Abstract The objective of this study was to evaluate the fractal dimension (FD) and lacunarity of the mandibular bone, comparing patients with and without osteoradionecrosis (ORN). In a cross-sectional study with a control group, 25 patients were included and divided into a case group (with ORN, n = 14) and a control group (without ORN, n = 11). A digital panoramic radiograph taken after the end of radiotherapy (RT) was evaluated for each patient. FD and lacunarity of the mandibular bone were determined using ImageJ software. Descriptive, bivariate, and ROC curve analyses were performed. Cohen's d effect sizes were calculated. Significance was established at p < 0.05. The mean FD and lacunarity values were not significantly different between the groups. The area under the curve for FD and lacunarity were 0.579 and 0.661, respectively. The cut-off point for FD was ≤1.1714 and for lacunarity, > 0.3821, correctly classifying the majority of cases and controls. Most participants in the case group (63.6%) had a FD ≤ 1.1714 and the majority of participants in the control group (63.6%) had a FD >1.1714 (p = 0.395). For lacunarity, most individuals in the case group (72.7%) had a value > 0.3821 and most participants in the control group (63.6%) had a value ≤ 0.3821 (p = 0.198). In conclusion, the FD and lacunarity values did not show statistically significant differences between patients with and without ORN. However, the moderate and large magnitude of the effects seem to indicate that the results may be clinically relevant. (FD ORN . (ORN) crosssectional cross sectional 2 14 11. 11 11) RT (RT patient software Descriptive bivariate performed Cohens Cohen s calculated 005 0 05 0.05 groups 0579 579 0.57 0661 661 0.661 respectively cutoff cut off 11714 1 1714 ≤1.171 03821 3821 controls 63.6% 636 63 6 (63.6% 1.171 >1.171 0.395. 0395 0.395 395 0.395) 72.7% 727 72 7 (72.7% 0.382 0.198. 0198 0.198 198 0.198) conclusion However relevant (ORN 00 0.0 057 57 0.5 066 66 0.66 1171 171 ≤1.17 0382 382 63.6 (63.6 1.17 >1.17 039 0.39 39 72.7 (72.7 0.38 019 0.19 19 0. 5 06 0.6 117 17 ≤1.1 038 38 63. (63. 1.1 >1.1 03 0.3 3 72. (72. 01 0.1 ≤1. (63 1. >1. (72 ≤1 (6 >1 (7 (

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,

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: 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 We evaluated the accuracy of radiomorphometric indices (RI) and fractal dimension (FD) for screening bone mineral density (BMD) in postmenopausal patients who had breast cancer and were using aromatase inhibitors (AI). The sample consisted of 40 participants. Digital panoramic radiography (DPR) and cone beam computed tomography (CBCT) were evaluated along with dual-energy X-ray absorptiometry (DXA), which is the gold standard for detecting low BMD. According to the T-scores of DXA, the subjects were assigned into two groups: with normal BMD and with low BMD (osteopenia and osteoporosis). The area under the curve (AUC), sensitivity, and specificity with their respective confidence intervals were determined for DPR and CBCT. For DPR indices, AUC ranged from 52.6 to 75.8%. The mandibular cortical width (MCW) had the highest AUC. For FD, the total trabecular index had the highest sensitivity, while the index anterior to the mental foramen (MF) had the highest specificity. In CBCT, the AUC ranged from 51.8 to 62.0%. The indices with the highest AUC were the molar (M) and anterior (A). The symphysis (S) index had the highest sensitivity and the posterior (P) index had the highest specificity. Sensitivity and specificity were adequate for the computed tomography index (Inferior; CTI [I]). Therefore, MCW, FD of the mandible angle, and total trabecular ROI in DPR and the CTI (I), M, P, and A indices in CBCT proved to be promising tools in distinguishing individuals with low BMD. Cutoff point for these indices could be a useful tool to investigate low BMD in postmenopausal women taking AI.

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.

RESUMO A displasia cemento-óssea florida é um subtipo de lesão fibro-óssea que geralmente aparece nos ossos gnáticos de mulheres negras de meia idade. Clinicamente a displasia cemento-óssea florida é assintomática. Os aspectos radiográficos mostram uma área radiolucente com várias massas de estruturas radiopacas, tipicamente encontradas próximas às raízes dos dentes. O tratamento é requerido quando ocorre infecção devido à exposição da lesão na cavidade oral. Em casos mais severos, dor e deformidade podem estar presentes. Concomitante a higiene oral, visitas de rotina ao dentista são recomendadas ao indivíduo afetado. O objetivo deste estudo foi apresentar o caso clínico de uma mulher de 24 anos de idade, cor da pele branca com diagnóstico de displasia cemento-óssea florida com acompanhamento de 13 anos. Algumas alterações no padrão radiográfico foram observadas, como a mineralização progressiva da lesão. Tratamento ortodôntico foi realizado em um serviço privado. Não foi realizado exodontia. Esta alteração era esperada, pois a displasia cemento-óssea florida tem diferentes estágios de desenvolvimento. É sugerido, portanto, que a presença da displasia cemento-óssea florida não impediu o sucesso do tratamento ortodôntico.

