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Oral Squamous Cell Carcinoma (OSCC) is conventionally treated by surgical resection, and positive surgical margins strongly increase local recurrence and decrease survival. This study aimed to evaluate whether a Three-Dimensional Segmentation (3DS) image of OSCC confers advantage over Multiplanar Reconstruction (MPR) of OSCC using images of computed tomography scan in surgical planning of tumor resection.Twenty-six patients with locally advanced OSCC had tumor morphology and dimensions evaluated by MPR images, 3DS images, and Surgical Pathology Specimen (SPS) analyses (gold standard). OSCC resection was performed with curative intent using only MPR images.OSCC morphology was more accurately assessed by 3DS than by MPR images. Similar OSCC volumes and dimensions were obtained when MPR images, 3DS images and SPS measurements were considered. Nevertheless, there was a strong correlation between the OSCC longest axis measured by 3DS and SPS analyses (ICC = 0.82; 95% CI 0.59‒0.92), whereas only a moderate correlation was observed between the longest axis of OSCC measured by MPR images and SPS analyses (ICC = 0.51; 95% CI 0.09‒0.78). Taking only SPS with positive margins into account, MPR images and 3DS images underestimated the tumor's longest axis in eight out of 11 (72.7%) and 5 out of the 11 (45.5%) cases, respectively.Our data present preliminary evidence that 3DS model represents a useful tool for surgical planning of OSCC resection, but confirmation in a larger cohort of patients is required.Laboratory study.

Made available in DSpace on 2022-04-28T19:47:30Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objective: The aim of this study was to investigate the TMJ components in patients with juvenile idiopathic arthritis (JIA) and to compare them with a control group based on magnetic resonance imaging (MRI) measurements. Methods: This study comprised an assessment of MRI measurements of 96 temporomandibular joints (TMJ) following classification criteria set by the International League of Associations for Rheumatology (ILAR). Three measurements were considered for study: condyle excursion angle (CEA), height of articular eminence (HAE) and inclination of articular eminence (IAE). All TMJs were assessed by linear measurements made by using the OnDemand 3D software. The comparison between the groups was performed by using Mann–Whitney’s test. Results: Lower measurement values were found for IAE, HAE and CEA in JIA patients (P-values < 0.001, 0.005 and < 0.001, respectively). Conclusion: The study showed the differences in MRI measurements between JIA patients and controls, with the former with the lowest indices. Postgraduate Program in Dentistry Cruzeiro Do Sul University (UNICSUL), Rua Galvão Bueno, 868, Liberdade Rheumatology Department Faculty of Medical Sciences University of Campinas (UNICAMP) Department of Diagnosis and Surgery São José Dos Campos School of Dentistry São Paulo State University (UNESP) Department of Orthodontics Univeritas UNG Department of Oral Medicine and Pathology Institute of Odontology The Sahlgrenska Academy University of Gothenburg Department of Diagnosis and Surgery São José Dos Campos School of Dentistry São Paulo State University (UNESP)

Dentigerous cyst is the most common developmental maxillary cyst, often being associated with impacted third molars. The occurrence of bilateral or multiple lesions is usually associated with syndromes. The present report describes a case of multiple dentigerous cyst affecting both maxilla and mandible in association with impacted third molars in a non-syndromic patient. The complementary use of cone beam computed tomography (CBCT) could provide accurate knowledge for pre-operative radiologic assessment to delineate the extension of the lesion as well as its relationship with adjacent structures. The typical imaging characteristics can be useful for an adequate diagnosis. This type of lesion requires comprehensive pre-operative evaluation and logical operational approach.

Made available in DSpace on 2021-06-25T11:08:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 Objective: To assess volume and surface of the mandibular condyle on cone beam computed tomography (CBCT) scans by comparing Class I, II, and III malocclusions. Methods: CBCT scans of 55 patients were assessed to measure ANB angle, condyle volume, and surface by using VistaDent software. The values were compared between the different skeletal malocclusions and correlated to gender and sides. Kruskal–Wallis test was used for comparison of malocclusions and Mann–Whitney test and Wilcoxon test for comparisons of genders and sides. Statistical significance was defined as p

The odontogenic keratocyst is a benign cystic lesion that preferentially affects the posterior region of the mandible, having an infiltrative and aggressive feature with unique and varied behavior, high recurrence rates, and distinct molecular findings among odontogenic lesions. Also, its differential diagnosis and treatment is a challenge, due to the presence of other lesions of the jaw with similar aspects. The present study aims to report a clinical case of odontogenic keratocyst associated with a third molar included in an ectopic position, focusing on its radiographic and tomographic characteristics that are confused with a dentigerous cyst.

Introduction: Medication-related osteonecrosis of the jaw (MRONJ) occurs by the use of a drug that has osteonecrosis as one of its side effects. Case Report: We describe a case of a 48-year-old oncological patient who had brain and bone metastasis due to breast cancer and was medicated with bisphosphonates (BPs). She presented cavities, and after an incorrect exodontia, the lesion evolved into a jaw osteonecrosis. Then she did a sequestrectomy and was treated using laser therapy. Radiological and clinical features are also described. Conclusion: In a case like this, we notice how necessary is a complete evaluation of the oncological patient before some procedures and laser therapy as an effective ally in the management.

