetros de viabilidade (motilidade espermática, viabilidade espermática, concentrações de proteínas e atividade enzimática da superóxido dismutase no plasma seminal), enquanto apenas o tempo de armazenamento afetou a capacidade de fertilização e atividade enzimática da catalase no plasma seminal. A análise resultante pode concluir que a presença de antioxidante melhora a viabilidade do leite frio, especialmente as condições de transporte, e os antioxidantes permitem a fecundidade apesar da diminuição da motilidade.

Use of antioxidants and time of cold storage: effects over viability parameters and enzymatic levels in semen of rainbow trout (Oncorhynchus mykiss, Walbaum, 1792)

Abstract The cold storage of milt implies potentials alterations in its quality because the storage generates as main process, free radicals that produce spermatozoa membrane lipids damage with the consequent motility and fertilising capacity disruptions. To decrease the damage generated by free radicals the cells have antioxidant defences (proteins, enzymes, and low molecular weight substances). The objective of the present study evaluated the time storage effect and different antioxidants prepared in spermatic diluents on sperm viability of O. mykiss milt stored at 4°C. The two-way ANOVA denoted that the time storage and antioxidant influence have significant effects separated or combined on viability parameters (sperm motility and viability, proteins concentrations and superoxide dismutase enzymatic activity in seminal plasma). In contrast, only the storage time affected the fertilising capacity and catalase enzymatic activity in seminal plasma. The resulting analysis can conclude that the antioxidant presence improves the viability of cold stored milt, especially the transport conditions and the antioxidants allow the fecundity despite motility decrease.

Resumo O armazenamento a frio de leite implica potenciais alterações em sua qualidade, pois gera como processo principal radicais livres que provocam danos aos lipídios da membrana dos espermatozoides, com as consequentes alterações na motilidade e na capacidade de fertilização. Para diminuir os danos causados pelos radicais livres, as células têm defesas antioxidantes (proteínas, enzimas e substâncias de baixo peso molecular). O presente estudo avaliou o efeito do tempo de armazenamento e diferentes antioxidantes preparados em diluentes espermáticos no armazenamento de viabilidade de O. mykiss milt a 4°C. A ANOVA de duas vias denotou que o armazenamento no tempo e a influência antioxidante têm efeitos significativos separados ou combinados nos parâmetros de viabilidade (motilidade espermática, viabilidade espermática, concentrações de proteínas e atividade enzimática da superóxido dismutase no plasma seminal), enquanto apenas o tempo de armazenamento afetou a capacidade de fertilização e atividade enzimática da catalase no plasma seminal. A análise resultante pode concluir que a presença de antioxidante melhora a viabilidade do leite frio, especialmente as condições de transporte, e os antioxidantes permitem a fecundidade apesar da diminuição da motilidade.

Use of antioxidants and time of cold storage: effects over viability parameters and enzymatic levels in semen of rainbow trout (Oncorhynchus mykiss, Walbaum, 1792) / Uso de antioxidantes e tempo de armazenamento a frio: efeitos sobre parâmetros de viabilidade e níveis enzimáticos no sêmen da truta arco-íris (Oncorhynchus mykiss, Walbaum, 1792)

Abstract The cold storage of milt implies potentials alterations in its quality because the storage generates as main process, free radicals that produce spermatozoa membrane lipids damage with the consequent motility and fertilising capacity disruptions. To decrease the damage generated by free radicals the cells have antioxidant defences (proteins, enzymes, and low molecular weight substances). The objective of the present study evaluated the time storage effect and different antioxidants prepared in spermatic diluents on sperm viability of O. mykiss milt stored at 4°C. The two-way ANOVA denoted that the time storage and antioxidant influence have significant effects separated or combined on viability parameters (sperm motility and viability, proteins concentrations and superoxide dismutase enzymatic activity in seminal plasma). In contrast, only the storage time affected the fertilising capacity and catalase enzymatic activity in seminal plasma. The resulting analysis can conclude that the antioxidant presence improves the viability of cold stored milt, especially the transport conditions and the antioxidants allow the fecundity despite motility decrease.

