Radiographically guided femoral neck osteosynthesis with cannulated compressive titanium screw and anti-rotational component in a Brown Howler Monkey (Alouatta guariba clamitans).

A Brown Howler Monkey presented with a femoral neck fracture was successfully treated with a cannulated compressive screw and an anti-rotational component inserted with radiographically guided technique. Complete bone consolidation and functional recovery were observed 9 weeks after the surgery, and the monkey was released to his place of origin.

Investigation of the relationship between the mandibular third molar teeth and the inferior alveolar nerve using posteroanterior radiographs: a pilot study.

BACKGROUND: The most severe complication that can occur after mandibular third molar (MM3) surgery is inferior alveolar nerve (IAN) damage. It is crucial to have a comprehensive radiographic evaluation to reduce the possibility of nerve damage. The objective of this study is to assess the diagnostic accuracy of panoramic radiographs (PR) and posteroanterior (PA) radiographs in identifying the association between impacted MM3 roots and IAN. METHODS: This study included individuals who had PR, PA radiographs, and cone beam computed tomography (CBCT) and who had at least one impacted MM3. A total of 141 impacted MM3s were evaluated on CBCT images, and the findings were considered gold standard. The relationship between impacted MM3 roots and IAN was also evaluated on PR and PA radiographies. The data was analyzed using the McNemar and Chi-squared tests. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of PR and PA radiographies were determined. RESULTS: Considering CBCT the gold standard, the relationship between MM3 roots and IAN was found to be statistically significant between PR and CBCT (p = 0.00). However, there was no statistically significant relationship between PA radiography and CBCT (0.227). The study revealed that the most prevalent limitation of the PR in assessing the relationship between MM3 roots and IAN was the identification of false-positive relationship. CONCLUSIONS: PA radiography may be a good alternative in developing countries to find out if there is a contact between MM3 roots and IAN because it is easier to get to, cheaper, and uses less radiation.

The CT dorsolateral subluxation index is a feasible method for quantifying laxity in the feline hip joint.

The dorsolateral subluxation index of the femoral head is a good proxy of hip dysplasia in dogs. An exploratory, prospective, descriptive study was carried out in order to assess whether the dorsolateral subluxation index may also be useful to improve diagnosis of hip dysplasia in cats. The dorsolateral subluxation index was determined by CT scans simulating the loading position, and compared with measurements of the Norberg-Olsson angle. A total of 82 cats were subjected to radiographic examination of the pelvis, in the standard ventro-dorsal projection, and to CT scans of the pelvis and hips. The Norberg-Olsson angle of each hip was calculated radiographically, while the dorsolateral subluxation index of the femur was calculated on CT images according to a technique recently developed for evaluation of hip dysplasia in dogs. Using the Norberg-Olsson angle a total of 52 hips (31,7%) were diagnosed as dysplastic, 74 (45,1%) as non-dysplastic, and 38 (23,1%) as borderline. Using the dorsolateral subluxation index, values ranged from a minimum of 34.6% to a maximum of 66.6% and four distribution classes were proposed. Findings indicated that the dorsolateral subluxation index previously described as method for quantifying hip dysplasia in dogs is also a feasible method for quantifying hip dysplasia in cats. Future studies are needed to more definitively determine the diagnostic sensitivity of this method.

The JP2 genotype of Aggregatibacter actinomycetemcomitans and marginal periodontitis in the mixed dentition.

AIM: To perform a cross-sectional study on the carrier frequency of JP2 and non-JP2 genotypes of A. actinomycetemcomitans in Moroccan school children and relate the presence of these genotypes to the periodontal status in the mixed dentition. MATERIAL AND METHODS: A plaque sample from 513 children was analysed by PCR. JP2 genotype-positive subjects (n = 46), an equally sized group of non-JP2 genotype-positive subjects, and an A. actinomycetemcomitans-negative group were randomly chosen among the remaining subjects for clinical and radiographic examination. RESULTS: Among 513 children, 46 (9.0%) carried the JP2 genotype and 186 (36.3%) were positive for non-JP2 genotypes, whereas A. actinomycetemcomitans could not be detected in the remaining 281 subjects. Among 75 subjects with mixed dentition and selected for clinical examination, clinical attachment loss (CAL) ≥ 3 mm at two or more periodontal sites on primary teeth was found in the JP2 genotype-positive group only. In total, 6.7% of subjects with primary teeth present showed CAL ≥ 3 mm at two or more sites. CONCLUSIONS: The carrier frequency of the JP2 genotype of A. actinomycetemcomitans was at a comparable level to frequencies previously found in Moroccan adolescent populations. Clinical attachment loss, manifesting already in the primary dentition, was found only in the group of Moroccan children carrying the JP2 genotype of A. actinomycetemcomitans.

