Hypervigilance to Pain and Sleep Quality are Confounding Variables in the Infrared Thermography Examination of the Temporomandibular Joint and Temporal and Masseter Muscles.

OBJECTIVE: Verify whether Hypervigilance to Pain (HP) and Sleep Quality (SQ) are confounding variables in the infrared thermography (IT) examination of the temporomandibular joint and temporal and masseter muscles. MATERIALS AND METHODS: A cross-sectional and analytical study was conducted, collecting HP and SQ data from 80 participants without Temporomandibular Disorders (TMD), performing their IT and another 40 participants with TMD. For the selection of participants with and without TMD, the TMD Pain Screener questionnaire and axis I of the Diagnostic Criteria for Temporomandibular Disorders were applied. SQ was verified using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. For the HP assessment the Pain Vigilance and Awareness Questionnaire (PVAQ) was applied. And the IT was performed through a FLIR infrared sensor camera, model T650 Infrared. RESULTS: No significant correlations were found between SQ and the temperatures of the areas of interest (p > 0.05), and regarding HP, a statistically significant positive correlation was found with the dimensionless (ρ = 0.289) and non-dimensionless (ρ = 0.223) asymmetries of temporal muscle temperatures. In the temperature comparisons between the participants without TMD and the participants with TMD, significant differences were found (p < 0.05), also when the group without TMD was controlled according to both HP and SQ (p < 0.05), with higher temperatures found in the TMD group. CONCLUSION: HP and SQ can be considered confounding variables in infrared thermography examination of the temporomandibular region.

Prevalence of second molar external root resorption caused by mandibular third molars: a CBCT study.

The aims of this study were to use cone beam computed tomographic (CBCT) scans to assess the prevalence of second molar external root resorption (ERR) caused by impacted mandibular third molars and to associate the location and severity of ERR with the third molar position using 2 classification systems-1 proposed by Pell and Gregory and the other proposed by Winter. In this cross-sectional study, 2 calibrated observers evaluated a total of 107 CBCT scans (71 female and 36 male patients). After the presence or absence of ERR was determined, ERR was classified according to its location (cervical, middle, apical third, or root apex) and severity (mild, moderate, or severe resorption). The data were assessed with the Pearson chi-square test, the chi-square test for linear trend, and Poisson regression analysis. The significance level was set at P < 0.05. The prevalence of second molar ERR in the sample as a whole was 47.7% (n = 51). The prevalence was significantly higher (69.4%) for male patients (P = 0.002; Pearson chi-square test). The probability that ERR would affect the second molar was 1.71 times greater when the third molar exhibited the Pell and Gregory class IC position (95% CI, 1.27-2.31) and 1.64 times greater when the third molar exhibited the Winter mesioangular position (95% CI, 1.38-1.95). There was a statistically significant association between ERR location and severity; the cervical third was the most affected by mild ERR and the middle third was the most affected by severe ERR. The prevalence of mandibular second molar ERR caused by impacted third molars is high, especially in male patients. Mandibular third molars in the Pell and Gregory class IC position or Winter mesioangular position demonstrated greater potential to result in ERR of the adjacent second molar.

Evaluation of oral manifestations of patients with mucopolysaccharidosis IV and VI: clinical and imaging study.

OBJECTIVE: The aim of this study is to assess oral manifestations in patients with mucopolysaccharidosis IV (MPS IVA) and mucopolysaccharidosis VI (MPS VI). MATERIALS AND METHODS: Seventeen patients were assessed, nine with MPS IVA and eight with MPS VI, treated at the Medical Genetics Outpatient Clinic of Hospital Universitário Alcides Carneiro (HUAC) in Campina Grande, Paraíba State, Brazil. Assessments included clinical and intraoral examinations, analysis of occlusal function, and panoramic X-rays. RESULTS: Among all, 64.7% of the patients had unerupted teeth and 52.9% of them had enamel hypoplasia. Regarding the temporomandibular joint, 88.2% of the patients showed flattening of the mandibular condyle, 52.9% showed condylar hypoplasia, and all of them showed decreased mobility. Enamel hypoplasia was observed only in patients with MPS IVA (p < 0.05). On the other hand, only MPS VI patients presented with anterior open bite, restricted mouth opening (p < 0.05), and a higher rate of unerupted teeth, hyperplastic tooth follicle, and condylar defects (p < 0.05). CONCLUSIONS: Enamel hypoplasia was observed only in patients with MPS IVA, whereas anterior open bite was observed only in patients with MPS VI. Abnormal findings in the maxillomandibular complex were more frequent in patients with MPS VI. CLINICAL RELEVANCE: The relevant frequency of MPS VI and IVA in the sample allows us to compare the changes occurring in both groups of patients, therefore enabling us to further comprehend the oral manifestations in specific types of MPS.

