The impact of digital filters on the diagnosis of simulated root resorptions in digital radiographic systems.

OBJECTIVES: To evaluate the influence of digital filters of intraoral radiographic systems on the diagnosis of simulated internal and external root resorptions and image quality. MATERIALS AND METHODS: Internal root resorption (IRR) and external root resorption (ERR) were simulated in 34 teeth. For image acquisition, two radiographic systems were used: Digora Toto and VistaScan. All filters available in these systems were applied. Three observers scored the detection of root resorptions in a 5-point scale. The noise and the contrast-to-noise ratio (CNR) were calculated. The area under ROC curve, sensitivity, specificity, and accuracy were obtained. One-way ANOVA with Tukey's post hoc tests compared the diagnostic values, noise, and CNR between the filters (α = 0.05). RESULTS: For ERR, there were no significant differences in diagnostic values between the filters tested for both systems. For IRR, Original and Noise Reduction filters presented higher sensitivity than the Sharpen2 filter for images from Digora Toto, with no differences between the other groups. For VistaScan, there were no significant differences of diagnostic values between the groups studied. Noise values differed among the filters of both systems. The CNR of the filters differed only for the bone region for Digora Toto, while for VistaScan, both tooth and bone regions differed. CONCLUSIONS: Despite promoting changes in pixel intensities and affecting the noise level of the radiographic images, the digital filters of Digora Toto and VistaScan systems do not affect the diagnosis of internal or external root resorptions. CLINICAL RELEVANCE: Digital filters are common tools in digital radiographic systems and may be used by the professional without impairment in root resorptions diagnosis.

The Importance of Ultrasound in Excision of the Buccal Fat Pad.

Partial excision of the buccal fat pad is a surgery indicated for different functional and aesthetic procedures. Although this surgery offers minimal risks, the ultrasound examination can provide security in performing the surgery, in addition to predicting preoperative anatomical variations and assisting in the treatment of postoperative complications. With the worldwide search for aesthetic procedures, concomitant with the development of imaging tests that help in different diagnoses and treatments, ultrasonography has become an excellent indication for planning oral fat pad surgeries.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Ultrasonography and Facial Aesthetics.

Ultrasonography examination is an important ally of facial aesthetic procedures. This examination allows for precise planning, with complete vascular mapping of the face, cutaneous and subcutaneous thickness, in addition to enabling procedures guided by filled substances. The knowledge of this information allows the professional to carry out his work in a safe manner, with reduced chances of complications and clinical failures, combining aesthetics with a satisfactory function.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Assessment of dentists' behaviour on the use of patients' images.

BACKGROUND: Photographs and radiographs are indispensable resources for dental education, research and dissemination of clinical cases in scientific journals. The objective of this study was to evaluate the behaviour of dentists on the use of patients' images. MATERIAL AND METHODS: Fifty-two dentists were interviewed using a semi-structured script containing open-ended questions on the use of patients' images. The answers were analysed using a qualitative-quantitative method of the discourse of the collective subject, and the distribution of the absolute and relative frequency of the answers was presented according to the central ideas obtained from the discourses. RESULTS: The following central ideas on the use of patients' images were identified: (a) purpose: didactic and/or academic; (b) informed consent: verbal or absent when the patient cannot be identified; (c) discussion groups on social media contribute to learning; (d) most dentists would not appreciate and sue the author if they had their own photographs/imaging examinations posted on social media; 5. most dentists received some information on ethical regulations during dental school and state that images can be used with patient authorisation, without identification and for didactic/academic purposes. CONCLUSION: Dentists consider the use of patients' images for didactic and scientific purposes beneficial, request informed consent to share mainly images that reveal the identity and would not appreciate if their personal images were shared without consent.

