ABSTRACT Objective: The present study aimed to evaluate cone beam computed tomography image segmentation as a tool for measuring the volume of external inflammatory root resorption in human permanent teeth. Methods: A total of 40 cone beam computed tomography images of permanent maxillary and mandibular anterior teeth diagnosed with external inflammatory root resorption. The images were exported in the DICOM format to the Materialise MIMICS software program (version 10.01; Materialise NV, Belgium) for segmentation and characterisation of resorption cavities in terms of location, number of reabsorption sites, relationship to resorption sites, and nominal and percentage volumetric beside assessment of root resorption cavities and remaining root volume. All measurements were performed in duplicate and blindly by a trained radiologist at an interval of 30 days to analyse the intraclass correlation coefficients. Results: The nominal volumetric measures of root resorption cavities ranged from 0.6 mm3 to 114.4 mm3 (median, 13.2 mm3). The percentage volume of root resorption cavities ranged from 0.37% to 39.44% (median, 4.73%). The nominal of remaining root volume ranged from 88 mm3 to 401.3 mm3 (median, 212.4 mm3). The percentage of remaining root volume ranged from 60.34% to 99.63% (median, 95.37%). Conclusions: The results of this preliminary study suggest that segmentation is an effective and reproducible tool for measuring the volumetric size of external inflammatory root resorption cavities. Further longitudinal studies are needed to explore the usefulness of cone beam computed tomography image segmentation in improving external inflammatory root resorption diagnosis and supporting decision making for the treatment of such conditions. Objective Methods 4 version 10.01 1001 10 01 NV Belgium location sites 3 coefficients Results 06 0 6 0. mm 1144 114 114. median, median (median 132 13 2 13. mm3. . mm3) 037 37 0.37 3944 39 44 39.44 4.73%. 473 4.73% 73 4.73%) 8 4013 401 401. 2124 212 212. 6034 60 34 60.34 9963 99 63 99.63 95.37%. 9537 95.37% 95 95.37%) Conclusions conditions 10.0 100 1 11 03 0.3 394 39.4 47 4.73 7 21 603 60.3 996 9 99.6 953 95.37 10. 39. 4.7 60. 99. 95.3 4. 95.

RESUMO Objetivo: O presente estudo teve como objetivo avaliar a segmentação de imagens de tomografia computadorizada de feixe cônico como ferramenta para medir o volume de reabsorção radicular inflamatória externa em dentes permanentes humanos. Métodos: Um total de 40 imagens de tomografia computadorizada de dentes anteriores permanentes superiores e inferiores com diagnóstico de reabsorção radicular inflamatória externa. As imagens foram exportadas no formato DICOM para o software Materialize MIMICS (versão 10.01; Materialize NV, Bélgica) para segmentação e caracterização das cavidades de reabsorção em termos de localização, quantidade de sitios de reabsorção, relação com locais de reabsorção e avaliação volumétrica nominal e percentual da raiz. Além da avaliação das cavidades de reabsorção radicular e do volume radicular remanescente. Todas as medidas foram realizadas em duplicata e às cegas por um radiologista treinado com intervalo de 30 dias para análise dos coeficientes de correlação intraclasse. Resultados: As medidas volumétricas nominais das cavidades de reabsorção radicular variaram de 0,6 mm3 a 114,4 mm3 (mediana de 13,2 mm3). O volume percentual de cavidades de reabsorção radicular variou de 0,37% a 39,44% (mediana, 4,73%). O volume nominal de volume radicular remanescente variou de 88 mm3 a 401,3 mm3 (mediana 212,4 mm3). O volume percentual de volume radicular remanescente variou de 60,34% a 99,63% (mediana, 95,37%). Conclusões: Os resultados deste estudo preliminar sugerem que a segmentação é uma ferramenta eficaz e reprodutível para medir o tamanho volumétrico das cavidades com reabsorção radicular inflamatória externa. Mais estudos longitudinais são necessários para explorar a utilidade da segmentação de imagens de tomografia computadorizada de feixe cônico na melhoria do diagnóstico de reabsorção radicular inflamatória externa e no apoio à tomada de decisões para o tratamento de tais condições. Objetivo humanos Métodos 4 versão 10.01 1001 10 01 NV Bélgica localização raiz 3 intraclasse Resultados 06 0 6 0, mm 1144 114 114, mediana 132 13 2 13, mm3. . mm3) 037 37 0,37 3944 39 44 39,44 mediana, 4,73%. 473 4,73% 73 4,73%) 8 4013 401 401, 2124 212 212, 6034 60 34 60,34 9963 99 63 99,63 95,37%. 9537 95,37% 95 95,37%) Conclusões condições 10.0 100 1 11 03 0,3 394 39,4 47 4,73 7 21 603 60,3 996 9 99,6 953 95,37 10. 39, 4,7 60, 99, 95,3 4, 95,