Condyle Excursion Angle, Articular Eminence Inclination, and Temporomandibular Joint Morphologic Relations With Disc Displacement.

PURPOSE: The aim of this study was to evaluate the relations of the condyle excursion angle (CEA) and the morphology and morphometry of the articular eminence to disc displacement (DD) using magnetic resonance imaging (MRI) of symptomatic patients. MATERIALS AND METHODS: MRIs of 199 temporomandibular joints (TMJs) were evaluated. Qualitative and quantitative morphologic analyses were performed with tools available in PACS 11.0 (Carestream Health, Inc, Rochester, NY). The articular eminence inclination (AEI), eminence height (EH), CEA, and articular eminence morphologic shape were evaluated. Statistical analyses were used to evaluate any possible association of the variables with DD in the closed- and open-mouth positions, age, and gender. The significance level was set at .05. RESULTS: Elderly women (>60 yr) presented higher prevalence values (43.26%). There was no statistical correlation between DD and gender (P = .4290). Higher mean values of the AEI and EH were associated with box-shaped eminences. The EH, AEI, and CEA were not related to the presence or absence of DD and the different types of DD. The AEI (P = .002) and CEA (P < .001) values were higher for TMJs with disc reduction in the open-mouth position. CONCLUSION: Disc position in the closed- and open-mouth positions is not influenced by articular eminence morphology; however, the AEI and CEA have an influence on disc reduction.

Effects of red laser, infrared, photodynamic therapy, and green LED on the healing process of third-degree burns: clinical and histological study in rats.

The aim of this study was to evaluate the effects of red laser, infrared, photodynamic therapy, and green light-emitting diode (LED) on the healing process of skin burns through clinical and histopathologic analysis in rats. For this, 100 animals were randomly divided into five groups: G1-untreated control (CTR), G2-red laser (LVER), G3-infrared (LINF), G4-photodynamic therapy (PDT), and G5-green LED. Burn was induced on the dorsum of the rat and the treatment of the experimental groups was red light (10 J/cm(2), 10 s, 40 mW, and λ660 nm), infrared (10 J/cm(2), 10 s, 40 mW, and λ780 nm), green LED irradiation (60 J/cm(2), 10 s, λ520, and 550 nm), and photodynamic therapy (10 J/cm(2), 40 mW, and λ660 nm), the latter combined with methylene blue photosensitizer at concentration 0.5 µg/mL. Applications were performed daily until day prior to sacrifice of the animal at 3, 7, 14, and 21 days with intraperitoneal anesthetic overdose. The specimens collected were clinically examined and soon after processed and stained with hematoxylin-eosin and Picrosirius for analysis under light and polarized light microscopy, respectively. Animals treated with LVER, LINF, PDT (p < 0.001), and LED (p < 0.05) stimulated production and maturation of collagen, and increased the consumption of food and water compared to the CTR (p < 0.001). Laser λ660 nm and λ780 nm showed the largest wound reductions in all groups (p = 0.001). In conclusion, red laser, infrared, photodynamic therapy, and green LED favored the healing process of third-degree burns in rats.

Digital panoramic radiography versus cone beam computed tomography in the delineation of maxillomandibular tumors.

