SUMMARY: Knowledge about Gaucher disease, characteristics, clinical and radiographic alterations, demonstrate the importance of using anamnesis, laboratory tests and radiological images, among these dental analysis and images, making possible the early detection in the oral manifestations and the success in the control and treatment of the disease.

RESUMEN: El conocimiento sobre la enfermedad de Gaucher, características, alteraciones clínicas y radiográficas, demuestra la importancia de utilizar la anamnesis, los exámenes de laboratorio e imágenes radiológicas, entre ellas las odontológicas, posibilitando la detección precoz de las manifestaciones orales, y el éxito en el control y tratamiento de la enfermedad.

Abstract This study aimed at evaluating the validity of cone-beam computed tomography (CBCT) for assessing mandibular bone quality using the Klemetti classification. The morphology of the endosteal mandibular cortex of 30 (60 hemi-mandibles) postmenopausal women between the ages of 45 and 80 years was evaluated based on the Klemetti classification in panoramic radiographs used as reference images. Afterwards, panoramic reconstruction and cross-sectional slices of CBCT examinations of these patients were analyzed and categorized according to the same classification. All the images were assessed by two oral radiologists. The McNemar-Bowker test compared the agreement between the CBCT images and the reference images. No differences were found between the diagnostic results based on panoramic radiography and panoramic reconstruction. However, the mean scores for the cross-sectional evaluation were higher, and the results, statistically different from the others. Based on the disagreement found between the panoramic radiographs and the CBCT cross-sectional slices, the Klemetti classification is not an adequate means of assessing bone quality with CBCT. On the other hand, the higher values found for the cross-sectional slices could be associated with better visibility on the CBCT images.

Due the importance of diagnosis precocious of osteoporosis, this study carried out the comparison of two conventional radiological methods for the evaluation of bone density in postmenopausal women. X-ray images of panoramic and carpal were selected, corresponding to 68 women between 49 and 80 years old, obtained at the Clinic of Dental Radiology, for holding dental implant. The interpretation of bone density in jaw on panoramic radiography was the method to determine mandibular cortical thickness. The carpal radiography was evaluated for the radiogrammetry method. It was concluded that there was a correlation between low bone density observed in the mandibular panoramic radiography with low bone density on carpal radiography.

Debido a la importancia del diagnóstico precoz de osteoporosis, fue objeto de este estudio realizar la comparación de dos métodos radiológicos convencionales para la evaluación de la densidad ósea en mujeres posmenopáusicas. Fueron seleccionadas imágenes de radiografía panorámica y de radiografía carpal, correspondiente a 68 pacientes de sexo femenino, con edades comprendidas entre los 49 y 80 años de edad, realizadas en la Clínica de Radiología Odontológica, para evaluación previa a la colocación de implantes. Para la interpretación de la densidad ósea en la mandíbula a través de las radiografías panorámicas fue utilizado el método del espesor cortical mandibular (PMI). Para la evaluación de las imágenes radiológicas obtenidas por la radiografía carpal, fue aplicado el método de la radiogrametría. Se concluye que existe correlación entre la presencia de una baja densidad ósea a nivel mandibular observada en la radiografía panorámica en las pacientes de la muestra, con la baja densidad ósea presentada en la radiografía carpal.

Precise techniques for the measurement of maxillary bone mineral density (BMD) are useful for the early diagnosis of systemic diseases. The aim of this study was to compare in vivo the efficacy of dual-energy x-ray absorptiometry (DXA) and radiographic densitometry for the measurement of BMD after systemic administration of sodium alendronate. Wistar rats were randomly allocated to a control group (n = 5), which received distilled water, and a sodium alendronate group (n = 8), which received two doses of chemically pure sodium alendronate (1 mg/kg) per week. After 8 weeks, the animals were euthanized, the tibias were removed, and the BMD of the proximal tibial metaphysis was analyzed radiographically and by DXA. The data were subjected to statistical analysis by the Kruskal-Wallis test at a significance level of 5%. Both of the techniques revealed that the alendronate-treated group had a significantly higher BMD (p < 0.05) than the control group after 8 weeks of treatment. Comparing the groups with and without alendronate therapy revealed increases of 14.9% and 29.6% in BMD, as detected radiographically and by DXA, respectively. In conclusion, both of the methods were able to detect an increase in BMD of the proximal tibial metaphysis after alendronate therapy.

