Utility of intraoral scanner imaging for dental plaque detection.

Purpose: Oral hygiene, maintained through plaque control, helps prevent periodontal disease and dental caries. This study was conducted to examine the accuracy of plaque detection with an intraoral scanner (IOS) compared to images captured with an optical camera. Materials and Methods: To examine the effect of color tone, artificial tooth resin samples were stained red, blue, and green, after which images were acquired with a digital single-lens reflex (DSLR) camera and an IOS device. Stained surface ratios were then determined and compared. Additionally, the deviation rate of the IOS relative to the DSLR camera was computed for each color. In the clinical study, following plaque staining with red disclosing solution, the staining was captured by the DSLR and IOS devices, and the stained area on each image was measured. Results: The stained surface ratios did not differ significantly between DSLR and IOS images for any color group. Additionally, the deviation rate did not vary significantly across colors. In the clinical test, the stained plaque appeared slightly lighter in color, and the delineation of the stained areas less distinct, on the IOS compared to the DSLR images. However, the stained surface ratio was significantly higher in the IOS than in the DSLR group. Conclusion: When employing IOS with dental plaque staining, the impact of color was minimal, suggesting that the traditional red stain remains suitable for plaque detection. IOS images appeared relatively blurred and enlarged relative to the true state of the teeth, due to inferior sharpness compared to camera images.

Prevalence of Oral Lesions Diagnosed at a Pathology Institute: A Four-year Analysis

Abstract Objective: To identify the most prevalent oral lesions based on reports from a pathology institute's reports and associations between malignant and oral potentially malignant disorders with patient's demographic variables and the anatomical location. Material and Methods: All 1,298 histopathological reports of oral lesions recorded in the database were reviewed. Demographic variables, anatomical location of the lesion, histopathological diagnosis of the lesions, and their biological behavior were analyzed. Results: Regarding the biological behavior of the identified lesions, benign lesions were predominant (70%), followed by lesions of undetermined behavior (14.3%), malignant lesions (14.2%), absence of histological alteration (1.2%), and finally, oral potentially malignant disorders (0.5%). The anatomical locations of the most prevalent oral lesions potentially malignant disorders and malignant were in the following structures of the oral cavity: gums, buccal mucosa, floor of the mouth and hard palate (p=49.2%), and tongue (p=48.7%). Conclusion: The probability of malignant and premalignant lesions was higher among males (PR= 4.21; 95% CI 2.08-6.22), the increase in age (PR = 1.06; 95% CI 1.05-1.08), and in the tongue region (PR = 5.48; 95% CI 1.67; 17.92). Identification of malignant and potentially malignant oral conditions is higher in older men and in tongue specimens.

Frecuencia de Bacilos Gram Negativos en la cavidad bucal de estudiantes de una Universidad de Asunción

Introducción: La cavidad bucal hospeda una gran cantidad de microorganismos, como los bacilos Gram negativos, y entre ellas, bacterias de gran importancia médica debido a su capacidad de producir enfermedades graves para el ser humano, especialmente en pacientes inmunodeprimidos. El objetivo de este trabajo fue determinar la presencia de Bacilos Gram Negativos y sus patrones de resistencia a antibióticos, en una población estudiantil de la ciudad de Asunción, en los años 2019 y 2020. Materiales y métodos: Se realizó un estudio observacional, descriptivo de corte transversal, donde se realizaron hisopados de la cavidad bucal a 35 alumnos de entre 18 a 24 años, de una universidad privada en la ciudad de Asunción. Se requirió consentimiento informado firmado por los participantes y fueron excluidos quienes tuvieron tratamientos antibióticos. Las muestras fueron obtenidas con un hisopo de algodón, posteriormente se colocaron en un medio de transporte para luego ser cultivadas en Agar MacConkey. El cultivo se realizó por 48 horas a 37° centígrados, luego se procedió a la identificación bacteriana. Por último, se realizó el antibiograma. Resultados: De los 35 alumnos se encontró una frecuencia de 48,57% de bacilos Gram negativos. Cepas de Klebsiella pneumoniae fueron las más frecuentes (35,29%). Se observó que las bacterias eran altamente resistentes a la Amoxicilina/Ácido Clavulánico. Conclusiones: La presencia de estos tipos de microorganismos puede ser peligrosa para la salud general de las personas, específicamente de los pacientes con algún tipo de inmunodepresión, debido a la gran la resistencia a antibióticos presentadas por algunas cepas.