Association and comparison between visual inspection and bitewing radiography for the detection of recurrent dental caries under restorations.

PURPOSE: The aim of the present study was to investigate, in posterior teeth, the association between the characteristics of the margins of a restoration visually inspected and the presence, under restorations, of recurrent or residual dental caries detected by radiographic examination. Furthermore, the agreement between visual inspection and radiographs to detect dental caries was assessed. METHODS: Eighty-five permanent molars and premolars with resin restorations on the interproximal and/or occlusal faces, from 18 patients, were submitted for visual inspection and radiographic examination. The visual inspection involved the criteria of the International Caries Detection and Assessment System (ICDAS). Bitewing radiographs were used for the radiographic examination. Logistic regression was used to analyse the association between the characteristics of the margins of a restoration assessed by visual inspection (absence of dental caries, or early, established, inactive and active lesions) and the presence of recurrent caries detected by radiographs. Kappa coefficients were calculated for determining agreement between the two methods. RESULTS: The Kappa coefficient for agreement between visual inspection and radiographic examination was 0.19. Established lesions [odds ratio (OR) = 9.89; 95% confidence interval (95% CI): 2.94-33.25; P < 0.05] and lesion activity (OR = 2.57; 95% CI: 0.91-7.27; P < 0.05) detected by visual inspection, were associated with recurrent or residual dental caries detected by radiographs. Restorations with established and active lesions at the margins had a greater chance of exhibiting recurrent or residual lesions in the radiographic examination. CLINICAL SIGNIFICANCE: The present findings demonstrate that restorations with established and active lesions at the margins when visually inspected often require removal and retreatment.

An unusual case of ameloblastoma observed in the left anterior mandible.

AIM: To report a small intaalveolar ameloblastoma which resembled cystic lesion, and to emphasize the value of Computed tomography (CT) in radiographic examination. BACKGROUND: Ameloblastoma is a slow-growing, locally invasive odontogenic neoplasm that accounts for approximately 10% of all tumors detected in the jaws. Radiographically, those tumors are usually well-defined. Computerized tomography is highly recommended to confirm the diagnosis. CASE DESCRIPTION: A 48-year-old female attended with a chief complaint of painless swelling in the left anterior of mandible, 1 month duration. In intraoral examination, non-fluctuant, immobile, approximately 1 × 1 cm in dimension, painless, swelling which had a bone-like hardness and located in the mandibular canine region was detected. Panoramic radiography revealed a well circumscribed unilocular radiolucent lesion located in the inter-radicular area of left mandibular lateral and canine teeth. In CT examination it was realized that the lesion was multilocular. Histopathological examination of the biopsy specimen was reported as ameloblastoma. CLINICAL SIGNIFICANCE: It is extremely difficult to find such an ameloblastoma in small dimension in alvolar bone.

Incidental Discovery of a Cervical Rib in a Case of Acute Cholecystitis: A Rare Anatomical Variant.

This case report discusses the incidental discovery of a cervical rib in a 53-year-old woman presenting with acute cholecystitis. While cervical ribs are rare, their identification holds clinical significance due to their potential implications for vascular compression or thoracic outlet syndrome. Despite the patient's primary complaint of cholecystitis, a chest X-ray incidentally revealed the cervical rib. This finding underscores the importance of a thorough radiographic examination. The report discusses similar cases, emphasizing varying clinical presentations and associated vascular complications. The case highlights the necessity for a comprehensive assessment of incidental findings to ensure holistic patient care and management, emphasizing the importance of considering anatomical variants in clinical practice.

An In Vitro Validation of DIAGNOdent Versus Radiography for the Detection of Caries Underneath Different Types of Restorations.

Objective This study aimed to assess the validity of DIAGNOdent as a diagnostic device for the detection of secondary dental caries underneath different types of restorations. Methods A total of 60 extracted human permanent molars were used in this experimental study (30 sound teeth and 30 teeth with proximal caries); 20 teeth (10 sound and 10 carious) were randomly allocated into one of three restoration groups: composite, amalgam, or resin-modified glass ionomer (RMGI). All teeth were examined using both KaVo DIAGNOdent Classic and digital radiographic sensors. Results In the composite-restored teeth, DIAGNOdent showed excellent sensitivity (90%) and specificity (90%). On the other hand, digital radiography had high sensitivity (80%) and poor specificity (20%). In amalgam-restored teeth, DIAGNOdent showed low sensitivity (30%) and excellent specificity (100%), while radiographs showed good sensitivity (70%) and low specificity (30%). In the RMGI-restored teeth, DIAGNOdent had excellent sensitivity (100%) and 70% specificity, while digital radiography had poor sensitivity (30%) and excellent specificity (90%). Conclusions DIAGNOdent showed superior results in detecting secondary caries lesions underneath composite and RMGI restorations when compared to digital radiography. On the other hand, radiography emerged as a preferable method for the detection of secondary caries underneath amalgam restorations. Based on our findings, DIAGNOdent can be used in dental clinics for the early diagnosis of hidden secondary caries underneath composite and RMGI restorations.