Este estudo investigou a existência de associação entre a angulação do processo estiloide nas direções anterior e medial e a intensidade dos sintomas de disfunção temporomandibular. Cinquenta pacientes (8 homens e 42 mulheres) com idade entre 25 a 70 anos, com sintomas relevantes de DTM foram avaliados. Os exames clínicos foram realizados para determinar a severidade dos sintomas da DTM (dor orofacial, cefaleia, zumbido e tontura) com base nos critérios do RDC / DTM e na escala visual analógica (EVA), e imagens de radiografias digitais do processo estiloide foram obtidas: cefalométrica lateral com incidência reversa (análise de angulação anterior), e póstero-anterior do crânio (projeção reversa de Towne) (análise de angulação medial). A média de angulação anterior do processo estilóide foi 20,89°, enquanto a média da angulação medial foi 19,1° no lado direito e 19,04° no lado esquerdo. Não houve diferença estatisticamente significativa entre os grupos de pacientes (sintomas severos, moderados ou leves) em associação com os sintomas de DTM e as angulações anterior ou medial do processo estiloide (p>0,05). Não houve correlação entre a intensidade dos sintomas de DTM e as medidas das angulações anterior e medial do processo estiloide utilizando a radiografia cefalométrica lateral ou a póstero-anterior (projeção reversa de Towne).

This study investigated the existence of association between the angulation of the styloid process on the anterior and medial directions with the intensity of temporomandibular dysfunction (TMD) symptoms. Fifty patients (8 men and 42 women) aged 25 to 70 years, with relevant TMD symptoms were evaluated. Clinical examinations were performed to determine the severity of TMD symptoms (orofacial pain, headache, tinnitus and dizziness) based on the RDC/TMD criteria and the visual analogue scale (VAS), and digital radiographic images of the styloid process were obtained: lateral cephalometric skull radiograph (analysis of anterior angulation) and posteroanterior skull radiograph (reverse Towne's projection) (analysis of medial angulation). The anterior angulation average of the styloid process was 20.89° while the medial angulation average was 19.1° in the right side and 19.04° in the left side. There was no statistically significant difference among the patient groups (severe, moderate and mild symptoms) associating the TMD symptoms and the anterior or medial angulation of the styloid process (p>0.05). There was no correlation between the intensity of the TMD symptoms and the measurements of anterior and medial angulation of the styloid process using either lateral cephalometric or posteroanterior radiographs (reverse Towne's projection).

O conhecimento adquirido sobre a síndrome de Eagle demonstra que sua sintomatologia pode ser confundida muito facilmente com outros tipos de desordens craniomandibulares, principalmente a disfunção temporomandibular (DTM). O objetivo do estudo foi encontrar uma possível correlação entre a presença de DTM e o alongamento do processo estilóide, assim como a relação com a calcificação da cadeia estilo-hiódea. Para tanto foram analisados 50 pacientes com DTM, confirmada a partir do RDC/TMD. Foi realizado o exame clínico e documentação radiográfica de cada paciente, composta por: radiografia panorâmica digital e cefalométrica lateral digital. Para a análise das radiografias foi utilizado o programa computacional Radiocef (Radiomemory), onde foram realizados traçados cefalométricos por análise específica e medidas lineares do processo estilóide. Cada radiografia foi traçada e medida por três vezes, com intervalos de tempo de 1 mês entre as medições a fim de diluir o erro. Foi realizada a estatística através do Programa Biostat 4.0 e o teste de Pearson (?=0,001). Como resultado foi encontrada uma incidência de 76% de alongamento do processo estilóide na amostra. Houve correlação positiva para as medidas bilaterais realizadas na radiografias panorâmicas (?<0,001) e também para as medidas de comprimento do processo estilóide realizados nas diferentes tomadas radiográficas panorâmicas e cefalométricas laterais (?<0,001). Concluiu-se que há prevalência de alongamento do processo estilóide em pacientes com DTM, embora não tenha sido encontrada relação entre as medidas realizadas na cadeia estilo-hióidea com os sintomas de cefaléia, dor orofacial, zumbido e vertigem