Introduction: The oral cavity hosts a large number of microorganisms, such as Gram negative bacilli, and among them, bacteria of great medical importance due to their capacity to cause serious diseases for humans, especially in immunosuppressed patients. The objective of this work was to determine the presence of Gram Negative Bacilli and their patterns of resistance to antibiotics, in a student population of the city of Asunción, in the years 2019 and 2020. Materials and methods: An observational, descriptive cross-sectional study was carried out, where oral cavity swabs were made from 35 students between 18 and 24 years of age, from a private university in the city of Asunción. Informed consent signed by the participants was required and those who had antibiotic treatments were excluded. The samples were obtained with a cotton swab, later they were placed in a transport medium to later be cultured in MacConkey Agar. The culture was carried out for 48 hours at 37° Celsius, then the bacterial identification was carried out. Finally, the antibiogram was performed. Results: Of the 35 students, a frequency of 48,57% of Gram negative bacilli was found. Klebsiella pneumoniae strains were the most frequent (35.29%). The bacteria were found to be highly resistant to Amoxicillin/Clavulanic Acid. Conclusions: The presence of these types of microorganisms can be dangerous for the general health of people, specifically of patients with some type of immunosuppression, due to the great resistance to antibiotics presented by some strains.

Role of reflectance confocal microscopy for in vivo investigation of oral disorders: White, red and pigmented lesions.

In vivo reflectance confocal microscopy (RCM) is poorly investigated in oral pathology due to the peculiar anatomical and topographical oral mucosa features. A dedicated handheld confocal microscope with an intra-oral probe was developed for oral mucosa imaging. The main objective was to describe the healthy oral mucosa and the cytoarchitectural findings detectable in different oral disorders by means of the newly designed handheld confocal microscope. Secondary aim was to identify the main RCM criteria that differentiate oral lesions in order to provide algorithm for a rapid non-invasive evaluation. This observational retrospective study included all consecutive patients with oral disorders and volunteers with healthy oral mucosa who underwent RCM examination in our outpatient clinic from September 2018 to December 2021. Three different investigators examined together the RCM images to detect the key features and secondary criteria for each type of oral lesion collected. The study population included 110 patients affected by oral lesions and seven volunteers with healthy oral mucosae. A total of 15 oral disorders were imaged and divided in three main groups: white, red and pigmented lesions. Key features and secondary criteria were identified for every single type of oral disease. RCM permits a cytoarchitectural evaluation of the oral mucosae affected by inflammatory, dysplastic and neoplastic diseases, thus orienting the clinicians towards non-invasive diagnosis and enhancing the diagnostic management. The "tree diagrams" proposed allow a schematic and simplified view of confocal features for each type of oral disease, thus drastically reducing the diagnostic timing.

A Fibroblastic Reticular Cell Tumour Arising in the Oral Cavity: A Case Report and Review of the Literature.

BACKGROUND: Tumours of dendritic or histiocytic lineage are amongst the rarest tumours and probably account for < 1% of tumours affecting the lymph nodes or soft tissue. Because several of these entities were poorly recognised until recently, the true incidence is not determined. METHODS: We present what we believe is the first reported case report of a fibroblastic reticular cell tumour arising in the oral cavity as well as reviewing the current literature regarding this rare subset of tumours. RESULTS: We discuss the clinical and histopathological findings of our reported case and examine the literature regarding this entity. We discuss the key differential diagnoses to consider when making this diagnosis. CONCLUSION: Histiocytic and dendritic cell derived tumours are exceptionally rare within the head and neck region although a number of these tumours have been reported within the oral cavity. We present what we believe is the first reported case of a fibroblastic reticular cell tumour arising within the oral cavity.