RESUMO Objetivo: Avaliar a frequência dos forames linguais mediais presentes na cortical da mandíbula por meio da tomografia computadorizada de feixe cônico (TCFC). Métodos: Um total de 953 exames de TCFC da mandíbula foram avaliados para determinar a presença de canais na linha média mandibular, localização do canal em relação ao tubérculo geniano, diâmetro do canal, distância à base e crista alveolar da mandíbula, trajetória da canal e medidas de coincidência da imagem panorâmica contendo a localização do canal em relação ao tubérculo geniano. Resultados: Os forames localizaram-se em três posições: acima do tubérculo (FSS) 89,2%, abaixo do tubérculo (FIS) 67,9% e outras posições (FOP) 21,3%. Indivíduos não edêntulos apresentaram um número significativamente maior de FSS do que indivíduos edêntulos (P <0,001). Indivíduos do sexo masculino apresentaram distâncias significativamente maior do FSS (P = 0,001), FIS (P = 0,045) e FOP (p = 0,002) até a base da mandíbula do que indivíduos do sexo feminino. Os indivíduos mais jovens apresentaram uma distância significativamente maior do FSS (P = 0,001) e FIS (P = 0,001) até a crista alveolar da mandíbula. Indivíduos do sexo masculino tiveram um diâmetro de FIS (P = 0,002) e FOP (P = 0,001) significativamente maior do que indivíduos do sexo feminino. Indivíduos do sexo masculino tiveram um número significativamente maior de bifurcações no FOP do que indivíduos do sexo feminino (P = 0,017). Conclusão: a TCFC fornece ao profissional uma avaliação detalhada dos forames e canais, o que melhora a qualidade do planejamento cirúrgico e diminui as chances de intercorrências.

ABSTRACT Objective: To evaluate the frequency of medial lingual foramina present in the cortex of the mandible using cone beam computed tomography (CBCT). Methods: A total of 953 CBTC exams of the mandible were evaluated to determine the presence of canals in the mandibular midline, canal location in relation to the mental spine, canal diameter, distance to the base and alveolar crest of the mandible, trajectory of the canal, and coincidence measurements of the panoramic image containing the location of the canal in relation to the mental spine. Results: Foramina were located in three positions: above the mental spine (FSS) 89.2%, below the mental spine (FIS) 67.9%, and other positions (FOP) 21.3%. Non-edentulous individuals had a significantly higher number of FSS than did edentulous individuals (P<0.001). Male individuals presented a significantly greater distance from the FSS (P=0.001), FIS (P=0.045) and FOP (p=0.002) to the base of the mandible than female individuals. Younger individuals presented a significantly higher distance from the FSS (P=0.001) and FIS (P=0.001) to the alveolar crest of the mandible. Male individuals had a significantly greater FIS (P=0.002) and FOP (P=0.001) diameter than female individuals. Male individuals had a significantly higher number of bifurcations in FOP than female individuals (P=0.017). Conclusion: CBCT supplies the provider with a detailed assessment of the foramina and canals, which improves the quality of surgical planning and mitigates the chances of surgical intercurrences.