Knowledge of the Eagle's syndrome shows that its symptoms can be very easily confused with other types of craniomandibular disorders, especially temporomandibular disorders (TMD). The aim of this study was to find a possible correlation between the presence of TMD and elongation of the styloid process as well relate to presence of calcification of the stilohyoid chain. Fifty patients with TMD, confirmed from the RDC/TMD, were examined clinically and radiographically. Radiographic documentation consisted of digital panoramic radiograph and digital lateral cephalometric radiograph. Radiocef software (Radiomemory) was used for the analysis of radiographs by means of specific cephalometric tracing and linear measurements of the styloid process. Each radiograph was traced and measured three times with intervals of 1 month to spread the error. Statistical analysis was performed by Pearson's test (p=0.001) using Biostat 4.0 statistical software. Result showed an incidence of 76% elongation of the styloid process in the sample. There was a correlation between the bilateral measures taken in panoramic radiographs (?<0.001) and also for measures of styloid process length carried out in different panoramic radiographs and lateral cephalometric radiographs (?<0.001). It was concluded that there is prevalence of elongated styloid process in patients with TMD. However, no relationship was found between measurements on the stylohyoid chain and symptoms of headache, orofacial pain, tinnitus and vertigo.

Este estudo teve como objetivo analisar a atividade eletromiográfica e a força de mordida molar máxima de indivíduos diagnosticados com osteoporose na região maxilar e mandibular, visto que os hábitos e condições que provocam o desenvolvimento de uma perda óssea generalizada no esqueleto, inclusive no esqueleto facial, podem causar distúrbios na harmonia funcional do sistema mastigatório. Vinte e sete indivíduos portadores de osteoporose na mandíbula e maxila e 27 voluntários sem a doença participaram deste estudo. Um eletromiógrafo de 5 canais foi utilizado. A avaliação da atividade muscular foi realizada por meio de registros eletromiográficos da musculatura mastigatória (músculos masseter e temporal, bilateralmente) durante as seguintes condições clínicas: Repouso (5 s); Lateralidades direita e esquerda (5 s); Protrusão (5 s); Apertamento dental máximo com parafilme (4 s) e a contração voluntária máxima (4 s), sendo que esta condição clínica foi utilizada como fator de normalização dos dados da amostra. Verificou-se que os indivíduos com osteoporose apresentaram maior atividade eletromiográfica durante a manutenção das condições posturais da mandíbula e menor atividade durante o apertamento dental e na obtenção da força de mordida molar máxima. Conclui-se que a osteoporose na região dos ossos da face pode interferir nos padrões de ativação da musculatura mastigatória e na força de mordida máxima do sistema estomatognático.

The purpose of this study was to analyze the electromyographic (EMG) activity and the maximal molar bite force in women diagnosed with osteoporosis in the maxillary and mandibular regions, considering the habits and conditions that lead to development of generalized skeletal bone loss, including on face bones, can disturb the functional harmony of the stomatognathic system. Twenty-seven women with mandibular and maxillary osteoporosis and 27 healthy controls volunteered to participate in the study. A 5-channel electromyographer was used. Muscle activity was evaluated by means of EMG recordings of the masticatory musculature (masseter and temporalis muscles, bilaterally) during the following clinical conditions: rest (5 s); right and left lateral excursions (5 s); protrusion (5 s); maximal dental clenching on Parafilm™ (4 s) and maximal voluntary contraction (4 s). This latter clinical condition was used as the normalization factor of the sample data. It was observed that individuals with osteoporosis presented greater EMG activity when maintaining mandible posture conditions and less activity during dental clenching and when obtaining maximal molar bite force. It may be concluded that facial osteoporosis can interfere on the patterns of masticatory muscle activation and maximal bite force of the stomatognathic system.