Invasive Cervical Root Resorption: A Comprehensive Review on Pathogenesis, Diagnosis, and Treatment.

Invasive cervical root resorption (ICRR) is a dental pathology, marked by unexpected destruction originating in the cervical region of the tooth. This comprehensive literature review provides a holistic view into the pathogenesis, clinical manifestation, and precise management of ICRR, aiming to guide endodontists and enhance patient care and treatment outcomes. The review delves into the potential etiology of ICRR, covering contributing factors such as trauma, orthodontic treatment, and other pertinent conditions. It outlines the clinical and radiographic indicators, underscoring the crucial role of early detection and precise diagnosis in effectively managing and halting ICRR progression. The exploration of treatment approaches is thorough, ranging from non-surgical methods like vital pulp therapy or root canal treatment to surgical interventions. This review accentuates the essential role of interdisciplinary collaboration among diverse dental specialties in enhancing ICRR management. It highlights the importance of a consolidated strategy in enhancing treatment outcomes and preserving tooth structure and function. Moreover, it investigates prevention methods, risk evaluation, and identifies prospective research pathways to address the existing knowledge gaps.

Will it hurt? Verbal interaction between child and radiographer during radiographic examination.

This study investigated the nature of verbal interactions between child, parent and radiographer and the extent to which it varied as a function of the child's age. The participants were 20 female radiographers and 32 children (3-15 years) examined for acute injuries. The verbal interactions during the examination were video recorded and analyzed using the Roter Interaction Analysis System (RIAS). Results indicated that 80% of the verbal interaction was accounted for by the radiographer, 17% by the child and 3% by the parent. The distribution of utterances varied with regard to children's age.

Comparison of organ dose from chest radiography with varying beam quality and constant exposure index.

The optimum X-ray tube voltage for chest radiographic examinations remains unclear; hence, the tube voltage varies between medical facilities. An exposure index (EI) was proposed to standardize the parameters for radiographic examinations. However, even if identical EI values are used to examine the same person, organ doses may vary due to differences in tube voltages. In this study, the variation in organ doses between different beam qualities under identical EI values for chest radiographic examinations was investigated using Monte Carlo simulations. A focused anti-scatter grid as well as standard and larger physique-type medical internal radiation dose (MIRD) phantoms were studied under tube voltages of 90, 100, 110, and 120 kVp. The organ doses in the MIRD phantom increased as the X-ray tube voltage decreased, even with identical EI values. The absorbed doses in the lungs of standard and large-sized MIRD phantoms at 90 kVp were 23% and 35% higher than those at 120 kVp, respectively. The doses to organs other than the lung at 90 kVp were also higher than those at 120 kVp. From the perspective of reducing radiation doses, a tube voltage of 120 kVp is considered better for chest examinations compared with a tube voltage of 90 kVp under identical EI values.

Comparative Evaluation of Condylar Guidance Angles Measured Using Arcon and Non-Arcon Articulators and Panoramic Radiographs-A Systematic Review and Meta-Analysis.

The condylar guidance value (CGV) measurement constitutes an important part of a holistic prosthodontic treatment plan, with horizontal CGVs (HCGVs) and lateral CGVs (LCGVs) being two of the most prominently recognized. This systematic review aimed at evaluating the efficacy of two different types of CGV measurement protocols-articulators (both arcon and non-arcon) and panoramic radiographs. Additionally, it attempts to determine which of the mentioned methods performs better across several parameters. Several important web databases were searched using search terms derived from medical subject headings (MeSH), using keywords linked to "Arcon articulator", "Condylar guidance angle", "non-arcon articulator", "Panoramic x-ray" and "Radiographic examination", which constituted the first step in the study selection strategy. After completion, the search strategy which initially turned up to 831 papers, eventually ended up with 13 studies. The review and subsequent meta-analysis revealed that panoramic radiographs had noticeably greater efficacy in terms of the CGVs as compared to the articulators in the majority of the studies. Within the articulators, the arcon types recorded slightly higher CGVs than the non-arcon variety owing to the precision of jaw movement simulation in the former. However, further studies are required to validate these findings and establish more precise guidelines for the use of CGV measurement protocols in prosthodontic practice.