Oral and oropharyngeal cancer: time from first symptoms to treatment initiation and associated factors

Abstract The aim of this study was to evaluate the time elapsed from first symptoms to the treatment of oral and oropharyngeal cancer (OOC) and to identify variables associated with treatment delay. This is an observational study with retrospective and prospective data collection. Patients with a diagnosis of OOC seen at the Head and Neck Surgery outpatient clinic of a Brazilian public hospital were included and followed up to treatment initiation. Participants answered a questionnaire for the collection of socioeconomic, demographic, cultural, and clinical information, as well as information about the time elapsed from first symptoms to the first appointment with a head and neck surgeon. Time to treatment was classified into four intervals: 1- first symptoms to first medical appointment; 2- first medical appointment to specialized medical care; 3- specialized medical care to preparation for treatment; and 4- preparation for treatment to treatment initiation. Bivariate statistics were computed. Out of 100 participants, nine died before treatment. Mean time to treatment was 217 days. Highest mean time was observed for interval 2 (94 days), followed by interval 1 (63 days), interval 4 (39 days), and interval 3 (21 days). At interval 1, a longer time was associated with severe alcohol consumption, severe smoking, and family history of cancer. At interval 2, the delay was associated with appointment with a general practitioner, clinical diagnosis of disease other than cancer, and antibiotic prescription. At interval 4, delay in treatment was associated with surgical treatment. Patients with OOC experience delays from symptom onset to treatment initiation. The longest interval was associated with professional delay, followed by patient delay in help-seeking.

Artificial intelligence for oral cancer diagnosis: What are the possibilities?

Oral cancer could be prevented. The primary strategy is based on prevention. Most patients with oral cancer present to the hospital network with advanced staging and a low chance of cure. This condition may be related to physicians' difficulty of making an early diagnosis. With the advancement of information technology, artificial intelligence (AI) holds great promise in terms of assisting in diagnosis. Few machine learning algorithms have been developed for this purpose to date. In this paper, we will discuss the possibilities for diagnosing oral cancer using AI as a tool, as well as the implications for the population. A set of photographic images of oral lesions has been segmented, indicating not only the area of the lesion but also the class of lesion associated with it. Different neural network architectures were trained with the goal of fine segmentation (pixel by pixel), classification of image crops, and classification of whole images based on the presence or absence of a lesion. The accuracy results are acceptable, opening up possibilities not only for identifying lesions but also for classifying the pathology associated with them.

Hiperplasia epitelial focal: relato de caso clínico / Focal epithelial hyperplasia: case report

Introdução: a hiperplasia epitelial focal (HEF) ou doença de Heck, caracteriza-se por ser uma lesão benigna rara da mucosa bucal. Geralmente, está associada a proliferação do epitélio pavimentoso atribuída principalmente ao papiloma vírus humano (HPV) dos subtipos 13 e 32. Objetivo: relatar o caso de um paciente, com suspeita diagnóstica de HEF, descrever suas manifestações clínicas bucais e histopatológicas. Metodologia: homem, 38 anos, melanoderma, compareceu no Serviço Universitário com queixa de ardência em mucosa bucal. Ao exame clínico, apresentava múltiplas lesões papulares, firmes à palpação, de coloração rósea, com pápulas aglomeradas ou isoladas, localizadas em rebordo alveolares, gengiva inserida e livre da arcada superior e inferior, mucosas jugais e labiais, compatíveis com lesões causadas por HPV. Realizou-se biópsia incisional das lesões bucais, o laudo histopatológico descreveu o fragmento de mucosa bucal que estava revestida por epitélio pavimentoso estratificado paraceratinizado com acantose proeminente, projeções focais confluentes para o tecido conjuntivo, confirmando a suspeita diagnóstica clínica. Conclusão: a HEF é uma patologia rara, benigna da mucosa, indolor e que pode se resolver espontaneamente. Portanto, é necessário o diagnóstico adequado através da biopsia e laudo histopatológico.