This research aimed to compare the efficacy of digital panoramic radiography (DPR) with that of cone beam computed tomography (CBCT) for delineation of odontogenic and nonodontogenic tumors. From November 2009 through March 2011, 23 tumors in the maxillomandibular complex were diagnosed by histopathological examination. All DPRs and CBCTs were obtained and analyzed by a single previously calibrated radiologist, who considered the following radiographic aspects: clarity of the lesion edges, relation with dental elements, involvement of adjacent anatomical structures, cortical bone expansion and disruption, and, if present, type of involved anatomical structures and site of bone expansion and disruption. Of 23 patients, 15 (65.2%) were male and 8 (34.8%) were female. The tumor was classified as odontogenic in 73.9% of patients and nonodontogenic in 26.1% of patients. Analysis revealed that 56.5% of the tumors were located in the mandible, 34.8% in the maxilla, and 8.7% in both arches. For all analyzed variables, CBCTs offered more accurate details than did DPRs. Panoramic radiography should not be the examination of choice to visualize lesions in the maxillomandibular complex.

External root thermal analysis of three different obturation techniques.

Background: The purpose of this study was to assess the external root surface thermal behavior when submitted to three different obturation techniques. Material and Methods: Forty-five single-rooted premolars were selected, prepared and randomly divided into three groups according to the studied obturation techniques: lateral condensation (LC), single cone technique (SCT) and injectable thermoplasticized technique (IT). Each tooth was placed in a customized apparatus and connected to a thermocouple. A FLIR T650sc infrared thermal camera was used to assess root temperature in a room under controlled temperature and humidity. Temperature values were recorded using the thermal camera and thermocouples before, during and 30, 60, 90, 120, 150s after obturation. Shapiro-Wilk, QQ-plot, Levene's, ANOVA-three-way, Mauchly's sphericity, Box's M and Bonferroni tests were used to assess data. The significance level was set at 5%. Results: Infrared assessment showed significant temperature changes between time intervals, obturation techniques and root thirds. Temperature increase was observed 30s after obturation for STL, LC and IT, followed by a gradual temperature decline, with temperature values similar to the initial temperature at 150s for LC and IT. SCT temperature values only returned to normal 60s after obturation in the apical third and 90s in the middle and cervical thirds. In all techniques, the temperature did not rise above the critical limit of 10°C. Conclusions: All studied obturation techniques increased root surface temperature with IT showing the highest temperature increase. However, the temperature increase does not exceed the acceptable limits, not causing damage to the surrounding tissues. Key words:Endodontics, changes in body temperature, root canal filling, thermography.

The effects of different metal posts, cements, and exposure parameters on cone-beam computed tomography artifacts.

Purpose: This study assessed the intensity of artifacts produced by 2 metal posts, 2 cements, and different exposure parameters using 2 cone-beam computed tomography (CBCT) units. Materials and Methods: The sample was composed of 20 single-rooted premolars, divided into 4 groups: Ni-Cr/zinc phosphate, Ni-Cr/resin cement, Ag-Pd/zinc phosphate, and Ag-Pd/resin cement. Samples were scanned before and after post insertion and cementation using a CS9000 3D scanner with 4 exposure parameters (85/90 kV and 6.3/10 mA) and an i-CAT scanner with 120 kV and 5 mA. The presence of artifacts was assessed subjectively by 2 observers and objectively by a trained observer using ImageJ software. The Mann-Whitney, Wilcoxon, weighted kappa, and chi-square tests were used to assess data at a 95% confidence level (α<0.05). Results: In the subjective analyses, AgPd presented more hypodense and hyperdense lines than NiCr (P<0.05), and more hypodense halos were found using i-CAT (P<0.05) than using CS9000 3D. More hypodense halos, hypodense lines, and hyperdense lines were observed at 10 mA than at 6.3 mA (P<0.05). More hypodense halos were observed at 85 kV than at 90 kV (P<0.05). CS9000 3D presented more hypodense and hyperdense lines than i-CAT (P<0.05). In the objective analyses, AgPd presented higher percentages of hyperdense and hypodense artifacts than NiCr (P<0.05). Zinc phosphate cement presented higher hyperdense artifact percentages on CS9000 3D scans (P<0.05). CS9000 3D presented higher artifact percentages than i-CAT (P<0.05). Conclusion: High-atomic-number alloys, higher tube current, and lower tube voltage may increase the artifacts present in CBCT images.

Artificial intelligence and infrared thermography as auxiliary tools in the diagnosis of temporomandibular disorder.