Electronic Cigarettes, Oral Health, and COVID-19: What You Need to Know

ABSTRACT: Known as "vaping devices", electronic cigarettes (e-cigarettes) have been consumed more and more on a global scale, in addition to being considered another factor in the transmission of COVID-19. Electronic cigarettes use chemicals in liquid form, which are incorporated, heated and vaporized. Such solutions may or may not contain nicotine. For this reason, many users of conventional cigarettes rely on the idea of stopping their addiction by switching to electronic cigarettes, with the justification of reduced harm. Despite a scientific knowledge still in formation, unable to remedy all the consequences that these cigarettes cause on the individual's health, as well as their effects on the mouth, the purpose of this article is to discuss the main results that scientific studies have found on this topic and propose an awareness of the population about its harmful effects on health and transmission of COVID-19 by sharing among users.

RESUMEN: Conocidos como "dispositivos de vapeo", los cigarrillos electrónicos (e-cigarettes) se han consumido cada vez más a escala mundial, además de ser considerados un factor adicional en la transmisión del COVID-19. Los cigarrillos electrónicos utilizan productos químicos en forma líquida, que se incorporan, calientan y vaporizan. Tales soluciones pueden o no, contener nicotina. Por esta razón, muchos usuarios de cigarrillos convencionales confían en la idea de dejar su adicción pasándose a los cigarrillos electrónicos, con la justificación de la reducción del daño. A pesar de un conocimiento científico aún en formación es incapaz de remediar todas las consecuencias que estos cigarrillos provocan en la salud del individuo, así como sus efectos en la cavidad oral. El propósito de este artículo fue discutir los principales resultados que los estudios científicos han encontrado sobre este tema y proponer una concientización de la población sobre los efectos nocivos en la salud y transmisión del COVID-19 mediante el intercambio entre usuarios.

Intraoral Device for Optimal Antifungal Delivery in a Rat Model.

BACKGROUND: Antifungal agents incorporated into temporary denture resilient liners as drug carriers and delivery have been suggested as an alternative treatment for denture stomatitis. However, to test the in vivo biocompatibility of this protocol, standardization of an intraoral device for optimal drug delivery is required. OBJECTIVE: Standardized criteria were produced to adjust an acrylic intraoral device (IOD) for rats feasible for denture stomatitis treatment by sustained drug-delivery based on minimal inhibitory drug concentrations (MICs) of antifungals for Candida albicans biofilm. METHOD: Adjustments methodological involved diet, impression technique, type of retention device to the palate and histopathological analysis. 115 Wistar rats were tested without IOD, with devices without relining or relined with temporary resilient material (Trusoft) modified or not by drugs at MICs (nystatin-0.032g/mL; chlorhexidine diacetate-0.064g/mL; ketoconazole-0.128g/mL). The animals were sacrificed after 7 or 14 days from the IOD installation. RESULTS: Paste diet enabled the best animal survival conditions. The IODs that most satisfactorily remained in position were those designed only to the posterior palatal mucosa and cement-retained in molars, being all obtained from impressions highly detained and individual. In both periods, Trusoft without/with drugs showed good performance. Only histological samples from hard/soft tissues were considered appropriate for region of interest-RI determination (n=12), which corresponded to the area restricted to the first molars between the palatal neurovascular bundles. Final samples of all groups allowed a standardized descriptive histopathological analysis in both periods. CONCLUSION: The methodological standardization of this rat model resulted in IODs for optimal antifungal delivery for denture stomatitis treatment.

Dysgeusia and COVID-19: the Importance of the Dentist in the Diagnostic / Disgeusia y COVID-19: la Importancia del Dentista en el Diagnóstico

Dysgeusia is understood as changes in the perception of taste in patients infected with COVID-19 and has been frequently observed in the early stages of the disease. Along with the causes of dysgeusia, we can mention the correlation with infectious conditions, being of importance for the differential diagnosis. Dysgeusia can be considered one of the first manifestations of COVID-19, being an important contribution in the search for solutions regarding early diagnosis and treatment, in addition to its hospital and laboratory application.

La disgeusia se entiende como cambios en la percepción del gusto en pacientes infectados por COVID-19 y se ha observado con frecuencia en las primeras etapas de la enfermedad. Junto a las causas de la disgeusia, podemos mencionar la correlación con patologías infecciosas, siendo de importancia para el diagnóstico diferencial. La disgeusia se puede considerar como una de las primeras manifestaciones del COVID-19, siendo un aporte importante en la búsqueda de soluciones en cuanto al diagnóstico y tratamiento precoces, además de su aplicación hospitalaria y de laboratorio.