Introduction: focal epithelial hyperplasia (FEH) or Heck's disease is characterized as a rare benign lesion of the oral mucosa. It is usually associated with proliferation of the squamous epithelium, mainly attributed to human papillomavirus (HPV) subtypes 13 and 32. Objective: to report the case of a patient with a diagnostic suspicion of HEF, to describe its oral clinical and histopathological manifestations. Methodology: hale, 38 years old, black, attended the University Service with a complaint of burning in the oral mucosa. On clinical examination, she presented multiple papular lesions, firm to palpation, pink in color, with agglomerated or isolated papules, located in the alveolar ridge, inserted gingiva free from the upper and lower arch, jugal and labial mucosa, compatible with lesions caused by HPV. An incisional biopsy of the oral lesions was performed, the histopathological report described the fragment of oral mucosa that was lined with parakeratinized stratified squamous epithelium with prominent acanthosis, focal projections confluent to the connective tissue, confirming the clinical diagnostic suspicion. Conclusion: FEH is a rare, benign mucosal pathology, painless and can resolve spontaneously. Therefore, proper diagnosis through biopsy and histopathological report is necessary.

Diagnóstico educativo sobre salud bucal en escolares de Trinidad / Educational diagnosis on oral health in schoolchildren from Trinidad city

RESUMEN Fundamento: En escolares de 4.to grado están presentes enfermedades bucales y se realizan acciones curativas, mientras que las educativas precedidas de un diagnóstico educativo, son deficientes e insuficientes. Objetivo: Identificar los conocimientos, actitudes, prácticas sobre salud bucal y la eficiencia del cepillado bucodental en los escolares de 4.to grado. Metodología: Se realizó un estudio observacional, descriptivo y transversal durante el curso 2020-2021 de la Escuela Primaria Pepito Tey del municipio Trinidad, provincia Sancti Spíritus, con la totalidad (71) de los escolares de 4.to grado. Las variables estudiadas fueron: conocimientos, prácticas, actitudes sobre salud bucal y eficiencia del cepillado bucodental. Se utilizaron métodos del nivel teórico, empírico y estadístico-matemático con la aplicación de un cuestionario y una guía de entrevista, para la eficiencia del cepillado se determinó el Índice de Love. Resultados: Se constató el 71.8 % de los escolares con conocimientos insuficientes, el 74.6 % con actitud desfavorable y el 81.7 % con prácticas insuficientes sobre salud bucal, así como el 93 % con cepillado bucodental no eficiente. Conclusiones: Más de la tercera parte de los escolares tuvo conocimientos insuficientes, actitudes no favorables y prácticas insuficientes de salud bucal y la mayoría un cepillado no eficiente.

ABSTRACT Background: Oral diseases and curative actions are present in 4th grade schoolchildren while educational actions preceded by an educational diagnosis are deficient and insufficient. Objective: To identify the knowledge, attitudes, practices on oral health and the efficiency of Oral brushing in 4th grade schoolchildren. Methodology: An observational, descriptive and cross-sectional study was carried out during the 2020-2021 academic course at Pepito Tey primary school in Trinidad city, in Sancti Spíritus province, with all (71) of the 4th grade students. The variables studied were: knowledge, practices, attitudes about oral health and efficiency of oral brushing. Some methods from the theoretical, empirical and statistical-mathematical level were used with the application of a questionnaire and an interview guide, for brushing efficiency. Results: 71.8 % of schoolchildren with insufficient knowledge were found, 74.6 % with an unfavorable attitude and 81.7 % with insufficient practices on oral health, as well as the 93 % with inefficient oral brushing. Conclusions: More than a third of the schoolchildren had insufficient knowledge, unfavorable attitudes and insufficient practices of oral health and most brushing is not efficient.

Alineadores en ortodoncia / Aligners in orthodontics

Objetivo: Describir los alineadores en ortodoncia y su utilidad en la salub bucal del paciente. Método: descriptiva documental desde un diseño bibliográfico, siendo escrutada una población de 15 artículos científicos tomados de bases de datos publicadas entre 2016 al 2021. Conclusión: Los alineadores dentales sirven para corregir casos simples, nivelar arcos, mantener la longitud de la raíz y cerrar espacios. Estos alineadores se pueden alterar con cambios térmicos físicos sobre todo si es sometido a alimentos calientes. Da la posibilidad de mostrar al paciente cómo será el resultado final, esto se logra mediante las simulaciones digitales que permite este método. Es un tratamiento que requiere de experiencia por parte del profesional.