OBJECTIVE: To assess three machine learning (ML) attribute extraction methods: radiomic, semantic and radiomic-semantic association on temporomandibular disorder (TMD) detection using infrared thermography (IT); and to determine which ML classifier, KNN, SVM and MLP, is the most efficient for this purpose. METHODS AND MATERIALS: 78 patients were selected by applying the Fonseca questionnaire and RDC/TMD to categorize control patients (37) and TMD patients (41). IT lateral projections of each patient were acquired. The masseter and temporal muscles were selected as regions of interest (ROI) for attribute extraction. Three methods of extracting attributes were assessed: radiomic, semantic and radiomic-semantic association. For radiomic attribute extraction, 20 texture attributes were assessed using co-occurrence matrix in a standardized angulation of 0°. The semantic features were the ROI mean temperature and pain intensity data. For radiomic-semantic association, a single dataset composed of 28 features was assessed. The classification algorithms assessed were KNN, SVM and MLP. Hopkins's statistic, Shapiro-Wilk, ANOVA and Tukey tests were used to assess data. The significance level was set at 5% (p < 0.05). RESULTS: Training and testing accuracy values differed statistically for the radiomic-semantic association (p = 0.003). MLP differed from the other classifiers for the radiomic-semantic association (p = 0.004). Accuracy, precision and sensitivity values of semantic and radiomic-semantic association differed statistically from radiomic features (p = 0.008, p = 0.016 and p = 0.013). CONCLUSION: Semantic and radiomic-semantic-associated ML feature extraction methods and MLP classifier should be chosen for TMD detection using IT images and pain scale data. IT associated with ML presents promising results for TMD detection.

Influence of size of field of view (FOV), position within the FOV, and scanning mode on the detection of root fracture and observer's perception of artifacts in CBCT images.

OBJECTIVE: To assess the influence of field of view (FOV) size, scanning position within the FOV and scanning mode on the detection of root fracture and artifact perception. METHODS: Forty single-rooted premolars restored with NiCr and AgPd posts were divided into two groups: fractured and sound. All teeth were scanned using four CBCT scanning protocols varying FOV sizes (80 × 80 mm and 50 × 55 mm) and scanning modes (Standard and High Definition). The sample was positioned within the FOV in two pre-set positions (central and lateral) and in four positions established by the operator (quadrants). Detection of root fracture and artifact perception were assessed by two observers using 5-point and 4-point scales. Sensitivity, specificity, accuracy, and AUC values were calculated and compared by ANOVA two-way and Tukey's test. Chi-square and Fisher's exact test were used to assess artifact perception. The level of significance was set at p < 0.05. RESULTS: The central position within the FOV presented higher sensitivity, specificity, accuracy, and AUC values and differed from the lateral position within the FOV for the studied metal posts (p<0.05). Quadrant 2 presented the best sensitivity, accuracy, and AUC values (p<0.05). The lateral position within the FOV, AgPd posts, quadrants 1 and 3 and protocols 1 (SM, 80 × 80) and 2 (HD, 80× 80) presented higher frequency of artifacts classified as "severe". CONCLUSION: Positioning the object in the center or closer to the anterior periphery of the FOV while using a small FOV improved the detection of root fracture and decreased artifact perception.

Root Canal Treatment and Apical Periodontitis in a Brazilian Population with Type 1 Diabetes Mellitus: A Cross-sectional Paired Study.

INTRODUCTION: This study radiographically analyzed the prevalence of root canal treatment (RCT) and apical periodontitis (AP) in type 1 diabetes mellitus (T1DM) and nondiabetic individuals and its association with the history/current status of T1DM. METHODS: In a cross-sectional paired study, the radiographic records of 50 individuals with T1DM and 100 age- and sex-matched nondiabetic subjects were examined. The presence of RCT and AP was evaluated. Information regarding the history and current status of T1DM was collected from the medical records of each patient. RESULTS: One or more RCTs were found in 76% and 44% of diabetic and nondiabetic subjects, respectively (P = .000). AP in 1 or more teeth was found in most T1DM patients (58%) and in 15% of the control subjects (P = .000). One or more RCTs associated with AP were found in 52% and 8% of T1DM and nondiabetic subjects, respectively (P = .000). Bivariate logistic regression analyses suggested that RCT (odds ratio [OR] = 10.435, P = .000), AP (OR = 3.508, P = .011), and RCT + AP (OR = 7.220, P = .000) were significantly associated with the presence of T1DM. Multivariate logistic regression showed that among T1DM individuals, there is an association between 11-15 years of diagnosis time and at least 1 RCT (OR = 46.316, P = .038) and an association between T1DM control and at least 1 tooth with AP (OR = 15.611, P = .016). CONCLUSIONS: RCT, AP, and RCT with AP were more prevalent in individuals with T1DM than in nondiabetic individuals. RCT and AP were associated with the presence of T1DM, specifically RCT with diagnostic time and AP with glycemic control.