Prevalence of Errors and Number of Retakes in Panoramic Radiography: Influence of Professional Training and Patient Characteristics

ABSTRACT: Panoramic radiography has clinical importance in several dental specialties. The objective of this study was to evaluate the influence of professionals' experience and patient characteristics (age group and dental absence) in the prevalence of errors and the number of retakes in the panoramic radiography.771 panoramic radiographs were evaluated and classified according to the group of patients (children, dentulous adults, total edentulous adults, and anterior edentulous adults) and professionals who performed the technique (novice and experienced). The association between frequency and type of error, group of patients, professionals' experience, and number of retakes was performed by the Chi-square and Fisher's exact test (a=0.05). There was no significant association between the frequency of errors or retakes of the radiograph s and the professionals' experience or patients' characteristics (p<0.05). The errors "turned head" and "tongue not against the palate," "chin tipped low", "chin not resting on the support," "patient movement during exposure," and "lead apron artifact" showed significantly higher frequency of retake (p<0.05). The most frequent type of error was due to the failure to position the tongue against the palate for all patients and both groups of professionals. The frequency of errors in the panoramic radiography occurs regardless of the professionals' experience, and age and dental absence of the patients. Error occurs mainly due to the lack of patient collaboration, and the examination is rarely repeated by the professionals.

RESUMEN: La radiografía panorámica es de importancia clínica en varias especialidades dentales. El objetivo de este estudio fue evaluar la experiencia de los profesionales y las características de los pacientes (grupo etario y ausencia dentaria) en la prevalencia de errores y el número de repeticiones en la radiografía panorámica.771 radiografías panorámicas fueron evaluadas y clasificadas según la grupo de pacientes (niños, adultos desdentados, adultos desdentados totales y adultos desdentados anteriores) y profesionales que realizaron la técnica (novatos y experimentados). La asociación entre frecuencia y tipo de error, grupo de pacientes, experiencia de los profesionales y número de repeticiones se realizó mediante la prueba de Chicuadrado y exacta de Fisher (a = 0,05). No hubo asociación significativa entre la frecuencia de errores o repetición de las radiografías y la experiencia de los profesionales o las características de los pacientes (p <0,05). Los errores "cabeza girada" y "lengua no contra el paladar", "mentón inclinado hacia abajo", "mentón no apoyado en el soporte", "movimiento del paciente durante la exposición" y "artefacto del delantal de plomo" mostraron una frecuencia de repetición significativamente mayor (p < 0,05). El error más frecuente se debió a la falta de posicionamiento de la lengua contra el paladar para todos los pacientes y en ambos grupos de profesionales. La frecuencia de errores en la radiografía panorámica ocurre independientemente de la experiencia de los profesionales, edad y ausencia dentaria del pacientes. El error se produce principalmente por la falta de colaboración del paciente, y los profesionales rara vez repiten el examen.

Radiographic evaluation of the prevalence of Stafne bone defect / Evaluación radiográfica de prevalencia de defecto óseo de Stafne

Stafne bone defect (SBD) is a bone cavity in the lingual surface of the mandible normally filled by salivary gland tissue. In conventional radiographs, SBD typically resembles a radiolucent unilocular lesion with welldefined margins, localized under the inferior alveolar canal. The diagnosis of SBD is often incidental due to the asymptomatic nature. The aim of this study was to investigate the prevalence of SBDs in a Brazilian population and to describe the radiographic features of the cases reported. This retrospective study evaluated 17,180 digital panoramic radiographs of patients with an indication of radiography for dental treatment seen at three centers located in the three Brazilian states. In each center, two researchers evaluated the images for establishment of the consensual diagnosis of SBD. In the case of disagreement, a third researcher was consulted to reach a final consensus. To assess the prevalence of SBDs, sex and age of patients were considered, and SBDs were classified according to their form and location. Data were submitted to descriptive analysis. Among the 17.180 patients, only 15 (0.08 %) had SDB, including 3 women and 12 men. The age range of the patients with SDB was 30-69 years (mean: 49.2). Fourteen cases were located in the posterior region of the mandibular body and one case in the ascending ramus. Stafne bone defect is a rare developmental anomaly that more commonly affects middle-aged men. The condition has a typical radiographic appearance and panoramic radiography is a valuable tool for its diagnosis.