Made available in DSpace on 2020-12-12T01:38:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-09-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Background: The aim of this study was to apply texture analysis (TA) to cone-beam computed tomography (CBCT) scans of patients with grade C periodontitis for detection of non-visible changes in the image. Methods: TA was performed on CBCT scans of 34 patients with grade C periodontitis. Axial sections of CBCT were divided into three groups as follows: Group L (lesion) in which there is a furcal lesion with periodontal bone loss; Group I (intermediate) in which the border of the furcal lesion has normal characteristics; and Group C (control) in which the area is healthy. Eleven texture parameters were extracted from the region of interest. Mann-Whitney U test was used to assess the differences in the texture between the three groups as follows: L versus I; L versus C, and I versus C. Results: Statistically significant differences (P

Made available in DSpace on 2019-10-06T15:43:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-01-01 This study aimed to investigate the olfactory fossa according to the Keros classification using cone beam computed tomography. This cross-sectional study analysed cone beam computed tomography images selected from a database belonging to a radiology centre. The scans of 174 healthy patients were analysed by using the Xoran software. Gender, age, and side were correlated with the Keros classification. The mean age of the 174 patients was 45.3 years. The most prevalent Keros classification was type II (65.52%), followed by type III (20.69%) and type I (13.79%). No significant differences were found between Keros classification and the variables age, right side (p value = 0.4620), and left side (p value = 0.5709). There were also no significant differences between gender and the variables right side (p value = 0.1421) and left side (p value = 0.2136). Based on these results, we suggest that cone beam computed tomography can be recommended for analysis of the anterior skull base. Keros type II was the most prevalent type in our sample. Postgraduate Program in Dentistry Cruzeiro do Sul University (UNICSUL) Department of Diagnosis and Surgery São José dos Campos Dental School São Paulo State University (UNESP) Department of Orthodontics and Radiology University of São Paulo City (UNICID) Department of Diagnosis and Surgery São José dos Campos Dental School São Paulo State University (UNESP)

Made available in DSpace on 2022-04-28T19:42:02Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objective: The aim of this study was to evaluate whether the volume of odontoid process of the second cervical vertebra on CBCT images can be used for sex estimation. Material and Methods: The volume of odontoid process on CBCT images of 138 subjects was measured. In addition, the patients were classified into five age groups. The comparisons between the groups in relation to sex and age were performed by using Mann-Whitney’s test and Kruskal-Wallis’ test, respectively. The ROC curve was used to assess the sensitivity and specificity of the volume to determine the sex. Results: No statistically significant difference was observed between age and volume. Males had significantly larger volumes than females. Values of volume equal to or greater than 1.254 mm3 have sensitivity of 68.2% and specificity of 68.1% to determine male sex. Conclusion: The volume of the odontoid process tends to be larger in males than in females and can be used as sex estimation. Cruzeiro do Sul University (UNICSUL) Department of Diagnosis and Surgery Institute of Science and Technology São Paulo State University (UNESP), São José dos Campos Department of Diagnosis and Surgery Institute of Science and Technology São Paulo State University (UNESP), São José dos Campos

Made available in DSpace on 2021-06-25T10:25:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objective: The purpose of the present investigation was to assess whether possible changes in the dynamic movements of the TMJ might cause a greater variation between the volumes of the upper airways in open- and closed-mouth positions. Methods: CBCT scans of 92 subjects were used to assess the TMJ bilaterally. All scans were acquired in closed (CM) and maximum mouth opening (MMO) positions. The difference in the volume of the oropharyngeal cavity obtained by subtracting the CM volume from the MMO volume (delta volume or volume variation) was calculated. The resulting volume was analyzed by Mann-Whitney test for variation in rotation. Results: A significant difference was found (p-value = 0.0188) on the right side regarding changes in the rotational movement of the condyle (Mann–Whitney test). Conclusion: This study showed a relationship between degree of abnormal or limited rotation and variation in the upper airway volume on one side. Cruzeiro do Sul University (UNICSUL) Department of Diagnosis and Surgery São José dos Campos Dental School São Paulo State University (UNESP) Department of Stomatology School of Dentistry University of São Paulo Department of Diagnosis and Surgery São José dos Campos Dental School São Paulo State University (UNESP)

Made available in DSpace on 2021-06-25T10:20:40Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objective: Forensic dentistry has used some methods for the human identification process. However, there is a need to study characteristics that are able to perform identification more specifically, increasing accuracy. Considering the role of dental arch assessment in prediction of gender and ethnicity, the purpose of this study was to assess the volume of pulp chamber as a mean to obtain new forensic evidence. Material and methods: For this task, 1.190 cone beam computed tomography (CBCT) images were retrospectively selected and subdivided according to the population number, gender, age and ethnicity. All DICOM files were imported to the open-source software ITK-SNAP® (http://www.itksnap.org/pmwiki/pmwiki.php). The segmentation process was performed in all pulp chamber aiming to obtain pulp tissue’s volume. Results: As a result, the pulp chamber volume of mandibular canine teeth showed to be larger in white population than in non-white (P-value = 0.003) and in male individuals in comparison with female (P-value = 0.038). Conclusion: These results, however, must be confirmed by future studies with a larger sample size and by the assessment of other variables, including texture analysis and density of dental tissues. Institute of Science and Technology Paulista State University Júlio de Mesquita Filho ICT UNESP Department of Stomatology Division of General Pathology School of Dentistry University of São Paulo Cruzeiro do Sul University Institute of Science and Technology Paulista State University Júlio de Mesquita Filho ICT UNESP

Objective This study aimed to investigate the use of texture analysis for characterization of radicular cysts and periapical granulomas and to assess its efficacy to differentiate between both lesions with histological diagnosis. Methods Cone beam computed tomography (CBCT) images were obtained from 19 patients with 25 periapical lesions (14 radicular cysts and 11 periapical granulomas) confirmed by biopsy. Regions of interest were created in the lesions from which 11 texture parameters were calculated. Spearman's correlation analysis was performed and adjusted with Benjamini-Hochberg false discovery rate procedure (FDR, Pathology; Dentistry; Oral Medicine; Eye-Ear-Nose-Throat; Radiology; Medical Imaging; l cone beam computed tomography; computer-assisted diagnosis; image processing, computer-assisted; periapical diseases.