For the purposes of this report, "systemic disease" will be interpreted as conditions that are spread out within the body rather than localized strictly to the tissues of the oral cavity. Since it would take many volumes to review all such conditions, the intent of the authors is to review a few examples of conditions where initial panoramic radiographic findings suggested widespread disease of significance enough to affect the quality of life and longevity of the patient.

Par los propósitos de este informe, "enfermedad sistémica" puede ser interpretado como las condiciones que se producen dentro del cuerpo, más que estrictamente en los tejidos de la cavidad oral. Aunque habría que ocupar muchos volúmenes para revisar todas las condiciones, la intención de los autores sólo fue revisar algunos ejemplos de éstas, en las que la radiografía panorámica inicial, indica los resultados de la enfermedad generalizada, dada la suficiente importancia al afectar la calidad de vida y la longevidad del paciente.

The purpose of this study was to evaluate the newly formed bone, comparing two different carriers for rhBMP-2, using the decortication and nondecorticatication surgical technique in Wistar rat mandibles, evaluated by radiographic densitometry method. It was used fifty six animals according to specific treatment, which were sacrificed after 3 and 6 weeks after this. It was concluded that the decortication surgical technique was able to optimize the osteoinduction properties of the rhBMP-2, independently of the material carrier used and the period of time, according to radiographic densitometry technique.

El propósito de este estudio es evaluar la neoformación ósea con la densitometría radiográfica, comparando dos transportadores diferentes para el rhBMP-2, mediante la técnica quirúrgica con o sin la retirada previa de la cortical ósea, en mandíbulas de ratas Wistar. Fueron utilizados 56 animales, de acuerdo con el tratamiento específico, sacrificados después de 3 y 6 semanas. La densitometría radiográfica permitió concluir que la técnica quirúrgica de retirada de la cortical puede optimizar las características osteoinductoras del rhBMP-2, independientemente del transportador usado y del tiempo transcurrido.

The aim of this study was to correlate the morphodigital characteristics of the trabecular mandibular bone, in this way, it is possible to observe osteoporosis clue in patients of both sex, using panoramic radiograph for analysis. The results of this study showed statistical difference between men and women considering the bone trabecular measures (p<0.05), but it was not found statistical difference between the sides in each analyzed group (p>0.05). Male group presented a more strongly trabecular and complex bone than the female group, this finding is important index to osteoporotic risk, being possible to affirm that the male bone is less probable to suffer a osteoporotic fracture

El objetivo de este estudio fue correlacionar las características morfodigitales del trabeculado óseo mandibular para de esta manera, verificar indicios de señales de osteoporosis, utilizando para esto, radiografías panorámicas de pacientes de ambos sexos. Los resultados del estudio mostraron diferencias entre los grupos masculino y femenino, en la cuantificación de hueso trabecular mandibular (p<0,05), pero no se encontraron diferencias enter los lados derecho e izquierdo en cada grupo analizado (p>0,05). El grupo masculino presentó un padrón óseo trabecular más compleo y fuerte que el grupo femenino. Este hallazgo puede ser un importante indicador en cuanto a los riesgos de osteoporosis, por ejemplo, siendo posible afirmar que los huesos de los individuos del grupo masculino están menos sujetos a riesgo de fractura por osteoporosis

The aim of this article is to present a singular and practical method to compare roentgenograms, concerning optical density and contrast. This method is specifically indicated for research related to stepwedge penetrometer and photodensitometer

El objetivo de este artículo es presentar un método singular y práctico para comparar roentgenogramas, referentes a la densidad óptica y al contraste. Este método se indica específicamente para la investigación con el penetrómetro stepwedge y el fotodensitómetro