Resumo O armazenamento a frio de leite implica potenciais alterações em sua qualidade, pois gera como processo principal radicais livres que provocam danos aos lipídios da membrana dos espermatozoides, com as consequentes alterações na motilidade e na capacidade de fertilização. Para diminuir os danos causados pelos radicais livres, as células têm defesas antioxidantes (proteínas, enzimas e substâncias de baixo peso molecular). O presente estudo avaliou o efeito do tempo de armazenamento e diferentes antioxidantes preparados em diluentes espermáticos no armazenamento de viabilidade de O. mykiss milt a 4°C. A ANOVA de duas vias denotou que o armazenamento no tempo e a influência antioxidante têm efeitos significativos separados ou combinados nos parâmetros de viabilidade (motilidade espermática, viabilidade espermática, concentrações de proteínas e atividade enzimática da superóxido dismutase no plasma seminal), enquanto apenas o tempo de armazenamento afetou a capacidade de fertilização e atividade enzimática da catalase no plasma seminal. A análise resultante pode concluir que a presença de antioxidante melhora a viabilidade do leite frio, especialmente as condições de transporte, e os antioxidantes permitem a fecundidade apesar da diminuição da motilidade.

Configurações dentárias reduzidas no contexto de estudos epidemiológicos: associação com desfechos de saúde e validação de critério diagnóstico / Shortened dental configurations in the context of epidemiological studies: association with health outcomes and validation of diagnostic criteria

Objetivou-se mapear os conceitos de configuração dentária reduzida empregados em estudos epidemiológicos associados com desfechos em saúde (estudo 1), bem como avaliar a validade de uma configuração utilizada em estudos epidemiológicos (pares de dentes antagonistas) (Estudo 2). Para o estudo 1 realizou-se uma revisão de literatura do tipo Scoping review com busca nas bases de dados PubMed/Medline, Scopus, Web of Science, Scielo e Cochrane. Dois pesquisadores treinados realizaram a seleção e extração de dados de estudos que avaliaram a associação entre configuração dentária reduzida (exposição) e desfechos em saúde clínicos e centrados na pessoa (saúde geral e saúde bucal), relacionados ao comportamento em saúde (padrões de dieta), além de mortalidade. Desfechos foram classificados de acordo com a Classificação Internacional de Funcionalidade, Incapacidade e Saúde e com a Classificação Internacional de Doenças da Organização Mundial de Saúde (OMS). Configurações dentárias reduzidas basearam-se na contagem de dentes presentes, na posição dos dentes considerando estética, oclusão dentária e condições periodontais. A busca inicial resultou em 12525 referências, sendo 283 incluídos. A atualização da busca incluiu 117 artigos (ntotal=400). Saúde geral (n=186) e saúde bucal (n=192) foram abordadas em número semelhante de estudos. A maioria dos desfechos foram clínicos de saúde geral (n=169), sendo as doenças endócrinas, nutricionais ou metabólicas (n=55) frequentes. Em 144 estudos foram abordadas medidas centradas na pessoa, sendo a qualidade de vida relacionada a saúde bucal (QRSB) a mais frequente (n=60). Os desfechos clínicos de saúde bucal foram predominantemente relacionados às funções de ingestão (n=42) e doenças ou distúrbios do complexo orofacial (n=23). Padrões de dieta (n=39) e mortalidade (n=34) também foram estudados. A configuração dentária reduzida definida como meta pela OMS foi a mais frequente (n=181). Para o estudo 2 avaliou-se a acurácia de pares de dentes antagonistas para mensurar a presença de pares de pré-molares e molares em contato oclusal e a concordância entre a prevalência de Arco Dental Reduzido (ADR) e Dentição funcional (DF) quando unidades oclusais dentárias (UOs)/pares de oclusão posterior (POPs) foram definidas por pares de dentes antagonistas ou pares de dentes em contato oclusal. Dados obtidos em inquérito epidemiológico de saúde bucal realizado em município de Minas Gerais, Brasil. UOs e POPs foram definidos pelo critério epidemiológico (condição da coroa dentária) ou critério clínico "padrão ouro" (registro em papel carbono dos contatos oclusais durante a máxima intercuspidação habitual). Foram calculados sensibilidade, valor preditivo positivo (VPP), valor preditivo negativo (VPN) e acurácia do critério epidemiológico. Sensibilidade, especificidade, VPP e VPN foram 88,5, 87,9, 92,5 e 81,9%, respectivamente, e acurácia foi de 88,3%. Os resultados sobre a concordância observada, coeficientes Kappa e valores estatísticos ß em relação à prevalência de ADR e DF (antagonista e contato oclusal) variaram de 0,82 a 0,98, indicando alto índice de concordância. Efeitos das configurações dentárias reduzidas têm sido investigados principalmente em relação às doenças endócrinas, nutricionais ou metabólicas e medidas de QVRSB. Há diversidade de desfechos em saúde. Critério epidemiológico mostrou-se válido e pode ser utilizado em estudos epidemiológicos para calcular a prevalência de configurações dentárias reduzidas que consideram POPs.