Made available in DSpace on 2021-06-25T10:29:49Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) The aim of this study was to characterize the alveolar bone of edentulous maxillary sites using texture analysis (TA) of cone beam computed tomography (CBCT) images and to correlate the results to the insertion torque, thus verifying whether TA is a predictive tool of final implant treatment. This study was conducted on patients who had received single implants in the maxilla (46 implants) 1 year earlier and whose torque values were properly recorded. Three cross-sections of the sites were selected on CBCT scans. Two regions of interest (ROIs) corresponding to the implant bone site and peri-implant bone were also outlined, according to virtual planning. The CBCT scans were exported to MaZda software, where the two ROIs were delimited following the previously demarcated contours. Values for the co-occurrence matrix were calculated for TA. With regard to the insertion torque value, there was a direct correlation with the contrast of the peri-implant bone (P < 0.001) and an inverse correlation with the entropy of the implant bone site (P = 0.006). A greater contrast indicates a greater torque value for insertion of the implants, and there is a possible association with a lower entropy value of the implant–bone interface. Postgraduate Program in Dentistry Cruzeiro do Sul University (UNICSUL) Department of Diagnosis and Surgery São José dos Campos School of Dentistry São Paulo State University (UNESP) Department of Diagnosis and Surgery São José dos Campos School of Dentistry São Paulo State University (UNESP) FAPESP: 2017/09550-4 FAPESP: 2018/11997-0 FAPESP: 2019/10675-1

The multimodal approach for patients with head and neck cancer (HNC) includes treatment with chemoradiation therapy (CRT). A common concern regarding CRT side effects is the occurrence of structural and physiological alterations of the salivary glands due to exposure to ionizing radiation. The aim of this study is to examine the morphology, volume, and density of the parotid glands before and after CRT in HNC patients. A total of 49 HNC patients treated exclusively with CRT were included in the study. Ninety-eight parotid glands were evaluated before and after treatment by using contrast-enhanced computed tomography (CECT). Shapiro–Wilk test was performed, and the variables (pre-CRT and post-CRT) presented normal distribution. Pearson’s coefficient was used to assess the correlation between volume and density. CRT resulted in a significant decrease in the mean volume of the parotid glands (i.e., original volume reduced by 20.5%; P<0.0001). CRT induced a 30.0% (7 Hounsfield units) increase in density of the right parotid gland and a 24.9% (8 Hounsfield units) increase in density of the left parotid gland (P=0.0198 and P=0.0079, respectively). Changes in morphology and spatial configuration, increased density, and substantial loss of volume of the parotid glands were observed after CRT. There was also a difference in density (P=0.003) in the right-side parotid glands in comparison between xerostomic and nonxerostomic groups of patients. These facts lead to the need for a personalized CRT planning in order to minimize oral complications related to the treatment.

Made available in DSpace on 2019-10-03T17:32:04Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-12-01. Added 1 bitstream(s) on 2019-10-04T16:21:05Z : No. of bitstreams: 1 S1981-86372018000400375.pdf: 1259315 bytes, checksum: 2b47417e2a285f4ed85b0015a3237dd3 (MD5) RESUMO A hipertrofia massetérica é uma condição benigna, assintomática e rara, caracterizada pelo desenvolvimento excessivo do músculo masseter, que geralmente resulta em queixas estéticas. São sempre recomendados os exames de imagem para diagnóstico diferencial de patologias na região parotídea-massetérica. Neste trabalho objetiva-se a caracterização da imagem da hipertrofia massetérica através do relato de dois casos clínicos combinando diferentes modalidades de imagem: radiografia panorâmica, ressonância magnética, tomografia computadorizada, ultra-sonografia e volumetria 3D. Dois indivíduos do sexo masculino sem história familiar de hipertrofia massetérica foram encaminhados para um centro de diagnóstico em radiologia dentomaxilofacial devido ao aumento do volume facial bilateral na região massetérica. As imagens da radiografia panorâmica mostraram um aumento do ângulo mandibular bilateral em ambos os casos. Usando tomografia computadorizada, foi demonstrada hipertrofia muscular massetérica bilateral nos pacientes, e a varredura de ressonância magnética e ultra-sonografia foram realizadas para melhor visualização e medição. A avaliação volumétrica em 3D da musculatura mostrou-se como ferramenta adicional para avaliar o estado dos músculos masseteros em pacientes com hipertrofia massetérica. Portanto, a associação de exames de imagem permitiu realizar a caracterização da imagem da hipertrofia massetérica com presença de exostose óssea. Abstract Masseteric hypertrophy is a benign condition, asymptomatic and rare, characterized by the excessive development of the masseter muscle, which usually results in aesthetic complaints. The imaging exams for differential diagnosis of pathologies in the parotid-masseteric region is always recommended. This work aims the imaging characterization of masseteric hypertrophy through the report of two clinical cases combining different imaging modalities: panoramic radiography, magnetic resonance imaging, computed tomography, ultrasonography and 3D volumetry. Two male subjects with no family history of masseteric hypertrophy were referred to a diagnostic center in dentomaxillofacial radiology due to an increase in bilateral facial volume in the masseteric region. Images of the panoramic radiography showed an increase of the bilateral mandibular angle in both cases. Using computerized tomography, bilateral masseter muscle hypertrophy was demonstrated in the patients, and magnetic resonance scan and ultrasound examination were performed for better visualization and muscle measurement. 3D volumetry assessment of musculature showed as additional tool to evaluate the status of the masseter muscles in patients with Masseteric hypertrophy. Therefore, the association of imaging examinations allowed to perform the imaging characterization of masseteric hypertrophy with presence of bone exostosis. Universidade Federal do Ceará Departamento de Morfologia Universidade Estadual de Campinas Faculdade de Odontologia Universidade Estadual do Piauí Faculdade de Odontologia Universidade Estadual Paulista - UNESP Instituto de Ciência e Tecnologia Departamento de Diagnóstico e Cirurgia Universidade Cidade de São Paulo Departamento de Ortodontia e Radiologia Universidade Estadual Paulista - UNESP Instituto de Ciência e Tecnologia Departamento de Diagnóstico e Cirurgia

