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 local trauma, secondary infections and osteomyelitis may occur. Patients may present with pain, mucosal ulceration, and lesion exposure in the oral cavity, fistula and swelling. In such cases, 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 del tejido óseo donde el hueso trabecular normal es sustituido por tejido conectivo fibroso y por tejido mineralizado amorfo. En general, las lesiones son de origen asintomático y los pacientes deben ser controlados con exámenes clínicos. Sin embargo, debido a la vascularización deficiente de la lesión y el trauma local, pueden ocurrir lesiones secundarias y osteomielitis. Los pacientes pueden presentar dolor, ulceración de la mucosa, lesión expuesta en la cavidad oral, fístula y edema. En estos casos, el diagnóstico adecuado y el tratamiento de la lesión es decisivo para estabilizar la salud y la calidad de la vida. El objetivo de este artículo fue presentar un caso de complicación secundaria crónica de la osteomielitis tratada con tratamiento conservador. Una paciente de 68 años de edad, negra, informa de "hinchazón de las encías" que presentaba durante once años, con episodios de dolor. En el examen intra-oral se observó una pápula con supuración en la mucosa alveolar del lado derecho de la mandíbula. Además de la radiografía panorámica y tomografía computarizada de haz cónico (TCHC) se tomaron muestras de la lesión debido a observación de hueso esclerótico. El paciente fue diagnosticado con una infección por osteomielitis en asociación con DOF y fue tratada con antibióticos, además de una cirugía curativa. En este artículo se presentaron la incidencia, el diagnóstico diferencial, el tratamiento y la prevención de los efectos secundarios de osteomielitis asociados con el DOF. La información de este trabajo podría ayudar a los dentistas en la aplicación del tratamiento indicado en casos similares.

RESUMO A anquilose alveolodentária consiste na fusão do cemento ou dentina radicular com o osso alveolar tanto em dentes decíduos como nos dentes permanentes. Isto leva a uma série de alterações clínicas e radiográficas importantes para o diagnóstico. Além disso, o conhecimento dos princípios biológicos envolvidos irá permitir o controle adequado dos dentes acometidos por este fenômeno.

ABSTRACT Alveolodental ankylosis is the fusion of cementum or root dentin with the alveolar bone in both deciduous and permanent teeth. This leads to important clinical and radiographic changes in the affected teeth. Moreover, knowledge of the biological principles involved allows adequate management of teeth affected by this phenomenon.

The aim of this study was to evaluate the reproducibility of the gray values and noise of a direct digital radiography system (Visualix eHD) for various exposure times and analyzed regions. To obtain radiographic images in a standardized manner, the digital sensor of the system and a stepwedge were positioned in a phantom at a focus-film distance of 30 cm in a dental device at 70 kV, 7 mA and 2.2 mm filtration. Ten consecutive repetitions of X-ray imaging were performed at each exposure time (0.05, 0.07, 0.09 and 0.13 s). Gray values were analyzed using ImageJ software in five regions of interest (ROIs): alveolar bone (AB), soft tissue (ST) and three steps of the stepwedge (S1, S2 and S3). The results showed that both the variability of the gray values and the noise were statistically greater (p < 0.05) in the most radiolucent region (ST). Only the noise was affected by the exposure time. In conclusion, the reproducibility of the gray values and the noise of the Visualix eHD system can vary in specific areas with different radiolucency.

The aim of this study was to determine the efficacy of pixel value analysis using images generated by the Digora™ and Visualix™ systems for the early detection of external root resorption (ERR). Thirty extracted human lower incisors were radiographed using the Digora and Visualix systems; then, ERR was induced by immersing the teeth in 6 mol L-1 of hydrochloric acid for different periods of time (10, 30 and 60 minutes). ERR was confirmed by calcium quantification with an atomic absorption spectrophotometer. One digital image was acquired per time period at 70 kVp, 7 mA, 2.2 mm filtration, focus-film distance of 30 cm, and with exposure times of 0.09 s in the Digora system and 0.05 s in Visualix system. The region of interest was defined using ImageJ software. Statistical analysis was performed using ANOVA and Pearson’s correlation (p < 0.05). There was no statistically significant difference between the time for ERR induction and the pixel values with either system. A positive correlation between the time of ERR induction and the calcium concentration was observed (r = 0.8892; p < 0.001). In conclusion, independent of the site of ERR induction and the digital system, pixel value analysis was not effective for ERR detection.