Influence of tooth position within the field of view on the intensity of cone-beam computed tomographic imaging artifacts when assessing teeth restored with various intracanal materials.

PURPOSE: This study aimed to quantify the influence of tooth position within the field-of-view (FOV) on cone-beam computed tomography (CBCT) imaging artifacts' intensity when assessing teeth restored with various intracanal materials. MATERIALS AND METHODS: Seventy single-rooted teeth were divided into 7 groups (10 teeth per group): NiCr post (NC), AgPd post (AP), metal core fiberglass post (MCFG), fiberglass post (FG), anatomical fiberglass post (AFG), fiberglass post cemented with core build-up cement (FGCo), and anatomical fiberglass post cemented with core build-up cement (AFGCo). All posts were cemented using a regular dual-curing resin cement (Allcem), except FGCo and AFGCo which were cemented with a core build-up dual-curing resin cement (AllcemCore). Each tooth was scanned on a CS9000 in 5 positions within the FOV: a central position, anterior horizontal peripheral, peripheral superior, peripheral inferior, and posterior horizontal peripheral position. Hyperdense, hypodense, remaining teeth areas and ROI areas were quantitatively analyzed using ImageJ software. RESULTS: Posterior horizontal peripheral position increased the intensity of artifacts on FGCo and AFGCo post groups (P<0.05), and specifically the hypodense artifact intensity on FG and AFG post groups (P<0.05). NC and AP groups presented greater intensity of artifacts than any other post groups (P<0.05). CONCLUSION: Artifact intensity increases in the presence of high atomic number materials and when the object is not centered within the FOV. The impact of positioning within the FOV on artifact was greater for fiberglass posts cemented with core build-up dual-curing cement than for metal posts and fiberglass posts cemented with regular dual-curing cement.

Assessment of the Influence of Different Intracanal Materials on the Detection of Root Fracture in Birooted Teeth by Cone-beam Computed Tomography.

INTRODUCTION: The aim of this study was to assess 2 cone-beam computed tomographic systems on the detection of artificially induced vertical root fractures (VRFs) and artifact intensity using birooted teeth restored with different intracanal materials. METHODS: The sample consisted of 20 extracted birooted premolars. Root fracture was induced in half of the sample. Seven intracanal material combinations were used in each tooth, 1 at a time: unrestored, gutta-percha, a buccal root with gutta-percha and a lingual root with a fiberglass post, a buccal root with gutta-percha and a lingual root with a metal core fiberglass post, fiberglass posts, metal core fiberglass posts, and NiCr posts. Cone-beam computed tomographic scans were acquired using CS 9000 3D (Carestream Dental Rochester, NY) and OP300 (Instrumentarium Dental Inc, Tuusula, Finland) units. Exposure parameters were fixed at 90 kV and 8 mA. The voxel size and field of view were set at 0.085 mm and 5 × 5 cm for OP300 and 0.076 mm and 5 × 3.75 cm for CS 9000, respectively. Two observers assessed all images using a 5-point confidence scale for VRF detection and a 4-point score for artifact interference. The sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve were compared using 2-way analysis of variance and the Tukey test (α = 0.05). Artifact interference was evaluated by descriptive statistics and the chi-square test. RESULTS: There were significant differences between scanners (P > .05) and among the different intracanal material groups (OP300) (P < .05) for specificity. When a metal post was present in both roots, severe artifact interference was observed in all images. CONCLUSIONS: CS 9000 3D presented better performance than OP300 on VRF detection of endodontically treated teeth. Unrestored teeth and teeth filled with fiberglass posts were considered the groups with the lowest artifact interference and the highest VRF detection results.