Validity of near-infrared light transillumination for the assessment of proximal caries in permanent teeth.

PURPOSE: The aim of this study was to evaluate the performance of DIAGNOcam (DC) in diagnosing proximal caries and to compare its effectiveness with the International Caries Detection and Assessment System (ICDAS) and bitewing radiography (BWR). METHODS: 118 premolars extracted for orthodontic reasons were included and examined using three detection methods and validated by histological sections as the gold standard. The sensitivity, specificity and areas under the ROC curve (Az value) at the outer half enamel (D1), inner half enamel (D2) and dentine (D3) thresholds were compared between different methods. RESULTS: At all categories, the specificity of DC was almost as high as ICDAS and BWR. DC showed a significantly higher sensitivity (0.68) than both visual (0.33) and radiographic examination (0.47) at the D1 threshold. DC presented the highest Az value (area under the ROC curve) at the D1 and D2 threshold (0.81, 0.86), while BWR showed the greatest Az values at D3 (0.94). Furthermore, DC had the highest association strength with the gold standard (Spearman's ρ = 0.80). CONCLUSIONS: It can be concluded that DC could detect proximal caries effectively and showed comparable or even better performance than ICDAS and BWR.

Inter-Observer Agreement in Radiographic Diagnosis of Coxofemoral Joint Disease in a Closed Cohort of Four-Month-Old Rottweilers.

Canine hip dysplasia is a complex and multifactorial disease. The early diagnosis of dysplastic dogs under one year of age helps veterinarians to plan proper preventive/therapeutic methods. Having an accurate screening method increases the chance of the early detection of dysplasia. The goal of our study was to assess the inter-observer reliability of eight radiographic parameters in four-month-old Rottweilers. Radiographs of the 28 Rottweilers were investigated by five experienced observers. The radiographs were taken in ventrodorsal view with extended legs, frog-leg ventrodorsal view, distraction view, and dorsal acetabular rim view. Four quantitative parameters such as Norberg angle (NA), distraction index (DI), dorsal acetabular rim slope (DARS), and center edge angle (CEA) and four qualitative parameters such as sclerosis of the cranial acetabular rim (SCAR), location of the center of the femoral head (LCFH), grading of the degenerative joint disease (GDJD), and grading of the dorsal acetabular rim (GDAR) were evaluated. High inter-observer agreements were recorded for quantitative values, whereas the inter-observer agreement of the qualitative parameters was low. It can be deduced that the evaluated quantitative parameters are reliable, and a combination of these methods with clinical examinations might increase the accuracy of the examinations.

A new and spontaneous animal model for ankylosing spondylitis is found in cynomolgus monkeys.

BACKGROUND: Ankylosing spondylitis is a progressive, disabling joint disease that affects millions worldwide. Given its unclear etiology, studies of ankylosing spondylitis relied heavily on drug-induced or transgenic rodent models which retain only partial clinical features. There is obviously a lack of a useful disease model to conduct comprehensive mechanistic studies. METHODS: We followed a group of cynomolgus monkeys having joint lesions reported of spinal stiffness for 2 years by conducting hematological testing, radiographic examination, family aggregation analysis, pathological analysis, and genetic testing. RESULTS: The results confirmed that these diseased animals suffered from spontaneous ankylosing spondylitis with clinical features recapitulating human ankylosing spondylitis disease progression, manifested by pathological changes and biochemical indicators similar to that of ankylosing spondylitis patients. CONCLUSION: The study offers a promising non-human primate model for spontaneous ankylosing spondylitis which may serve as an excellent substitute for its pre-clinical research.

Toe white line separation associated with the notch (crena marginalis) on the distal phalanges in Thoroughbred yearling horses.

The shape of the white line of the hoof is closely related to the shape of the notch on the dorsal distal bearing border of the distal phalanx (P3). In this study, a radiographic survey of the P3 of both forelimbs of 163 Thoroughbred yearling horses was conducted. The correlation of the depth and width of the notch were analyzed with the toe white line separation grades (0 to 3). As a result, the toe white line separation grade increased, the depth and the width of the notch also increased significantly. Radiographic examination of the P3 of the forelimbs might be useful for deciding whether to implement hoof care to prevent onset of toe white line separation.

Is vitamin K2 a treatment choice for atypical femoral fractures in patients with secondary osteoporosis?