El defecto óseo de Stafne (DOS) es una cavidad ósea en la superficie lingual de la mandíbula, normalmente llena de tejido glandular salival. En las radiografías convencionales, el DOS generalmente se asemeja a una lesión unilocular radiotransparente con bordes bien definidos, ubicada debajo del canal alveolar inferior. El diagnóstico de DOS a menudo es accidental debido a su naturaleza asintomática. El objetivo de este estudio fue investigar la prevalencia de DOS en una población brasileña y describir las características radiográficas de los casos reportados. Este estudio retrospectivo evaluó 17.180 radiografías panorámicas digitales de pacientes con indicación radiográfica para tratamiento dental atendidos en tres centros ubicados en tres estados brasileños. En cada centro, dos investigadores evaluaron las imágenes para establecer un diagnóstico consensuado de DOS. En caso de desacuerdo, se consultó a un tercer investigador para llegar a un consenso final. Para evaluar la prevalencia de DOS, se consideraron el sexo y la edad de los pacientes, y se clasificaron según su forma y ubicación. Los datos fueron sometidos a análisis descriptivo. Entre los 17.180 pacientes, solo 15 (0,08 %) tenían DOS, incluidos 3 mujeres y 12 hombres. El rango de edad de los pacientes con DOS fue de 30 a 69 años (media: 49,2). Catorce casos se ubicaron en la región posterior del cuerpo mandibular y un caso en la rama ascendente. Los defectos óseos de Stafne son una anomalía rara del desarrollo que afecta más comúnmente a los hombres de mediana edad. La condición tiene una apariencia radiográfica típica y la radiografía panorámica es una herramienta valiosa para su diagnóstico.

Conservative Treatment of Chronic Osteomyelitis Associated with Florid Osseous Dysplasia / Tratamiento Conservador de la Osteomielitis Crónica Asociada con Displasia Ósea Florida

ABSTRACT: Florid osseous dysplasia (FOD) is an extensive form of osseous dysplasia where normal trabecular bone is substituted by fibrous connective tissue and amorphous mineralized tissue. Usually, the lesions are mainly asymptomatic and the patients should be followed with clinical and imaging examination, requiring no intervention. Nevertheless, due to the poor vascularization of the lesion and to local trauma, secondary infections and osteomyelitis may occur. Patients may present with pain, mucosal ulceration, lesion exposure in the oral cavity, fistula and swelling. In such cases, the correct diagnosis and management of the lesion is decisive to reestablish patient's health and quality of life. The aim of this article is to present a case of complicating secondary chronic osteomyelitis treated successfully with conservative intervention. A 68-year-old black female patient reported a "swelling of the gums" that was present for eleven years, with episodes of periodic pain and swelling. On physical examination, a papule with suppuration in the alveolar mucosa in the right side of the mandible was observed. Panoramic radiography and CBCT showed a mixed lesion surrounded by sclerotic bone. The patient was diagnosed with chronic osteomyelitis in association with FOD and treated with antibiotic therapy together with surgical curettage. The incidence, etiophatology, differential diagnosis, treatment and prevention of secondary osteomyelitis associated with FOD are discussed in the light of literature. This information might assist the dentists while choosing the best treatment options for similar cases.