Background The supracondylar fracture of the humerus is one of the most common fractures in pediatric age. Many classifications were proposed, with Gartland being the most widely used one and Lagrange and Rigault (L&R) the most used in French-speaking countries. Objectives The goal of this study was to compare the Wilkins-modified Gartland classification with the L&R classification in terms of reproducibility. Methods Three observers with similar training levels classified 35 fractures according to both classifications twice to evaluate both intra and interobserver variation. Results The mean intraobserver variation was 0.78 and 0.77 for Gartland and L&R classifications, respectively, and the mean interobserver variation was 0.55 and 0.62 for Gartland and L&R classifications, respectively. Conclusions Both classifications reveal adequate to usage in clinical and investigational practices, which is consistent with the literature.

Objective: To analyse the opening diameter of incisive foramen as a parameter for gender and age estimation by using cone beam computed tomography (CBCT). Material and Methods: After approval by the local research ethics committee, CBCT images were obtained from the dental database of a diagnostic centre and then selected. Images suggesting presence of periapical lesions and periodontal changes were excluded, as well as those of patients undergoing orthodontic treatment, with trauma to the mid-facial third, with cleft/lip palate, cranial or syndromic morphological changes, or even absence of one of the upper incisors. The images of male and female patients were distributed according to age groups (i.e. 10-30 years, 31-50 years, and 51 years or older) and then assessed twice and independently by three surgeon-dentists with experience in radiology by means of the XoranCat® software. The resulting data were tabulated and statistically analysed by using the SAS® software (version 2003) – PROC GLM for mixed generalised models – and Tukey’s test for comparison of the mean values at 5% significance level. Results: Considering the methodology used, the results have demonstrated no statistically significant difference in the method for gender estimation. However, it was observed that there was a gradual increase in the mean values as the age advances in the majority of the age groups for both males and females, with a statistically significant difference (P

Foreign body granulomas can develop after the injection of various cosmetic filling materials into the facial area to flatten wrinkles. Clinically, reactive lesions are easily mistaken for soft-tissue neoplasms or cysts. This report presents a case of foreign body granuloma in a 52-year-old female patient complaining of a painless swelling in the nasolabial region. Both clinical and histological features are described, underscoring the diagnostic role of magnetic resonance imaging findings.

Objective Ghost cell odontogenic carcinoma is a very rare malignant neoplasm. Tumor volume may be a more precise alternative for determining size, which is usually measured by maximum linear dimension. The purpose of this case report is to highlight the importance of obtaining 3-dimensional (3-D) images of the tumor for volumetric analysis to improve the chances of surgical success. This report presents a case of ghost cell odontogenic carcinoma infiltrating the maxillary sinus through the palate. The lesion was surgically treated and subsequently selected for volumetric reconstruction and analysis of the tumor by using InVesalius software. In this case report, we describe the use of a pictorial technique in which the tumor volume was calculated to help predict the surgical results. Results The tumor could be visualized in 3-D, with color improving the image of the segmented volume and thus increasing the perception of boundaries and depth. Conclusions Recognition of the lesion shape by volumetric analysis can provide the surgical team with clearer information, thereby helping in surgical planning and consequently increasing the chances of surgical success.

There is some controversy about the value of fetal MRI in prenatal diagnosis, and most of the studies examine its accuracy in central nervous system (CNS) pathology. The objective of this retrospective study was to assess the diagnostic accuracy and usefulness of fetal MRI in the prenatal diagnosis of central nervous system (CNS) pathology and non-CNS pathology. Patients referred to the Radiology Department between 2007 and 2018 for a fetal MRI after detection of an anomaly in the fetal ultrasound, a high-risk pregnancy, or an inconclusive fetal ultrasound (n = 623) were included in the study. Postnatal diagnosis was used to assess the diagnostic accuracy of MRI. Fetal MRI was considered to provide additional information over fetal ultrasound when findings of the fetal MRI were not detected in the fetal ultrasound or when established a pathological condition that was not detected in the fetal ultrasound. Fetal MRI provided useful information for the perinatal management and prognosis over fetal ultrasound when findings of the fetal MRI changed the postnatal prognosis, leaded to the decision to legally terminate the pregnancy, changed prenatal or postnatal follow-up, or helped in the planning of prenatal or postnatal treatment. Fetal MRI offered an accurate diagnosis in 97% of cases (compared to 90.4% of fetal ultrasound; p < 0.001 ). Concordance between fetal ultrasound and fetal MRI was 92.1%. Fetal MRI provided additional information over fetal ultrasound in 23.1% of cases. In 11.6% of cases, the information was useful for the perinatal management and prognosis. In 45 cases (7.2%), fetal MRI was the only accurate diagnosis. In conclusion, fetal MRI has a superior diagnostic accuracy, especially in CNS pathology, and provides additional useful information in CNS, thoracic, and abdominal pathology.

