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This study aimed to investigate the presence of BRAF V600E mutation in mandibular ameloblastoma by comparing the results of molecular detection and immunohistochemical analysis. A 128 cases of mandibular ameloblastoma and 30 cases of dentigerous cyst (control group) were selected for analysis. Detection of BRAF V600E mutation was performed with immunohistochemistry (IHC) and polymerase chain reaction techniques. Clinico-pathologic data were collected in order to investigate possible associations with the mutation. Of the 128 cases submitted to IHC, 81.2% (108 cases) showed positivity for anti-BRAF V600E antibody, whereas 24 were negative (18.8%). Molecular analysis of the BRAF V600E mutation by polymerase chain reaction was possible in 116 cases due to DNA quality. Of these cases, 96 were positive (82.8%) and 20 negative (17.2%). All cases of dentigerous cyst were negative for BRAF V600E mutation in both techniques. Considering the sequencing as a gold standard method, the receiver operating characteristics curve analysis showed sensitivity of 0.99 and specificity of 1 (area under the curve=0.995, standard error=0.006; P

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

OBJECTIVES To evaluate the oral shedding of herpesviruses in patients undergoing hematopoietic stem cell transplantation (HSCT) and correlate it with oral mucositis (OM). METHODS Saliva samples were collected before the HSCT and on day D + 8. Multiplex Polymerse Chain Reaction (PCR) was performed to detect herpes simplex virus (HSV)-1 and HSV-2, Epstein-Barr virus (EBV), Cytomegalovirus (CMV), Variella-zoster virus (VZV), and human herpesvirus (HHV)-6, HHV-7, and HHV-8. OM was assessed according to WHO criteria. RESULTS Thirty one patients were enrolled, in which 20 of 31 (64.5%) were males; median age was 50 (21-70) years; 16 of 31 (51.6%) underwent allo-HSCT; and 15 of 31 (48.4%) underwent auto-HSCT. On D + 8, OM grades III and IV were observed in 8 of 31 (25.8%) patients. In the first salivary collection, EBV was found in 24 of 31 (77.4%), followed by HHV-6 (7/31, 22.6%) and HHV-7 (8/31 25.8%). In the second collection, EBV was found in 24 of 27(89%), followed by HSV-1 (8/27, 30%) and CMV, HHV-6, and HHV-7 (5/27, 18.5%, each one). On D + 8, OM grades II and IV were associated with the presence of HSV-1. HSV-1 was also associated with worsening degrees of OM on D + 15. CONCLUSION The presence of HSV-1 and CMV in oral samples was more frequent on day D + 8 after HSCT. HSV-1 detection was associated with severity and worsening of OM. HSV-1 and CMV seem to be associated with oral dysbiosis due to HSCT.

Background and Overview Patients seropositive HIV and AIDS represent a group of patients who experience longer longevity at the expense of effective therapies for infection control and related opportunistic diseases. However, the prolonged use of these drugs is often associated with adverse events, which theoretically may influence dental management and the long-term stability of dental implants. The objective of this study was to prospectively evaluate a group of HIV-positive people from a previous study who had received dental implants for 12 years after oral rehabilitation and functional loading. Case Description Nine patients with a total of 18 implants participated in this study. Viral load was undetectable in 8 patients, with 1 who had 48 copies/milliliter. The cluster of differentiation 4 T lymphocyte count ranged from 227 through 1,000 cells/cubic millimeter, mean (standard deviation [SD]) 564 (271.13) cells/mm3. Five of the 9 (55.5%) patients had visible plaque, and 5 (55.5%) had bleeding on probing with no implant mobility. Radiographs obtained at 6 months, 12 months, and 12 years of functional loading showed mean (SD) marginal bone losses of 0.32 (0.23) mm, 0.37 (0.23) mm, and 2.43 (1.48), respectively. Conclusion and Practical Implications These results suggest that dental implant treatment in HIV-positive patients achieved long-term survival, with a success rate comparable with that observed in healthy patients, indicating that implant rehabilitation is not a contraindication for HIV-positive patients.