Objective: To describe aligners in orthodontics and their usefulness in the oral health of the patient. Method: Descriptive documentary from a bibliographic design, being scrutinized a population of 15 scientific articles taken from databases published between 2016 to 2021. Conclusion: Dental aligners are used to correct simple cases, level arches, maintain root length and close spaces. These aligners can be altered by physical thermal changes especially if subjected to hot food. It gives the possibility to show the patient how the final result will be, this is achieved through digital simulations that this method allows. It is a treatment that requires experience on the part of the professional.

Materiales de restauración dental / Dental restorative materials

Objetivo: Identificar los efectos que producen la utilización de materiales restauradores en los tejidos dentarios luego de utilizarlos como una solución funcional y estética ante los problemas provocados por cualquier tipo de microorganismo es necesario. Método: de tipo bibliográfica mediante una búsqueda de artículos en base PubMed y Scielo. Resultados: Se encontraron 30 artículos, de los cuales solo se pudieron utilizar 15 de ellos, ya que contribuyeron a cumplir con el objetivo de esta investigación y el resto no. Conclusiones: Los materiales dentales son la base fundamental de la odontología restauradora, protésica y de varias especialidades y procedimientos realizados por parte del odontólogo. Por lo tanto, es necesario tener conocimientos de cómo actúa cada uno de estos materiales restaurativos, con base en su estructura interna, para poder ver cuál va a ser su comportamiento físico, mecánico y fisicoquímico en su uso odontológico.

Objective: To identify the effects produced by the use of restorative materials on dental tissues after using them as a functional and esthetic solution to the problems caused by any type of microorganism. Method: bibliographic type by means of a search of articles in PubMed and Scielo databases. Results: 30 articles were found, of which only 15 of them could be used, since they contributed to fulfill the objective of this research and the rest could not. Conclusions: Dental materials are the fundamental basis of restorative dentistry, prosthetic dentistry and various specialties and procedures performed by the dentist. Therefore, it is necessary to have knowledge of how each of these restorative materials acts, based on their internal structure, in order to be able to see what their physical, mechanical and physicochemical behavior will be in their dental use.

Risk factors for oral alterations in intensive care unit patients: A pilot cohort study.

BACKGROUND: Several studies evidenced the presence of oral alterations in ICU patient. However, data about identification of their risk factors in ICU patients is scarce, especially due to the lack of longitudinal prospective studies. Here, we evaluate the risk factors for the development of oral alterations in a group of ICU patients through a prospective longitudinal cohort. METHODS: During May-December 2019, 43 ICU patients in a tertiary hospital in Brazil were evaluated. Medical record reviews and oral examinations of each patient were made by 3 dentists in five distinct moments. RESULTS: Among all patients, 53.5% (n = 23) were female, with a mean age of 59.8 years (±17.4). The incidence of oral alterations was 51.2% (35.6%-66.8%) and among these (n = 22), hyposalivation (n = 9; 40.9%), and lingual biofilm accumulation (n = 9; 40.9%) were the most common. The mean age of the group with oral alterations (66.9 years) was higher compared to the group without alterations (52.3 years). Furthermore, male patients (p = 0.02), older than 60 years (p = 0.004) and treated with mechanical ventilator (p = 0.03) had a higher risk of oral alterations. CONCLUSIONS: Systemic parameters, as age and mechanical ventilator, could influence the oral environment of ICU patients.

Telehealth in Oral Medicine: report of an experience from public health care in a southern Brazilian state