Correlation between temporomandibular joint morphometric measurements and gender, disk position, and condylar position.

OBJECTIVE: The aim of this study was to correlate the morphometric measurements of the temporomandibular joint, including condylar size, joint space, and articular eminence size, with gender, disk position, and condylar position by using magnetic resonance imaging. STUDY DESIGN: Overall, 93 patients were evaluated (31.2% males and 68.8% females; age 18-81 years; mean age 41 years). Condylar size (D1), joint space (D2), and eminence size (D3) were measured. Correlations with gender, disk position, and condylar position were calculated. RESULTS: A statistically significant correlation was found between D2 and gender, with the joint space being significantly larger in the male group (P = .05). There were correlations between D2 and the position of the disk and the position of the condyle (P ≤ .05). CONCLUSIONS: The results indicate a correlation between male gender and larger joint space. In addition, we found that the joint space size influences the articular disk and condyle position, which can cause disk displacement.

Is infrared thermography effective in the diagnosis of temporomandibular disorders? A systematic review.

OBJECTIVE: The aim of this study was to systematically review the scientific efficacy of infrared thermography (IT) on the diagnosis of temporomandibular joint disorders (TMDs). STUDY DESIGN: An electronic search was performed in 8 databases for publications up to May 2018. Additionally, a hand search of the reference lists was conducted. There were no restrictions on language or on year of publication. Two independent reviewers selected the studies, reviewed the abstract information, and assessed the quality. The methodology of the included articles was evaluated by using the QUADAS-2 tool. RESULTS: Nine studies fulfilled the eligibility criteria and were included in the systematic review. Four studies concluded that IT presents low accuracy or is not an accurate instrument for TMD diagnosis, but there was substantial variation in sensitivity, specificity, and receiver operating characteristic curve values. Five studies concluded that IT appears to be promising or may be a complementary diagnostic aid in the evaluation of TMDs. These studies presented sensitivity values ranging from 70% to 90% and specificity values ranging from 62% to 92%. All studies were judged as being "at risk of bias" and as having "concerns regarding applicability." CONCLUSIONS: The literature is still lacking in sufficient number of studies regarding the reliability of IT for the diagnosis of TMDs.

Assessment of Cone-beam Computed Tomographic Artifacts from Different Intracanal Materials on Birooted Teeth.

INTRODUCTION: This study quantitatively evaluated the type and amount of image artifacts generated by different intracanal materials in birooted teeth scanned at different exposure parameters. METHODS: The sample consisted of 15 birooted premolars. Seven different intracanal material combinations were used in each tooth one at a time: (1) roots without intracanal materials, (2) roots with gutta-percha, (3) a buccal root with gutta-percha and a lingual root with a fiberglass post, (4) a buccal root with gutta-percha and a lingual root with a metal core fiberglass post, (5) buccal and lingual roots with fiberglass posts, (6) buccal and lingual roots with metal core fiberglass posts, and (7) buccal and lingual roots with NiCr metal posts. Cone-beam computed tomographic scans were acquired using a CS 9000 unit (Carestream Dental, Atlanta, GA). An image of each tooth was captured under 5 exposure parameters: 2.5, 4, 6.3, 8, and 12 mA. The voxel size, field of view, and tube voltage were fixed at 0.076 mm, 5 × 3.75 cm, and 75 kV. We assessed each artifact quantitatively using ImageJ's threshold tool (National Institutes of Health, Bethesda, MD) to determine the hypodense and hyperdense artifact areas within 8-bit images extracted from the scans. All analyses were conducted with a 95% confidence level (α <0.05). RESULTS: The inferential analysis showed that roots filled with metal posts presented the highest amount of hypodense and hyperdense artifacts, whereas fiberglass post in both roots presented fewer artifacts. All materials presented more hypodense than hyperdense artifact formation. Overall, the low-exposure settings presented fewer artifacts and higher values of preserved dental images. CONCLUSIONS: Low-exposure protocols and fiberglass posts presented fewer image artifacts in CBCT scans.

Head and neck cancer, quality of life, and determinant factors: a novel approach using decision tree analysis.