The aim of this study was to assess a bilateral comparison of the mandible density in both sex young patients with computer densitometry. Fifty panoramic radiographs were obtained from young patients with ages between 18 and 23 years old (group A = 25 female and group B = 25 male) standardized, using the same X-Ray equipment (Siemens, lOKvp, 7mA), scanned with a 282.110 pixels resolution, and transferred later to a computer and using the SIDEXIS (Sirona, USA) program to analyze the bone densitometry performance. Bilateral sites were standardized with the objective to measure the bone density. Obtained data were registered and submitted to statistical analysis. The following means and standard deviations were obtained, in pixels, for the right and the left side, respectively: group A= 154.36±36.90 e 186.12+31.41, group B= 162.07±34.94 and 180.15+30.96. These values show statistical difference between different sides and groups (p<0.05), with a higher bone density on the left side in both groups, especially in group A

El objetivo de este estudio fue realizar una comparación bilateral de la densidad de mandíbula en pacientes jóvenes de ambos sexos con computadora densitométrica ósea. Fueron obtenidas 50 radiografías panorámicas de pacientes jóvenes entre 18 y 23 años de edad (Grupo A = 25 femenino y el grupo B = 25 masculino), utilizando el mismo equipo de radiografía (Siemens, 1 OKvp, 7mA). Se escaneó con una resolución de 282,110 pixels, transfiriéndose luego a un computador para el estudio por medio del programa SIDEXIS (Sirona, USA) para analizar el desempeño densitométrico de hueso. Los sitios bilaterales fueron estandarizados con el objetivo de medir la densidad de hueso. Los datos obtenidos fueron registrados y sometidos a análisis estadístico. Las medias y los desvíos padrón fueron obtenidos en pixels, para el lado derecho y el lado izquierdo, respectivamente: Grupo A = 154,36±36,90 y 186,12±31,41, grupo B = 162,07±34,94 y 180,15±30,96. Estos valores muestran la diferencia estadística entre lados y grupos diferentes (p<0,05), con una densidad más alta de hueso en el lado izquierdo en ambos grupos, especialmente en grupo A

The objective investigation is to study and analyze the sensibility of the esqueletonization methodology in the alterations of the trabecular bone pattern in digital panoramic radiographies. In order to use this analysis and look changes in the bone density in the trabecular structure in healthy patients and with osteoporosis.The elements analyzed consist in five dry human mandibles. The four studied zones of each mandible were selected in the mandible body under the alveolar bone, studied zones: 1) Bucal and anterior to the right mental foramen, 2) Bucal and posterior to the right mental foramen, 3) Bucal and anterior to the left mental foramen, 4) Bucal and posterior to the left mental foramen.We realized the digital panoramic radiographies. After the first radiography we cut the delimited areas removing the buccal cortical plates. we did intentional fractures in the trabecular bone. Then we replace the buccal cortical plates and realized the second radiography, using the support created for the mandibles replacement, maintaining the fixed guide lines for each specimen. mid Sagital plane, canine line and Frankfurt Plane.The studied zones were analyzed in the software using the Watanabe 2003 Method. The studied images that show the trabecular bone squeleton were analyzed using: Histogram, particulas analysis, Fractal dimension, unions quantity or trabecuialr third union and the trabecular percent.The statistical analysis of the different zones before and after of the renovation and insertion didn't show a statistical important difference. The trabecular that the panoramic radiography showed were formed for the insertions in the corticals. The method of take off the cortical bone plates just breaks part inside the mandible body