Abstract: This study aimed to describe the telediagnosis of oral lesions through a telehealth program offered in the State of Paraná, southern Brazil. This report included all oral medicine-related teleconsultations between January 2015 and December 2019. Primary care dentists from the public health services of the state were trained to use the Telessaúde Brasil Redes platform, a national telehealth program that provides telediagnostic support through teleconsultations with specialists. Clinical information and images of oral lesions were solicited to each teleconsultation request. An oral medicine specialist evaluated the cases and provided diagnostic hypotheses, management, and referral suggestions. Finally, dentists were invited to evaluate the services. A total of 162 cases were submitted by 44 dentists. The patient's main complaint was described in 98.8% of cases, while the duration/evolution and the type of lesions were 64.81% and 40.12%, respectively. No images were attached to 19 (11.70%) patients. The information sent was sufficient for diagnostic reasoning in 125 (77.16%) requests. The specialist considered 78 cases (48.1%) to be resolved in primary care. Among respondents (45.7%), dentists considered that the teleconsultation "totally attended" their needs in 92% of requests. The description of the telehealth platform usage in oral medicine in Paraná showed the need to improve the participation of primary care dentists and the quality of clinical information provided as barriers to be overcome, aiming for the best usage of the platform.

The need for communication between clinicians and pathologists in the context of oral and maxillofacial diseases

Abstract Good communication between clinicians and pathologists is a vital element in the diagnostic process, and poor communication can adversely affect patient care. There is a lack of research about communication in diagnostic oral and maxillofacial pathology. This narrative review explores different aspects of the quality of communication between clinicians and oral pathologists, with a focus on the diagnosis of oral and maxillofacial diseases. An electronic search was carried out in MEDLINE through the PubMed, Scopus, and Embase databases up to April 2021. No studies reporting communication, its adequacy or the required skills between clinicians and pathologists in oral diagnosis were found. According to studies published in medicine, strategies for improving communication skills include clinician-pathologist collaboration; a well-formatted, clear and thorough report; training in communication skills; and patient-centered care. Further studies evaluating the current practices and quality in oral and maxillofacial pathology are required to identify barriers and encourage optimal communication to facilitate diagnosis, as well as patient safety.

Self-reported oral health and normative indices of dental caries among adolescents: a cohort study

Abstract: This study assessed the association between self-reported oral health and the normative indices of dental caries in an adolescent population. This study is based on a 6-year data from a cohort, beginning in 2012, with 1,134 twelve-year-old adolescents. After three phases of data collection, 68% of the samples were followed up. Self-reported oral health was evaluated through the question: "Would you say that the health of your teeth, lips, jaws, and mouth is …?", and answers were categorized as "good" or "poor." Calibrated dentists examined clinical conditions using the decayed, missing, and filled teeth (DMFT) index. Statistical analysis was performed using multilevel logistic regression models, considering the dependence of those observed thrice and adjusted for demographic, socioeconomic, and dental visit variables. Adolescents who evaluated their oral health as poor had higher mean DMFT (OR: 1.35; CI95% 1.22-1.50). When evaluated separately, decayed (OR: 2.43; CI95% 1.83-3.23) and missing (OR: 3.94; CI95% 1.26-12.26) teeth also presented significant results, showing poor self-reported oral health associated with a higher mean. Adolescents' self-perceived oral health was associated with normative dental caries indices, and this association was maintained throughout adolescence.

Epidermal cyst: a rare case report in a 5-month-old child / Cisto epidérmico: relato de caso raro em criança de 5 meses

ABSTRACT The epidermal cyst is a rare, benign lesion, usually asymptomatic and slowly enlarging, more frequently located in the submandibular region. Its etiology is believed to be associated with the epithelial residual tissues retained in the midline during the closure of the first and second brachial arches, in the third and fourth weeks of intra-uterine life. Its clinical characteristics are of a rubbery consistency to palpation, well defined borders, with the absence of skin appendages within their squamous epithelium lined walls. The final diagnosis is confirmed through histopathological examination with stratified squamous epithelium findings in the cystic fluid lumen or keratin. The treatment is usually surgical and without recurrence and the final diagnosis is confirmed through histopathological examination. This paper aims to present a case report of a congenital epidermal cyst in a 5-month-old female patient located in the mouth floor near the sublingual gland duct. The case was treated with excisional biopsy and after follow-up, there was no recurrence.