Made available in DSpace on 2020-12-10T19:39:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-10-19 Fundacao de Amparoa Pesquisa do Estado de Sao Paulo (Sao Paulo State Research Support Foundation) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Objectives: To compare the volume and voxel intensity of articular disc and lateral pterygoid muscle (LPM) between a group of migraine patients and a control group (those without history of headache) by using magnetic resonance imaging (MRI). Patients and methods: MRI scans of 17 migraine patients and 15 healthy controls subjects were analysed and processed, using ITK-SNAP software, by a single investigator, for calculation of volumes and voxel intensity of articular disc and superior and inferior head of LPM. Results: There were statistically significant differences between migraine patients and controls regarding the volume and voxel intensity of articular disc and inferior head of LPM, increasing in migraine patients. Intra-rater was highly consistent and reproducible (intra-class correlation coefficient [ICC] = 1). Conclusions: Higher voxel intensity in disc and inferior head of LPM of MRI scans was linked to the increased volume of articular disc, inferior head of LPM and migraine. Sao Paulo State Univ, Inst Sci & Technol, Dept Diag & Surg, Sao Jose Dos Campos, Brazil Cruzeiro Do Sul Univ UNICSUL, Postgrad Program Dent, Rua Galvao Bueno 868, BR-01506000 Sao Paulo, SP, Brazil Univ Sao Paulo, Sch Dent, Dept Stomatol, Div Gen Pathol, Sao Paulo, Brazil Univ Sao Paulo, Inst Trop Med Sao Paulo, Lab Virol, Sao Paulo, SP, Brazil Sao Paulo State Univ, Inst Sci & Technol, Dept Diag & Surg, Sao Jose Dos Campos, Brazil FAPESP: 2013/10999-5

This study assessed whether the use of digital image filters influences the detection of temporomandibular joint (TMJ) bone changes on cone beam computed tomography (CBCT). Two radiologists evaluated the TMJ images of CBCT scans to verify the presence of osteophytes, erosions, pseudocysts, bone sclerosis and flattening, using the software XoranCAT®; each image of the TMJ was assessed with and without the use of the following filters: Angio Sharpen 3x3 and Angio Sharpen 5x5. Kruskal-Wallis’ test was used to assess whether the application of filters influenced the scores assigned to the degenerative bone changes in the condyle. Flattening was present in 15 cases (51.72%), followed by osteophytes in six cases (20.69%), sclerosis in three cases (10.34%), and erosion in three cases (10.34%), with pseudocyst found in two cases (6.90%). No statistically significant difference was found in the scores (P = 0.786) regarding the original images and those treated with both filters. Digital image filters used in our study did not influence the diagnosis of degenerative bone changes in the TMJ on CBCT images. Este estudio evaluó si el uso de filtros de imagen digital influye en la detección de cambios óseos de la articulación temporomandibular (ATM) en la tomografía computarizada de haz cónico (TCHC). Dos radiólogos evaluaron las imágenes de ATM de las exploraciones CBHT para verificar la presencia de osteofitos, erosiones, pseudoquistes, esclerosis ósea y aplanamiento, utilizando el software XoranCAT®; cada imagen de la ATM se evaluó con y sin el uso de los siguientes filtros: Angio Sharpen 3x3 y Angio Sharpen 5x5. Se utilizó la prueba de Kruskal-Wallis para evaluar si la aplicación de filtros influyó en las puntuaciones asignadas a los cambios óseos degenerativos en el cóndilo. El aplanamiento estuvo presente en 15 casos (51,72%), seguido de osteofitos en seis casos (20,69%), esclerosis en tres casos (10,34%) y erosión en tres casos (10,34%), encontrándose pseudoquiste en dos casos (6,90%). No se encontraron diferencias estadísticamente significativas en las puntuaciones (P = 0,786) con respecto a las imágenes originales y las tratadas con ambos filtros. Los filtros de imágenes digitales utilizados en nuestro estudio no influyeron en el diagnóstico de cambios óseos degenerativos en la ATM en las imágenes de TCHC. Este estudo avaliou se o uso de filtros de imagem digital influenciam na detecção de alterações ósseas da articulação temporomandibular (ATM) na tomografia computadorizada de feixe cônico (TCFC). Dois radiologistas avaliaram as imagens da ATM de TCFC para verificar a presença de osteófitos, erosões, pseudocistos, esclerose óssea e achatamento, utilizando o software XoranCAT®; cada imagem da ATM foi avaliada com e sem o uso dos seguintes filtros: Angio Sharpen 3x3 e Angio Sharpen 5x5. O teste de Kruskal-Wallis foi usado para avaliar se a aplicação de filtros influenciou os escores atribuídos às alterações ósseas degenerativas no côndilo. O achatamento esteve presente em 15 casos (51,72%), seguido por osteófitos em seis casos (20,69%), esclerose em três casos (10,34%) e erosão em três casos (10,34%), com pseudocisto encontrado em dois casos (6,90%). Nenhuma diferença estatisticamente significativa foi encontrada nos escores (P = 0,786) em relação às imagens originais e aquelas tratadas com os dois filtros. Os filtros de imagens digitais usados em nosso estudo não influenciaram no diagnóstico de alterações ósseas degenerativas da ATM em imagens de TCFC.