Nuestro propósito fue estudiar la sensibilidad de la metodología de esqueletonizacion en las alteraciones del patrón óseo trabecular, en radiografías panorámicas digitales. Con el fin de poder utilizar esta metodología a futuro para el análisis y la observación de los cambios de densidad ósea en la estructura trabecular, en pacientes con osteoporosis y sanos. El material examinado consistió en cinco mandíbulas adultas, maceradas. Los 4 sitios de interés de cada mandíbula fueron escogidos en cuerpo mandibular, debajo de los alvéolos dentarios: Sitio 1. Oral y anterior al foramen mentoniano derecho. Sitio 2. Oral y posterior al foramen mentoniano derecho. Sitio 3. Oral y anterior al foramen mentoniano izquierdo. Sitio 4. Oral y posterior al foramen mentoniano izquierdo. Se realizó la toma de radiografías panorámicas digitales. Posterior a la primera toma radiográfica, se recortaron las áreas delimitadas removiendo las tablas vestibulares, Se fracturó intencionalmente el trabeculado óseo y luego se reubicaron las tablas vestibulares y se realizó una segunda toma radiográfica, con el uso de un soporte confeccionado para el posicionamiento de las mandíbulas, manteniendo las líneas guía fijas,para cada especimen: Plano mediano, Línea canina y Plano de Frankfurt. Los sitios de interés fueron trabajados en software, siguiendo el método empleado por Watanabe (2003), las imágenes resultantes, que muestran los esqueletos de las trabéculas óseas fueron analizadas utilizando las siguientes herramientas: Histograma, Análisis de partículas, Dimensión fractal, Cantidad de Uniones o encuentro triple de trabéculas y Porcentaje de trabéculas por área. En el análisis estadístico según los datos obtenidos de las diferentes regiones, antes y después de la remoción/inserción, no se encontró una diferencia estadísticamente significativa. Las trabéculas vistas en la radiografía panorámica son formadas principalmente por inserciones en las corticales. El método de retirar la tabla ósea proporcionó apenas una ruptura en el interior (segmento) del cuerpo mandibular

OBJETIVO: avaliar radiograficamente a qualidade óssea no local da distração osteogênica. METODOLOGIA: vinte ratos foram divididos em 2 grupos: Distração Osteogênica (DO) e Controle (C). Os animais do grupo DO foram submetidos à osteotomia da mandíbula, fixação de um aparelho distrator e aplicação de força de distração osteogênica. Os animais do grupo C serviram como controle para a avaliação do tecido ósseo produzido pela técnica da distração osteogênica. As mandíbulas desses animais foram segmentadas transversalmente, tiveram seus segmentos separados em 2,5mm de forma aguda no ato cirúrgico e fixados nessa posição. Nos 2 grupos, os animais foram sacrificados com 2 e 6 semanas após o término da DO (5 animais em cada período). As mandíbulas foram radiografadas simultaneamente, sobre o mesmo filme radiográfico. As imagens obtidas foram digitalizadas e submetidas à análise de densitometria óssea. RESULTADOS E CONCLUSÕES: os grupos DO e C não apresentaram diferenças estatísticas na neoformação óssea nos períodos analisados. As mandíbulas dos dois grupos apresentaram consolidação incompleta na segunda semana e consolidação completa 6 semanas após a distração osteogênica e estabilização. As diferenças encontradas entre esses dois períodos foram significativas apenas para o grupo DO.

AIM: radiograph evaluation of osteogeneous distraction sites. METHODS: twenty rats were divided in 2 groups: Osteogeneous Distraction (OD) and Control (C). The animals of the OD group were subjected to mandibular osteotomy, fixation of a distractor device and application of osteogenic distraction force. Rats of the C groups were used as control on the evaluation of the osseous tissue formed from the osteogeneous distraction technique. These animals mandible (C group) were transversely segmented, the segments were acurately separeted one from other in 2,5mm and then fixed in position. The animals of both groups were sacrificed after 2 and 6 weeks of the end of the OD (5 animals in each period for both groups). All of the mandible were simultaneously radiographied over the same radiographic film. Images obtained from X-ray were scanned and the osseous densitometry performed. RESULTS AND CONCLUSIONS: there were found no significant difference between 2 groups in nome of the periods evaluated. Mandible of both groups showed incomplete osseous consolidation after 2 weeks while after 6 weeks it was found complete consolidation. It was found significant difference in ossoeus densitometry between the periods of evaluation (2 and 6 weeks) only to OD group.