This study mapped definitions of shortened dental configurations and health outcomes employed in association studies (Study 1), as well as to evaluate the validity of a configuration used in epidemiological studies (pairs of antagonistic teeth) (Study 2). For study 1, a literature review of the Scoping review type was carried out with a search in PubMed/Medline, Scopus, Web of Science, Scielo and Cochrane databases. Two trained researchers performed the selection and data extraction of studies that evaluated the association between reduced tooth configuration (exposure) and clinical and person-centered health outcomes (general health and oral health), related to health behavior (dietary patterns), in addition to mortality. Outcomes were classified according to the International Classification of Functioning, Disability and Health and the International Classification of Diseases of the World Health Organization (WHO). Shortened dental configurations were based on the number of teeth present, the position of the teeth regarding esthetics, dental occlusion and periodontal conditions. The initial search resulted in 12525 references, 283 of which were included. The search update included 117 articles (ntotal=400). General health (n=186) and oral health (n=192) were addressed in a similar number of studies. Most outcomes were general health clinics (n=169), with endocrine, nutritional or metabolic diseases (n=55) being frequent. In 144 studies, person-centered measures were addressed, with oral healthrelated quality of life (OHQoL) being the most frequent (n=60). Clinical oral health outcomes were predominantly related to eating functions (n=42) and diseases or disorders of the orofacial complex (n=23). Diet patterns (n=39) and mortality (n=34) were also studied. The shortened dental configuration defined as a goal by the WHO was the most frequent (n=181). For study 2, the accuracy of pairs of antagonistic teeth was evaluated to measure the presence of pairs of premolars and molars in occlusal contact and the agreement between the prevalence of Shortened Dental Arch (SDA) and Functional Dentition (FD) when units occlusal (UOs)/posterior occlusion pairs (POPs) were defined by pairs of antagonistic teeth or pairs of teeth in occlusal contact. Data obtained from an epidemiological survey of oral health carried out in the municipality of Minas Gerais, Brazil. UOs and POPs were defined by epidemiological criteria (condition of the dental crown) or clinical "gold standard" criteria (carbon paper recording of occlusal contacts during maximum habitual intercuspation). Sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of the epidemiological criterion were calculated. Sensitivity, specificity, PPV and NPV were 88.5, 87.9, 92.5 and 81.9%, respectively, and accuracy was 88.3%. The results on observed agreement, Kappa coefficients and ß statistical values in relation to the prevalence of SDA and FD (antagonist and occlusal contact) ranged from 0.82 to 0.98, indicating a high level of agreement. Effects of reduced tooth configurations have been investigated mainly in relation to endocrine, nutritional or metabolic diseases and OHQoL measures. There is a diversity of health outcomes. Epidemiological criteria proved to be valid and can be used in epidemiological studies to calculate the prevalence of reduced dental configurations that consider POPs.