Cementum is an adaptable component of the periodontium which can respond to functional changes throughout its development, with its formation being characterized by apposition during the final stage of the tooth's life. In some cases, this formation occurs in excess, giving rise to hypercementosis, or other lesions (e.g., cementoblastoma) often presenting similar clinical and imaging features, but they are actually distinct entities requiring different approaches. The objective of the present study is to demonstrate the clinical and imaging characteristics of a case based on a differential diagnosis of these entities. Accurate diagnosis through detailed examination and adequate interpretation of imaging characteristics is essential for appropriate and successful therapy.

Made available in DSpace on 2018-11-26T17:10:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-01-01 We evaluated lateral pterygoid muscle volume in closed and open mouth positions in association with anterior disc displacement, effusion and abnormal articular disc shape from three-dimensional reformations of MRI. A total of 24 MRI of a sample (15 females, 9 males) aged 19-64 years (37.2 years +/- 11.4) were assessed. Segmentation and volumetric assessment of the total, upper and lower heads of the lateral pterygoid muscle were performed using free software. The upper head of the lateral pterygoid muscle had a smaller volume than the lower head at both sides, in the closed- and open-mouth positions. In the open-mouth position, individuals with a subdivided upper head, where one component was inserted in the articular disc and another in the mandibular head, displayed a significantly larger volume of the upper head compared to individuals who had a single attachment to the articular disc (p = 0.0130). The lateral pterygoid muscle has different volumes in the closed-and open-mouth positions. Gender affected muscle volume, specifically the upper head component. Insertion type in the upper head also seemed to affect muscle volume. (C) 2016 Elsevier GmbH. All rights reserved. Univ Sao Paulo City, Dept Orthodont, Sao Paulo, SP, Brazil Sao Paulo State Univ, Sao Jose dos Campos Dent Sch, Dept Diag & Surg, Sao Jose Dos Campos, SP, Brazil Univ Paulista, Dept Radiol, Campinas, SP, Brazil Sao Paulo State Univ, Sao Jose dos Campos Dent Sch, Dept Diag & Surg, Sao Jose Dos Campos, SP, Brazil

Objectives This study was aimed to investigate the relationship between geometric parameters of furcation lesions - maximum area of lesion opening (MALO), angle formed between the roots (ABR), lesion volume (LV) and presence and height of infra-osseous defects (IOD) - and the success of therapy with enamel matrix derivative proteins (EMD) in patients with grade C periodontitis, using cone-beam computed tomography (CBCT). Methods The study consisted of two groups of patients with grade C periodontitis: control (surgery) (n = 17) and test (surgery + EMD) (n = 17). Images parameters on CBCT were recorded using OnDemand3D and ITK-SNAP software. Results Pearson's correlation coefficient demonstrated that only IOD was statistically significant in the probing depth PD (P = 0.01), with a moderate positive correlation (R = 0.59). MALO was found to be statistically significant (P = 0.03) in the test group (surgery + EMD), with moderate negative correlation (R = -0.5). Conclusion The presence of infra-osseous defects and height were relevant in relation to the success of the type of treatment addressed in this study., Cone beam computed tomography; Digital volume tomography; Furcation defect; Furcation involvement; Periodontal regeneration; Periodontal disease.

Made available in DSpace on 2020-12-12T00:56:23Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-01-01 Ameloblastoma is an odontogenic tumor that shares clinical and imaging characteristics with other lesions of the jaws, such as odontogenic keratocyst, which makes the diagnosis difficult.However, in addition to radiographic and tomographic examinations, Magnetic Resonance Imaging (MRI) has been increasingly used, contributing with relevant additional information about thedifferentiation between solid and liquid components of the lesion. This case report was conducted to present two variations of ameloblastoma and discuss the radiographic, tomographic and MRI contribution in the differential diagnosis between ameloblastoma and odontogenic keratocyst. The signal intensity in T1-weighted MRI revealed internal fluid content in both cases, which was important in the differential diagnosis with other intraosseous lesions such as odontogenic keratocysts. This is probably due to the presence of keratin that increases the viscosity of the content and also for an intermediate signal intensity signal in T2-weighted MRI. Therefore, MRI revealed important internal characteristics of the reported lesions, which was very useful in the establishment of the differential diagnosis with other lesions. Piracicaba Dental School University of Campinas (UNICAMP) Department of Morphology Federal University of Ceará Dentistry Course Federal University of Ceará Cruzeiro do Sul University (UNICSUL) São Paulo State University (Unesp) Institute of Science and Technology Department of Diagnosis and Surgery São Paulo State University (Unesp) Institute of Science and Technology Department of Diagnosis and Surgery