OBJECTIVE: The goal of the present study was to investigate health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL) in patients under treatment for head and neck cancer and to identify the associated factors. STUDY DESIGN: A cross-sectional study was conducted with 102 patients undergoing treatment for head and neck cancer at 2 medical centers. Participants answered a sociodemographic questionnaire and the Brazilian versions of the Medical Outcomes Study 36 (SF-36) and the Oral Health Impact Profile (OHIP-14) questionnaires to assess HRQoL and OHRQoL, respectively. Clinical aspects, cancer staging, and treatment approach were also investigated. Descriptive and multivariate analyses were performed by using decision tree analysis with the Chi-square Automatic Interaction Detector (CHAID) algorithm. RESULTS: The decision tree revealed that reduced quality of life is associated with the clinical staging (adjusted P value = .035), patient's gender (adjusted P value = .028), and treatment approach (adjusted P value = .032). Female patients who are diagnosed with advanced head and neck cancer and undergo radiotherapy or chemotherapy are more likely to exhibit lower rates of quality of life. CONCLUSIONS: The results suggested that sociodemographic characteristics, clinical staging, and treatment approach can exert a significant influence on the quality of life of patients with head and neck cancer.

Comparison of microtomography and optical coherence tomography on apical endodontic filling analysis.

OBJECTIVES: To comparein vitro differences in the apical filling regarding working length (WL) change and presence of voids and to validate optical coherence tomography (OCT) in comparison with computerized microtomography (µCT) for the detection of failures in the apical filling. METHODS: Forty-five uniradicular teeth with round canals, divided into groups (n = 15) following the obturation protocols: LC (lateral condensation), TMC (thermomechanical compaction) and SC (single cone). Samples were scanned using µCT (parameters: 80 kV, 222 µA, and resolution of 11 µm), OCT (parameters: SSOCT, 1300 nm and axial resolution of 12 µm), and periapical digital radiography. The images were analyzsed by two blind and calibrated observers using ImageJ software to measure the boundary of the obturation WL and voids presence. Categorical and metric data were submitted to inferential analysis, and the validity of the OCT as a diagnostic test was assessed with performance and reliability tests. RESULTS: The WL average remained constant for all obturation techniques and image methods. OCT showed adequate sensitivity and specificity to detect voids in the WL of apical obturations in vitro in comparison with µCT. Both image methods found a higher number of voids for LC technique (µCT p = 0.011/OCT p = 0.002). CONCLUSIONS: OCT can be used in apical obturation voids assessment and the LC technique revealed more voids with larger dimensions.

Decrease in Mandibular Cortical in Patients With Type 1 Diabetes Mellitus Combined with Poor Glycemic Control.

In this study we analyzed the mandibular cortical bone of patients with type 1 diabetes mellitus (T1DM) and non-diabetic. Fifty patients with T1DM and 100 non-diabetic ones paired by age and gender were analyzed. Two double-blinded observers evaluated 150 digital panoramic images of both groups. The mandibular cortical bone was analyzed using the Mandibular Cortical Index (MCI), Mental Index (MI), Gonial Index (GI), Antegonial Index (AI) and Upper and Lower Panoramic Mandibular Indexes (UPMI and LPMI), with the aid of RADIOIMP® software. Influence of T1DM in the morphology of the mandibular cortical bone was studied based on obtaining data related to T1DM diagnosis time, blood glucose level, T1DM control and the presence of chronic complications. Collected data were submitted to descriptive (mean and standard deviation) and inferential analyzes (Pearson's chi-squared test and Fisher's exact test) (p≤0.05). According to the MCI, individuals with T1DM had higher frequencies of mandibular cortical alterations, in both sexes and all age groups (p<0.01). For quantitative indexes, MI, GI, AI, UPMI and LPMI, female patients showed statistically significant differences for GI and AI, while male patients had statistically significant differences for all indexes (p<0.05), presenting the individuals with TDM1 inferior measures. Individuals with poor T1DM control showed significantly higher frequency of mandibular cortical alteration (92.3%), with lower means for MI, GI, AI and LPMI (p≤0.05). In conclusion, patients with T1DM showed decrease in the mandibular cortical bone when compared to non-diabetic ones, indicating that poor disease control is associated with these alterations.