RESUMO O cisto epidérmico é um cisto de desenvolvimento, benigno, raro, localizado com maior frequência na região submandibular, geralmente assintomático e de evolução lenta. Acredita-se que a sua etiologia esteja associada aos restos epiteliais retidos na linha média durante o fechamento do primeiro e segundo arcos braquiais, na terceira ou quarta semana de vida intrauterina. Suas características clínicas são de uma consistência borrachóide à palpação, bordas delimitadas e sem apêndices de pele no seu interior. O diagnóstico é confirmado através do exame histopatológico com achados de epitélio escamoso estratificado e no lúmen fluído cístico ou queratina. O tratamento é geralmente cirúrgico e sem recidivas. Este trabalho relata um caso de cisto epidérmico congênito de uma paciente pediátrica, do sexo feminino, de cinco meses de idade e localizado no assoalho de boca próximo ao ducto da glândula sublingual. O caso foi tratado com a enucleação cirúrgica e em seis meses de acompanhamento não apresentou recidiva.

Can CBCT change the level of confidence of oral maxillofacial surgeons in mandibular third molar management?

Abstract This study analyzed the impact of CBCT on the level of confidence in diagnostic and treatment thinking in mandibular lower molar (M3M) clinical management. Thirty cases for which panoramic radiographs and CBTC images were available were selected and classified according to radiologic signs indicating the proximity of the M3M to the mandibular canal (interruption of the radiopaque borders of the canal of the mandibular canal wall, darkening of the roots, and diversion or narrowing of the canal, n = 10 for each classification). Twelve oral and maxillofacial surgeons (OMS) contributed to this study by answering two questionnaires. The first questionnaire contained a clinical description of the case and a panoramic radiograph. After 30 days, a second questionnaire with the same clinical illustrations and tomographic multiplanar reconstruction images was administered. Both questionnaires asked specialists to rate diagnostic confidence, the surgical complexity, chosen treatment, and surgical confidence. In approximately 40% of answers, CBCT images had a positive impact on ratings of diagnostic confidence and treatment thinking confidence, and in 24.4%, they increased the surgical complexity score. There was no change in the treatment plan following the use of CBCT, but the CBCT examination was a determining factor for diagnosis and treatment planning in 72.8% of the answers CBCT improved the confidence level in diagnostic and treatment thinking of the M3M management while also increasing the perceived level of surgical complexity. The findings of this study support the need to consider using CBCT in diagnosis and treatment planning for M3Ms with radiographic signs such as darkening of the roots, interruption of the radiopaque borders of the mandibular canal, or deviation of the mandibular canal and narrowing of the roots.

Dental developmental anomalies and post-eruption dental disorder: a series of panoramic radiographs

Panoramic radiographs are complementary exams to evaluate oral alterations in an early manner, these changes can be dental developmental anomalies, and post-eruption dental disorder. Aim: This study evaluated the findings in panoramic radiographs and correlated the variables of gender and dental location. Methods: A retrospective study was through the observation of 1.111 panoramic radiographs from the Radiology Department in Brazil. It was included patients from 5 to 79 years of age of both gender, and it classified the anomalies in shape, size, and number and post-eruption dental changes in and correlated with gender and location. Patients with syndromes were excluded from the sample. Results: The majority of the sample was composed of fameles 752 (67.7%), as to the frequency of dental developmental anomalies related lesions 684 cases (61.6%) and post-eruption dental disorder 567 (51.8%), in the radiographs. The most prevalent change was endodontic treatment (32.6%), followed by root dilaceration (25.9%), and included tooth (19.5%). The most prevailing alteration when correlated with the gender variables was the cyst root (p<0.01) in females, and orthodontic treatment (p=0.02) in males and the variable location in the mandible was root dilaceration, giroversion, impacted tooth, taurodontia, microdontia, and endodontic treatment (p<0.01). Conclusion: Our findings provide evidence that dental developmental anomalies e post-eruption dental disorder are frequent alterations in the population with particular characteristics of distribution by sex and location

Head and neck radiotherapy-induced changes in dentomaxillofacial structures detected on panoramic radiographs: A systematic review.