Patient: Male, 53 Final Diagnosis: Clivus chordoma Symptoms: Pain the eye Medication: — Clinical Procedure: — Specialty: Radiology Objective: Rare disease Background: The clivus is a depression in the anterior occipital bone of the skull base, posterior to the dorsum sellae, at the junction with the sphenoid bone. Chordoma is a rare tumor arising from embryonic remnants of the notochord and can be locally aggressive with a tendency to recur. The optimal management of this rare tumor remains controversial. A report of a case of recurrent chordoma of the clivus is presented to illustrate the value of volumetric three-dimensional (3-D) reconstruction with computed tomography (CT) and magnetic resonance imaging (MRI) to determine optimal surgical management. Case Report: A 53-year-old man presented with pain in the right orbital cavity, right proptosis, swelling of the right cheek, and bilateral loss of vision. He also had adrenal insufficiency. CT and contrast-enhanced (gadolinium) T1-weighted MRI with multiplanar acquisition were performed with volumetric 3-D reconstruction of the tumor, to increase the chances of treatment success. Surgical resection was performed to remove the tumor and reduce the risk of recurrence. Histology of the tumor was consistent with chordoma, supported by positive immunohistochemical staining for S-100 and epithelial membrane antigen (EMA). Conclusions: This report highlighted the value of 3-D volume imaging in the diagnosis and treatment planning in a rare case of recurrent chordoma of the clivus. Analysis of tumor volume may be an indicator of the efficacy of surgery, complementing the Response Evaluation Criteria In Solid Tumors (RECIST) system and as a valuable tool to predict treatment outcome.

Made available in DSpace on 2019-10-06T15:28:17Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-06-01 Objective: The aim of this study was to investigate the effect of enhancement filters on magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ). Study Design: In total, 66 MRI scans of the TMJ were analyzed without filtration and with the application of 2 filters: Sharpen 1 and Sharpen 2 (OnDemand software). Two dentomaxillofacial radiologists examined the original and filtered images individually. Intra- and interobserver concordance was measured by using generalized estimating equations. The observers evaluated the subjective image quality and the visibility of 3 components of the TMJ: disk, condyle, and articular eminence. The images were ranked on a 4-point scale, from poor to excellent. The image quality of all filtered images was compared by using the χ 2 test and Bonferroni correction for multiple comparisons. Results: Intra- and interobserver concordance was good. The images filtered with Sharpen 1 and Sharpen 2 provided better definition of the structures compared with nonfiltered images, providing the highest scores for subjective image quality for all structures (P < .0001). Conclusions: The use of enhancement filters led to improved subjective quality and may improve the diagnostic efficacy of MRI in TMJ evaluation. Department of Orthodontics and Radiology University of São Paulo City (UNICID) Department of Diagnosis and Surgery São José dos Campos Dental School São Paulo State University (UNESP) School of Medicine University of Cuenca Department of Diagnosis and Surgery São José dos Campos Dental School São Paulo State University (UNESP)

The aim of this study was to evaluate and compare changes in linear distance and inclination of lower incisors and canines and intercanine distance after a 30 months orthodontic treatment with self-ligating appliances. Seven patients were treated orthodontically with a Roth prescription passive self-ligating bracket. To perform the measurements and comparisons, CBCT scans were taken before the start of the orthodontic treatment (T(1)) and after a period of 30 months treatment (T(2)). The following measurements were performed: (1) the lower incisors and canines inclination in relation to the mandibular plane, (2) intercanine linear distance in millimeters and (3) linear distance in millimeters of the incisal and apical part of lower anterior teeth to a plane (POGM) passing through pogonion point and perpendicular to the mandibular plane. No significant difference were observed between T(1) and T(2) for canine inclination (p = 0.835), incisors inclination (p = 0.149), canine incisal distance to POGM (p = 0.423) and incisors incisal distance to POGM (p = 0.966), however canine apical distance (p = 0.049) and incisors apical distance (p = 0.002) to POGM was lower at T(1) than at T(2). The intercanine distance was significantly lower (p = 0.022) at T(1) when compared to T(2.) The use of passive self-ligating brackets in orthodontic treatment to solve 4 mm tooth crowding were able to produce dental arch expansion by bodily tooth movement.

Aim The purpose of this study was to evaluate the dentoskeletal and soft tissue effects resulting from treatment with Klammt's elastic open activator (EOA) functional orthopedic appliance in patients with Class II malocclusion characterized by mandibular deficiency. Materials and methods Teleradiographs were evaluated in the lateral aspect of the initial (T1) and final (T2) orthopedic phases for 16 patients with Class II, Division 1 malocclusion. The age range was from 9 to 11.2 years, with a mean age of 9.9 years. The cephalometric points were demarcated, and cephalometric measurements were obtained by the same investigator to avoid interobserver variability. Results The EOA promoted increased lower anterior facial height (LAFH), increased effective mandibular length, clockwise rotation of the mandible, retrusion and verticalization of the upper incisors, proclination and protrusion of the lower incisors, extrusion of the upper molars, mesial movement of the lower molars and anterior projection of the lower lip. Conclusion Skeletal changes characterized by an increase in mandibular length and dentoalveolar changes with an emphasis on the verticalization and retrusion of the upper incisors, proclination of the lower incisors and mesial positioning of the lower molars were key to improving the occlusal relationship and esthetic facial factors. Clinical significance The EOA is well indicated in patients with Class II malocclusion due to mandibular deficiency with increased overbite, proclined upper incisors and verticalized lower incisors. How to cite this article Inamassu-Lemes SM, Fuziy A, Costa ALF, Carvalho PEG, Nahás-Scocate ACR. Dentoskeletal and Soft Tissue Effects in the Treatment of Class II Malocclusion with Klammt's Elastic Open Activator. J Contemp Dent Pract 2016;17(1):63-69. Conflicts of Interest None declared