RESUMEN: La displasia ósea florida (DOF) es una forma de displasia ósea donde el hueso trabecular normal es sustituido por tejido conectivo fibroso y tejido mineralizado amorfo. En general, las lesiones son de origen asintomático y los pacientes deben ser seguidos con el examen clínico. Sin embargo, debido a la pobre vascularización de la lesión y al trauma local, pueden producirse lesiones secundarias y osteomielitis. Los pacientes pueden presentarse con dolor, ulceración mucosa, lesión de exposición en la cavidad oral, fístula y edema. En estos casos, el correcto diagnóstico y tratamiento de la lesión es decisivo para reestabilizar la salud y la calidad de la vida. El objetivo de este artículo consistió en presentar un caso de complicación secundaria crónica de osteomielitis tratados con tratamiento conservador. El paciente, negro, de 68 años de edad, consulta por "hinchazón de las encías" que se presentó durante once años, con episodios de dolor. En el examen intraoral, se observó una pápula con supuración en la mucosa alveolar en el lado derecho de la mandíbula. La radiografía panorámica y CBCT mostraron una lesión mixta rodeada de hueso esclerótico. El paciente fue diagnosticado con osteomielitis crónica en asociación con DOF y fue tratado con tratamiento antibiótico junto con curetaje quirúrgico. La incidencia, la etiopatología, el diagnóstico diferencial, el tratamiento y la prevención de la osteomielitis secundaria asociada con DOF se discuten a la luz de la literatura. Esta información puede ayudar a los dentistas a elegir las mejores opciones de tratamiento para casos similares.

Utilização de Índices Radiomorfométricos em Exames de Imagem

A radiomorfometria consiste na aplicação de índices para avaliação da morfologia óssea em exames de imagem, principalmente em radiografias panorâmicas. Objetivo: o objetivo deste estudo é analisar as principais indicações dos índices radiomorfométricos em estudos publicados na literatura científica. Métodos: uma busca textual foi realizada utilizando a palavra-chave "radiomorphometric indices" na base de dados PubMed, procurando responder à seguinte questão: Qual a aplicação dos índices radiomorfométricos em exames de imagem? Resultados: 36 artigos sobre esse tópico foram identificados entre os anos de 1999 a 2016, sendo o periódico Dentomaxillofacial Radiology o que possui a maior quantidade de estudos (25,0%). Conclusão: a principal utilização dos índices radiomorfométricos inclui a avaliação da densidade óssea de diferentes grupos de pacientes, podendo não apresentar qualquer alteração sistêmica ou possuir doenças, como osteoporose e osteogênese imperfeita. As vantagens dos índices radiomorfométricos incluem principalmente acessibilidade e baixo custo, porém requerem conhecimento e treinamento técnico.

Achados incidentais em radiografias panorâmicas de pacientes pré e pós-tratamento ortodôntico / Incidental findings in panoramic radiographs comparing pre and postorthodontic treatment

A radiografia panorâmica é o exame complementar de imagem mais solicitado pelos cirurgiões-dentistas e parte essencial da documentação utilizada pelos ortodontistas no planejamento do tratamento ortodôntico. Durante a transição da dentadura mista para a permanente, o processo biológico é complexo, podendo ocorrer falhas ou irregularidades odontogênicas, que resultam em anomalias dentárias. Entretanto, outras alterações podem ser vistas nas imagens radiográficas panorâmicas, que modificam densidade óssea e alteram o trabeculado ósseo no período entre o início e o término do tratamento ortodôntico. Algumas destas alterações podem interferir ou modificar o diagnóstico durante o tratamento ortodôntico. O número de imagens radiográficas obtidas durante o tratamento ortodôntico depende do protocolo estabelecido caso a caso. Neste estudo interpretamos 500 imagens panorâmicas, sendo 250 pré-tratamento ortodôntico e 250 pós-tratamento ortodôntico, de pacientes com idade de 11 a 18 anos, pertencentes ao Departamento de Ortodontia da Faculdade de Odontologia de Bauru FOB USP. A interpretação radiográfica foi realizada por um único examinador. Nosso objetivo foi avaliar imagens que foram obtidas no início e no final do tratamento ortodôntico e os resultados nos permitiram concluir que no grupo referente à transição da dentadura mista para a dentição permanente, as imagens panorâmicas possuíram o maior número de achados incidentais; a remodelação apical ortodôntica dos incisivos foi encontrada em 180 casos pós-tratamento ortodôntico; houve diferença estatisticamente significante (Teste de Wilcoxon; p<0,05) nos resultados da ossificação do complexo estilo-hióideo bilateral e realização de tratamento endodôntico pré e pós-tratamento ortodôntico; e, muitos dos achados necessitam de intervenção durante o tratamento.