PURPOSE: This study aimed to summarize the impact of neck and head radiation treatment on maxillofacial structures detected on panoramic radiographs. MATERIALS AND METHODS: In this systematic review, the authors searched PubMed Central, Embase, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar for original research studies up to February 2020 that included the following Medical Subject Headings keywords: words related to "radiotherapy" and synonyms combined with keywords related to "panoramic radiography" and "oral diagnosis" and synonyms. Only original studies in English that investigated the maxillofacial effects of radiotherapy via panoramic radiographs were included. The quality of the selected manuscripts was evaluated by assessing the risk of bias using Cochrane's ROBINS-I tool for non-randomized studies. RESULTS: Thirty-three studies were eligible and included in this review. The main objectives pertained to the assessment of the effects of radiation on maxillofacial structures, including bone architecture alterations, periodontal space widening, teeth development abnormalities, osteoradionecrosis, and implant bone loss. The number of participants evaluated ranged from 8 to 176. CONCLUSION: The interaction between ionizing radiation and maxillofacial structures results in hazard to the tissues involved, particularly the bone tissue, periosteum, connective tissue of the mucosa, and endothelium. Hard tissue changes due to radiation therapy can be detected on panoramic radiographs.

A cross-sectional study on the level of severity of dental caries in adults / Estudio transversal sobre nivel de severidad de caries dental en adultos

Introduction: Oral diseases affect some 3.9 billion people worldwide, the most prevalent are dental caries, gingivitis, and periodontitis. Untreated dental caries lesions affect 35% of the population. Objective: To determine the level of severity of dental caries lesions in adults treated at public dental services in the cities of Asunción and Pirayú, Paraguay, in 2 017. Material and Methods: Sociodemographic and clinical variables of oral health status were evaluated by means of a cross-sectional study using consecutive sampling. Two dentists were calibrated to perform the oral examination. Caries experience was evaluated using the DMF-T index. The Chi square test and Fisher's exact test were applied, with a confidence level of 95%. Results:333 subjects with a mean age of 35 years participated in the study, 77.2% were females, and 64.0% did not have access to private health care services. The DMF-T index was 11.43 (SD=6.7); 12.6% obtained a very low level, 35.7% low level, 41.7% had a medium level, and 9.9% had a high level in the DMF-T index. The DMF-T index was significantly higher in females (p=0.001), in the age range of 50 to 59 years (p<0.001), in those who did not have access to private health services (p=0.008), in those who reported a negative self-evaluation of their oral health (p=0.04), in those with a normal molar ratio (p=0.023) and a very severe aesthetic index (p<0 . 0 01). Conclusion: The general level of severity of global caries was medium and associated with sociodemographic and clinical variables.

Introducción: Las enfermedades orales afectan a 3,9 billones de personas a nivel mundial, siendo las más prevalentes la caries dental, la gingivitis y periodontitis; afectando al 35% de la población las lesiones de caries dental no tratadas. Objetivo: Determinar el nivel de severidad de lesiones de caries dental en adultos que acuden a servicios odontológicos públicos en las ciudades de Asunción y Pirayú, en el Paraguay, en el año 2017. Material y Métodos: Estudio transversal donde se evaluaron variables sociodemográficas y clínicas del estado de salud oral. El muestreo fue de casos consecutivos. Dos odontólogos fueron calibrados para realizar el examen oral. La experiencia de caries fue evaluada mediante el índice CPO-D. Se aplicaron las pruebas Chi cuadrado y Test exacto de Fisher, con un nivel de confianza del 95%. Resultados: Participaron del estudio 333 sujetos, con edad promedio de 35 años, el 77,2% mujeres y el 64,0% no tenía acceso a servicios de salud privado. El índice CPO-D fue de 11,43 (DE = 6,7). El 12,6% obtuvo un nivel muy bajo, el 35,7% nivel bajo, el 41,7% tuvo nivel medio y el 9,9% nivel alto del CPO-D, siendo significativamente más elevado en mujeres (p= 0, 0 01), en la edad de 50 a 59 años (p<0,001), en aquellos que no cuentan con acceso a servicios de salud privado (p=0,008), los que relataron una autoevaluación negativa de su salud bucal (p=0,04), los que tenían una relación molar normal (p=0,023) e índice de estética muy grave (p<0, 0 01). Conclusión: El nivel general de severidad de caries global fue medio, se asoció con variables sociodemográficas y clínicas.