Abstract The present study aimed to evaluate the performance of cone beam computed tomography (CBCT) and digital periapical radiographs (PR) in diagnosing external root resorption (ERR) in human permanent teeth replanted after traumatic avulsion. The samples comprised 39 permanent maxillary incisors replanted after traumatic avulsion. Digital PR and CBCT images were taken from each tooth and independently examined by 2 calibrated examiners to assess the ERR activity regarding type and extension. The degrees of agreement between both imaging examinations were determined by the mean global agreement index using SPSS software. The two imaging examinations diverged greatly in the diagnosis of the type of ERR since CBCT identified more cases as inflammatory ERR and PR as replacement ERR. A discordance level of 69.2% was observed between the two methods in the diagnosis of the type of ERR when CBCT for mesial and distal (MD) surfaces was considered and 61.5% when CBCT for mesial, distal, buccal and lingual (MD/BL) was considered. Likewise, CBCT and PR differed regarding the ERR index. PR examinations classified most cases as moderate or severe (69.2%), while CBCT examinations classified more cases as mild either in the MD surfaces analysis (41.4%) or in the analysis of the MD-BL surfaces (51.3%). In conclusion, the present results highlight a discrepancy between CBCT and digital PR performance in the diagnosis of different types and extent of ERR in replanted teeth.

Consideráveis evidências indicam que mecanismos serotoninérgicos, particularmente o transportador de serotonina, estão envolvidos no alcoolismo e no uso de fumo e são influenciados pelo polimorfismo da região promotora do 5HTT (5-HTTLPR). Como o consumo de álcool e fumo está implicado na patogênese do câncer, o objetivo deste estudo foi investigar o polimorfismo 5-HTTLPR em pacientes com carcinoma bucal de células escamosas (CBCE) comparado com um grupo controle em uma amostra de pacientes brasileiros. Cento e três pacientes afetados por CBCE e 103 voluntários sem história de CBCE foram genotipados para 5-HTTLPR. Ambos os grupos foram pareados pela idade, gênero e uso de fumo. O teste do qui-quadrado foi usado para análise estatística. Não houve diferença estatística entre os genótipos dos grupos caso e controle (p= 0,408). Concluindo, a presente investigação demonstrou que os polimorfismos do transportador de serotonina não estão implicados no desenvolvimento do CBCE.

Considerable evidence indicates that serotonergic mechanisms, particularly the serotonin transporter, are involved in alcoholism and tobacco use and are influenced by polymorphism of the promoter region of 5HTT (5-HTTLPR). As alcohol and tobacco consumption have been implicated in the pathogenesis of oral cancer, the purpose of this study was to investigate 5-HTTLPR polymorphism in patients with oral squamous cell carcinoma (OSCC) compared with a control group in a sample of Brazilian patients. One hundred and three patients affected by OSCC and 103 volunteers without OSCC were genotyped for 5-HTTLPR. Both groups were matched for age, sex and tobacco use. The chi-squared test was used for statistical analysis (α=0.05). There was no statistically significant difference in 5-HTTLPR genotypes between case and control group (p= 0.408). In conclusion, the present investigation demonstrated that serotonin transporter polymorphisms are not implicated in the OSSC development.

Objective: One of the most important objectives of a public health service is early diagnosis of disease, which provides a better prognosis and reduction in treatment cost. We investigated the delay for diagnosis and treatment of oral cancer in a public hospital. Material and methods: One hundred eighty records of patients who attended for their first consultation in the department of head and neck surgery in a public hospital from Belo Horizonte-Brazil, between the period from 1 January 1999 to 31 December 2001 were analysed. The following variables were analyzed: gender, age, evolution time (ET), time elapsed from referral to hospital and first appointment (RT), time elapsed from first appointment and treatment (TT), total time elapsed from first noticing the lesion and starting treatment (TTE), sites and staging. Results: Results for males and females were, respectively: mean age = 57.9 and 60.8 years; ET= 169.4 and 215.4 days; RT = 27.9 and 40.6 days; TT = 40.9 and 44.9days; TTE = 207.9 and 263.8 days. No correlation was observed between age and TTE for either gender. Women presented the highest mean values for ET and TTE (p<0.01). Conclusion: It was concluded that public health policy should be developed to address the excessively long time lapsed between diagnosis and treatment as well as improve public health education programs to promote early oral cancer identification.