Objetivo: Comparar os métodos de Greulich-Pyle (GP), o do Atlas Venezuelano de Maturação Óssea (AV) e o de Tanner-Whitehouse (TW3-RUS), na estimativa da idade em brasileiros. Metodologia: Utilizou- se uma amostra de 240 radiografias carpais de indivíduos de ambos os sexos (129 meninas e 111 meninos), com idades entre 84 e 199 meses (7 e 16,5 anos). As idades ósseas foram calculadas segundo os métodos GP, AV e TW3-RUS e posteriormente se obtiveram diferenças de media entre a idade cronológica (IC) as idades ósseas estimadas. Resultados: Observou-se uma correlação positiva e estatisticamente significativa entre a IC e as idades ósseas estimadas, (0,89- 0,94). Constatou-se uma superestimativa da idade por todos os métodos nas meninas. Nos meninos verificou-se a superestimativa pelo método AV, enquanto que o GP e o TW3-RUS subestimaram a idade. Verificou-se uma diferença significativa entre a IC e as idades ósseas estimadas pelos métodos GP e AV em ambos os sexos (meninas: GP -6,89; AV -6,41. Meninos: GP 4,45; AV-5,06) e para o TW3-RUS somente foi significativa para as meninas (meninas -2,94; meninos 1,56). Conclusões: O método TW3-RUS resultou ser mais preciso na estimativa da idade, porém se recomenda a utilização das equações de regressão calculadas para um melhor ajuste entre as idades inferidas pelos métodos estudados as idades reais dos indivíduos.

Made available in DSpace on 2015-12-07T15:35:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2015. Added 1 bitstream(s) on 2015-12-07T15:54:21Z : No. of bitstreams: 1 PMC4362986.pdf: 208180 bytes, checksum: 68a9080de4fa98886a47bd6b3f662e6f (MD5) Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable. Department of Diagnosis and Surgery, São José dos Campos Dental School, UNESP, São Paulo, Brazil. Department of Pediatric Dentistry and Orthodontics, University of São Paulo City, UNICID, São Paulo, Brazil. Department of Oral Diagnosis, School of Dentistry, UNICAMP, Piracicaba, São Paulo, Brazil. Department of Specific Formation, Area of Radiology, Nova Friburgo Dental School, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil. Laboratory of Neuroimaging, Department of Neurology, Faculty of Medical Sciences, UNICAMP, Campinas, São Paulo, Brazil. Department of Diagnosis and Surgery, São José dos Campos Dental School, UNESP, São Paulo, Brazil.

Aims: The objective of the present study was to assess the skeletal maturation by means of three-dimensional models of the cervical vertebrae generated through segmentation of the magnetic resonance (MR) images by using medical software. Methods: Twenty MR images of the skull of male and female individuals aged between 8 and 22 years old were selected. Assessment of the images was performed by using the ITK-SNAP software, consisting of three steps: 1) vertebral segmentation; 2) three-dimensional reconstruction; and 3) classification of skeletal maturation. Two specialists in orthodontics and two specialists in dentomaxillofacial radiology assessed the images. Results: Analysis of reproducibility and repeatability were performed by using the RR method, with paired t-test also being applied to the repeatability factor together with Lin’s concordance coefficient. The significance level was set at 5%. It was found that there was no difference in the inter-rater reliability (P-value = 0.625), but without statistical repeatability. Conclusions: New tools, as 3D reconstruction software, enabled us to build an effective and friendly 3D-reconstruction system for classification of the skeletal maturation stages of cervical vertebrae.

Objective: The aim of this retrospective study was to determine and quantify incidental findings in CBCT scans taken exclusively for orthodontic purposes. Methods: A total of 202 scans were evaluated by two examiners and classified into five different groups. Results: A total of 227 incidental findings were found in a sample of patients aged 5-58 years old. The highest number of findings was of dental origin (n = 157), followed by airway (N = 46), skull (N = 16) and ATM (n = 8). Scans with no incidental finding accounted for 20% of the examinations. Subjects having lower mean age were found in the group of airway findings. The prevalence of incidental findings in the current study was consistent with the literature, thus corroborating their high frequency. Orthodontists who make use of CBCT are responsible for assessment of all data. Conclusion: The precise evaluation of incidental findings may help in the early diagnosis, treatment and patient monitoring. Further studies should be conducted to assess the influence of these findings on the orthodontic treatment. RESUMO Objetivo: Investigar e quantificar achados incidentais em exames de tomografia computadorizada de feixe cônico realizadas unicamente para fins ortodôntico. Métodos: Foram incluídos os exames de tomografia de feixe cônico com finalidade de diagnóstico ortodôntico no período de novembro de 2011 a abril de 2014 (n=202) avaliados por dois examinadores e os dados coletados classificados em cinco grupos diferentes. Foi realizada análise exploratória dos dados através do cálculo de média, desvio padrão, frequência e porcentagem. A associação entre o local do achado e o gênero foi verificada através do teste exato de Fisher. Resultados: Foi encontrado um total de 227 achados; o grupo com maior número de achados foi o de origem dental (n=157), seguido do grupo de vias aéreas (n=46), de crânio (n=16) e de ATM (n=8). Exames sem nenhum achado representaram 20% do total. Os sujeitos com menores médias de idade foram encontrados no grupo de vias aéreas. A prevalência de alterações tomográficas incidentais em pacientes ortodônticos é alta. Conclusão: Um cuidadoso diagnóstico das imagens de tomografia de feixe cônico além da região de interesse ortodôntica é indispensável para prevenir patologias ocultas. Estudos adicionais podem ser realizados para avaliar qual a influência desses achados no tratamento ortodôntico.