ABSTRACT Florid cemento-osseous dysplasia is a subtype of fibrous-osseous lesion that commonly appears in the jaws of middle-aged black women. Clinically, the florid cemento-osseous dysplasia is asymptomatic. The radiographic aspect shows a radiolucent area with several masses of radiopaque structures, typically found in the toothbearing areas. Usually, the diagnosis is made during routine radiographic examination. The treatment is required when infection occurs due to exposure of the lesion in the oral cavity. In these severe cases, pain and facial deformity may be present. Commitment oral hygiene and routine dental visits for check-up are recommended for individuals affected. The objective of this study was to present a clinical case of a 24-year-old white woman with florid cemento-osseous dysplasia, who had been under surveillance for 13 years. Some changes in the radiographic pattern were observed as the orthodontic treatment was carried out in a private service. No tooth extraction was performed. This change is expected because florid cemento-osseous dysplasia has different radiographic aspects that correspond to the different developmental stages of the lesion. It is suggested, however, that the presence of florid cemento-osseous dysplasia did not preclude the success of the orthodontic treatment.

Abstract This clinical trial compared the efficacy of doxycycline (DOX) in β-cyclodextrin (DOX)/βCD) with DOX- alone in gel on thirty-three subjects with periodontitis. Patients were randomized to group 1 GI; 10% DOX + scaling and root planning (SRP); group 2 (GII (10% DOX /β-CD + SRP), and group 3 (GIII; SRP). Gels were applied in GI and GII at baseline (T0) and 30 days later (T1). Periodontal Probing Depth (PPD), Clinical Attachment Level (CAL), Bleeding on Probing (BOP) and Visible Plaque Index (VPI) were evaluated at (T0), 30 days (T1) and 60 days after T0 (T2). Bone density was analyzed after 18 months (T3). GII showed the most significant reduction of PPD (2.62 mm; p <0.003), and greatest gain in CAL (2.54 mm p <0.003) at T2. BOP and the VPI had a strong reduction in all groups at T2 (p <0.05), both decreased by ≥5 times and 2 times, respectively, in all groups at T1. Bone density increased in all groups in radiographs (T3). The use of DOX encapsulated in β-CD gel with SRP resulted in significant improvements in clinical periodontal parameters; such molecular inclusion of doxycycline into β-CD in gel for local application is relatively simple and useful in dentistry.

Abstract Osteoporosis is an insidious and increasingly prevalent disease that can cause fractures and affect patients’ quality of life. The current study comparatively evaluates patients with and without loss of bone mass in terms of salivary calcium, viscosity, and pH. A controlled cross-sectional study was conducted in two groups of 32 postmenopausal women subjected to a bone densitometry scan and later referred for dental management at the Federal University of Minas Gerais, Brazil. The patients were assigned to two groups: Group 1 - patients with low bone mineral density (BMD) and Group 2 - patients without bone mineral changes. The following salivary parameters were evaluated: calcium concentration, flow rate, viscosity, pH, and average total protein. An oral examination was performed for assessment of DMFT variables and tongue coating. Data were analyzed using descriptive and inferential statistics, adopting a p-value < 0.05. The patients’ mean age was 60 years (± 7.35). Salivary flow, pH, and viscosity were similar among the groups. Average total protein was 14.8 mg/mL and 19.0 mg/mL in Groups 1 and 2, respectively. Tongue coating and salivary calcium levels were significantly higher in Group 1 (p < 0.001). Salivary calcium is an important screening tool and may eventually be used for the diagnosis of bone mineral changes.

OBJETIVO: O objetivo deste estudo foi identificar processos inflamatórios na articulação temporomandibular empregando leucócitos autólogos marcados com tecnécio-99m hexametilpropilenoaminooxima (99mTc-HMPAO). MATERIAIS E MÉTODOS: Foi utilizado um modelo experimental de indução de artrite na articulação temporomandibular de dez coelhos machos da raça Nova Zelândia, por meio da injeção intra-articular de ovalbumina na articulação temporomandibular esquerda de cada animal. Para controle, na articulação contralateral foi injetada solução salina. Após a marcação dos leucócitos com 99mTc-HMPAO e injeção endovenosa deste complexo nos coelhos, imagens cintilográficas foram obtidas. RESULTADOS: Observou-se captação aumentada dos 99mTc-HMPAO-leucócitos na articulação temporomandibular esquerda quando comparada à direita. A análise estatística foi realizada utilizando-se o teste não-paramétrico de Wilcoxon. Houve diferença estatisticamente significativa dos valores das contagens por minuto de radioatividade, relativos à articulação inflamada quando comparados aos valores obtidos na articulação contralateral (p = 0,0073). CONCLUSÃO: O método empregando leucócitos autólogos marcados com 99mTc-HMPAO é capaz de identificar focos inflamatórios de forma precoce e precisa, o que poderá contribuir na conduta terapêutica dos pacientes, antes que alterações estruturais sejam instaladas.

OBJECTIVE: The present study was aimed at identifying temporomandibular joint inflammatory processes employing technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO)-labelled autonomous leukocytes. MATERIALS AND METHODS: We have utilized an experimental model of arthritis induction in ten adult male New Zealand rabbits by means of ovalbumin intra-articular injection into each left temporomandibular joint. For control purposes, saline solution was injected. After leukocytes radiolabelling with 99mTc-HMPAO and injection into rabbits, scintigraphic images were obtained. RESULTS: A higher 99mTcHMPAO-leukocytes uptake was observed in left temporomandibular joint in comparison with the contralateral joint. Wilcoxon non-parametric test was applied for statistical analysis. There was a statistically significant difference between counts of radioactivity per minute in the inflammed joint and the contralateral one (p = 0.0073). CONCLUSION: The method employing 99mTc-HMPAO-labelled autologous leukocytes allows an early and accurate detection of inflammatory processes, contributing to the adoption of a therapeutic conduct for patients before structural alterations have occurred.