An atypical femoral fracture (AFF) is a rare complication associated with excessive inhibition of osteoclast expression during treatment of osteoporosis. We herein describe a patient who had been treated with alendronate for more than 10 years and subsequently developed an AFF that healed after treatment with vitamin K2 (VK2). We also discuss the potential beneficial effects of VK2 on the healing of AFFs. A 48-year-old Asian man with secondary osteoporosis was treated with alendronate for more than 10 years. The patient underwent surgical treatment for a complete AFF of the right femur. Six months postoperatively, he complained of pain in his left thigh. X-ray examination revealed an incomplete AFF of the left femoral shaft. He was then treated with VK2. After 4 months of VK2 treatment, the patient reported that the pain in his left thigh had decreased, and follow-up X-ray examination demonstrated healing of the left AFF line. This case report indicates that VK2 may be a potential direction for pharmacological treatment of AFFs in future research.

Patient-Based Dose Audit for Common Radiographic Examinations With Digital Radiology Systems: A Retrospective Cross-Sectional Study.

This study aims to audit radiation doses of adult patients who underwent common diagnostic X-ray examinations and compare dose area product (DAP) values with the established International Diagnostic Reference Level (IDRLs). Retrospective cross-sectional records of 339-patients who underwent 699-radiographic examinations between October 2018 and March 2019 were obtained. Patient-related factors, exposure, and DAP data were recorded for the six most common examinations. The mean and 75th percentile of DAPs were recorded and compared to IDRLs values. The 75th percentiles of the locally measured DAPs were below IDRLs for all examinations except for lateral lumbar, AP, and lateral thoracic spine, in which DAP-75th-percentile exceeded all IDRLs by up to 40.7%, 2.8%, 365.5%, respectively. Considering the type of detector used, the mean of the locally measured DAPs significantly exceeded the UK DRLs for the lateral thoracic spine and lateral lumbar spine. Locally measured DAP values were below the IDRLs except for thoracic and lumbar spine projections, which significantly exceeded.

Facial indices in lateral cephalogram for sex prediction in Chennai population - A semi-novel study.

BACKGROUND: Osteological examination is a very reliable tool to determine the sex of the individual as the consolidation of the dimorphic characteristics concludes the sex of the individual. This study was performed with lateral cephalograms, which is a vital diagnostic tool for patients undergoing orthodontic treatment. An index was formed, which could be considered as a reliable sex determinant in forensic applications. MATERIALS AND METHODS: This pilot study was performed on samples of the Dravidian population. Two-fifty individuals, whose age ranged between 25 and 40 years, were taken (125 subjects were males and 125 subjects were females). A total of ninety-nine cephalometric variables were compared, subjected to statistical analysis and tested for significance using the t-test. RESULTS: Out of a total of 99 variables tested only twenty-four variables showed statistical significance. So, these twenty-four variables were then subjected to discriminant function analysis to evaluate the effectiveness of each variable in predicting the sex of an individual Individually, Ramus length (Ramus ln), Condylion to Gnathion (Co-Gn) and ramus height showed the highest sex determining dependability of 78%. On the flipside, lower anterior facial height (LAFH), with 52%, showed the lowest consistency. CONCLUSION: From this study, it is clearly evident that cephalometric landmarks are reliable sex determinants to a good extent. All the statistically significant measurements, but one, showed acceptable percentages of reliability. This means the chosen variables can be used for the Dravidian population to robustly determine the sex of the individuals of interest.

Lead Failure After Vagus Nerve Stimulation Implantation: Radiographic Examination and Revision Surgery.

OBJECTIVE: The present study assessed the most common types of lead failures, identified the causes, and discussed the potential procedures for revision surgery after vagus nerve stimulator implantation in patients with epilepsy. METHODS: In a retrospective study during an 8-year period, 13 patients had undergone revision surgery because of lead failure. Lead failure was classified as either lead intrinsic damage or lead pin disengagement from the generator header. On the radiographic image, we defined a rear lead connector (RC) ratio that represented the portion of the rear lead connector in the header receptacle. It was used to quantitatively evaluate the mechanical failure of the lead-header interface. The optimal procedures to identify and manage lead failure were established. RESULTS: All 13 patients presented with high lead impedance of ≥9 kOhms at the time of revision. Of 10 patients with lead damage, 7 had presented with an increased seizure frequency after a period of seizure remission. In contrast to lead damage occurring relatively late (>15 months), lead pin disengagement was usually found within the early months after device implantation. A significant association was found between an elevated RC ratio (≥35%) and lead pin disengagement. The microsurgical technique permitted removal or replacement of the lead without adverse effects. CONCLUSIONS: The method of measuring the RC ratio developed in the present study is feasible for identifying lead disengagement at the generator level. Lead revision was an effective and safe procedure for patients experiencing lead failure.