Panoramic radiograph is the most requested imaging exam by dentists and it plays essential role in documentation for orthodontic treatment planning. During the transition from mixed dentition to permanent dentition, the biological process is complex and may experience odontogenic failures or irregularities that result in dental abnormalities. However, other changes can be seen in the panoramic radiography that modify bone density and trabecular bone when it is compared before and after orthodontic treatment. Some of these changes may affect and modify the diagnosis during orthodontic treatment. The number of radiographic images obtained in orthodontic treatment depends on the protocol established for each case. In this study we interpret 500 panoramic radiograph, of patients with age of 11 to 18, belonging to the Department of Orthodontics, Bauru Dental School. The radiographic interpretation was performed by a single examiner. Our objective was to evaluate images that were taken at the beginning and end of orthodontic treatment and the results allowed us to conclude that the most incidental findings were observed in panoramic images in the group concerning the transition from mixed dentition to permanent dentition; apical root resorption of the incisors was found in 180 orthodontic post-treatment cases; there was a statistically significant difference (Wilcoxon Test; p<0.05) between the results of ossification of complex bilateral stylohyoid and endodontic treatment before and after orthodontic treatment; and many of the findings require intervention during treatment.

Utilização e vantagens da TomografiaComputadorizada por Feixe Cônico emUniversidade Pública / Use and advantages of Cone Beam Computed Tomography in Public University

Realizar uma análise crítica sobre a utilização da Tomografia Computadorizadapor Feixe Cônico (TCFC) na Faculdade de Odontologia de Bauru - USP e as respectivas indicaçõesdeste exame por imagem. Materiais e Métodos: O estudo foi realizado por um únicoexaminador, que avaliou e registrou todos os dados referentes às imagens de TCFC realizadasno período compreendido entre os anos de 2008 a 2011. Resultados: Um total de 1061 examesde imagem de TCFC foram solicitados em um período de quatro anos. Destes, foram considerados722 exames correspondentes ao critério de inclusão. Os motivos pelas quais os examesforam solicitados: avaliação ortodôntica, avaliação endodôntica, reabsorção dentária, cirurgiaparaendodôntica, localização de sialólito, avaliação óssea, dente supranumerário, avaliação daarticulação temporomandibular,, fratura radicular, dente irrompido, avaliação de terceiro molar,retratamento endodôntico, avaliação do seio maxilar, diagnóstico de lesão maxilar, avaliaçãoperiodontal, diagnóstico de lesão mandibular, controle pós-operatório e avaliação para implante.Conclusão: As solicitações de TCFC na Faculdade de Odontologia de Bauru - USP no períododeterminado no estudo em questão foram coerentes com as indicações apresentadas pela literaturacientífica, o preenchimento completo da requisição para a realização do atendimentoainda não é uma prática frequente e mecanismos para o esclarecimento dos usuários do serviço...

Objective: To conduct a critical analysis on the use of Cone-Beam Computed Tomography(CBCT) scanner at Bauru School of Dentistry (USP/Brazil) and the indications of this imagingtechnique. Materials and Methods: The study was conducted by a single examiner, who evaluatedand recorded all data pertaining to the images of CBCT between the year of 2008 and2011. Results: A total of 1061 imaging of CBCT were requested in the four years of the study.Among them, 722 were considered relevant to the inclusion criteria exams. The reasons whythe tests were requested were: orthodontic evaluation, endodontic evaluation, tooth resorption,paraendodontic surgery, salivary calculi location, bone evaluation, supernumerary teeth,temporomandibular joint assessment, root fracture, erupted teeth, third molar evaluation, endodonticretreatment , evaluation of the maxillary sinus, diagnosis of jaw injury, periodontalevaluation, postoperative control and evaluation for implantation. Conclusion: Applications ofCBCT at Bauru School of Dentistry (USP-Brazil) in the given period in the current study wereconsistent with the indications established by the scientific literature. Filling out the applicationto perform the service is still not a common practice and mechanisms for the clarification ofthe service users...