Tonsillolith is a rare dystrophic calcification as a result of chronic inflammation of the tonsils. Three asymptomatic cases of tonsillolith are reported, incidentally discovered through panoramic radiographs, which showed different sizes of radiopaque images, varying from 2 to 5mm; cases I and III images did not overlap the mandible ramus, which led to a probable diagnosis of soft tissue calcification. Case II had radiopaque unilateral images, with osseous tissue density, overlapping the mandibular ramus, leading to a benign intra-osseous lesion, which was considered as differential diagnosis. No symptoms were reported in any case. Only case I had clinical characteristics, showing highly consistent white plaques partially visible through the mucosa. Computed tomography of the maxillofacial region/head and neck were requested to find out the exact location of these images, since most of the overlapping radiopaque images in the mandibular ramus were very similar to intra-osseous abnormalities. The computed tomography showed hyperdense images in the palatine tonsils, confirming the diagnosis of tonsillolith. The patients are currently under follow-up. No treatment is required if there is no symptom. In conclusion, tonsillolith might show images on panoramic radiographs similar to intra osseous abnormalities. The diagnosis is relatively easy when computed tomography is requested, although the images are not pathognomonic. Therefore, clinicians should consider other pathologies as differential diagnosis.

El tonsilolito es una calcificación distrófica rara que surge como consecuencia de la inflamación crónica de las amígdalas. Se relatan tres casos asintomáticos de tonsilolitos, descubiertos durante el examen radiográfico de rutina por medio de radiografías panorámicas, que mostraron distintos tamaños de imágenes radiopacas, que variaron entre 2 y 5 mm. Los casos I y III presentaron imágenes que no se sobrepusieron a la línea de la mandíbula, lo que condujo a un diagnóstico probable de calcificación de tejido suave. El caso II tenía una imagen radiopaca unilateral, con densidad ósea, sobreponiéndose a la línea de la mandíbula, conduciendo a una lesión benigna intra-ósea, que fue considerada como el diagnóstico diferencial. No se encontraron síntomas en ningún caso. Sólo el caso I tenía características clínicas, mostrando unas placas blancas, visibles a través de la mucosa. Fueron solicitadas tomografías computarizadas de la región maxilo-facial para averiguar la ubicación exacta de estas imágenes, ya que la mayor parte de la superposición de las imágenes radiopacas en la línea mandibular era muy similar a anormalidades intra-óseas. Las tomografías computarizadas mostraron imágenes hiperdensas en las amígdalas palatinas, confirmando el diagnóstico de tonsilolitos. Los pacientes están actualmente en seguimiento. No se requiere tratamiento si no existen síntomas. Concluyendo que los tonsilolitos pueden mostrar imágenes en las radiografías panorámicas similares a alteraciones intra-óseas. El diagnostico es relativamente fácil cuando la tomografía computarizada es solicitada, a pesar de que las imágenes no son patognomónicas.

Oral Myiasis is a rare pathology in humans and is associated with poor oral hygiene, alcoholism, senility, supuranting lesions, severe halitosis and others conditions. The treatment is a mechanical removal of the maggots one by one but a systemic treatment with Ivermectin, a semi-synthetic macrolide antibiotic, have been used for treatment for oral myiasis. We present a case report of a 32-year-old man indigent, alcohol-dependent with an extensive necrotic area and acute swelling in upper lip and fetid odor. The patient’s manegement included topic use of gencian violet, oral therapy with ivermectin (6 mg orally), surgical exploration to remove the larvae and necrotic tissue. After the complete larvae removal the swelling and the wounds were healing normally, the patients was referred to plastic surgery to repair tissue damage. The prevention of human myiasis is by education, but unfortunately in the developing countries some people live in low social condition, predisposing the occurrence of the infestation.