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

Background Condylar cartilage acts as a centre of craniofacial complex growth and magnetic resonance imaging (MRI) is the most suitable examination to differentiate tissues and identify pathological conditions of TMJ. Condylar growth disturbance can alter the maxillofacial morphology, including occlusal relationship, and the affected children may not present symptoms. Although TMJ in children is similar to that in adults, the anterior condylar inclination is straight and increases with age, presenting slight condylar flattening and slight contrast enhancement. Objective The present work aimed to review the literature focussing to assess how MRI and the development of TMJ can contribute to orthopaedic/orthodontic diagnosis in growing patients. Main results MRI can also complement the predictive diagnosis of growth in which the image of a double contour of the condyle reveals proliferation of cartilage cells with immature ossification. Considering that orthodontic therapy usually begins after eruption of permanent teeth, the moment of alternation of the double contour-like structure is close or coincident with the eruption of upper second molars. Conclusion Clinically, the advantage of diagnosis of double contour is not to use any ionizing radiation related to scan in these subjects. Therefore, MRI could be a choice for the follow-up of growing patients.

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 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.

Asymptomatic Apical Periodontitis is essentially an inflammatory disease of microbial aetiology. Association and function of the cell components involved, or specific inductive factors and growth mediators associated with development, maintenance and resolution of the periapical lesions are still unknown. The objective of this study was to evaluate the concentration of Regulatory T cells (FoxP3+; Treg), Langerhans cells (CD1a+; LC) and mast cells in asymptomatic apical periodontitis. 73 cases were selected: 30 periapical granulomas, 29 radicular cysts and 14 residual cysts. All groups were submitted to morphological analysis for classification of inflammatory infiltrate and thickness of the epithelial lining as well as to immunohistochemical analysis for detection of LC and Treg cells. Toluidine blue staining was used for detecting mast cells. Analysis showed higher mean numbers of LC (8.2 cells/0.2mm2), and Treg cells in radicular cysts (5.910 cells/0.2mm2). As for mast cells, it was found that radicular cysts had a higher mean number of these cells compared to other periapical lesions (12.68 cells/0.2mm2). The association between thickness of the epithelial lining and inflammatory cells showed that the presence of hypertrophic epithelium in radicular cysts presented higher density of LC. The number of LC and Treg cells play an important role in the control of the inflammatory micro-environment in periapical granulomas and radicular cysts, respectively. The presence of mast cells in radicular cysts may be associated with progression of the lesion. Knowledge regarding the inflammatory cell profile is therefore essential for a better understanding of the pathogenesis of asymptomatic periapical periodontitis.

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 2019-10-06T15:36:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-01 Imaging examinations play an important role in the diagnosis of sialolithiasis, whose symptoms are initially confounded with other diseases. The objective of the present case report is to highlight imaging and processing techniques as well as image analysis for the preoperative assessment and planning of surgical interventions and adequate treatment of massive sialoliths. A 35-year-old male patient presented complaining of pain in the submandibular region and purulent secretions from a lingual caruncle with slightly increased volume in the region. Imaging examinations were ordered as follows: cone beam computed tomography, ultrasonography, and three-dimensional reconstruction, including clinical evaluation. A final diagnosis of sialolithiasis was established. Surgery was indicated and carried out by using a lateral transcervical approach for complete resection of the gland, which was based on the calculation of the total volume of the sialolith, thus increasing the surgery’s success. State University of Piauí Surgery and Clinic Integrated Department State University of Piauí Department of Oral Pathology São Leopoldo Mandic Institute and Research Center Department of Diagnosis and Surgery Institute of Science and Technology State University of São Paulo (UNESP) Department of Orthodontics and Radiology University of São Paulo City Department of Morphology Faculty of Medicine Federal University of Ceará Department of Diagnosis and Surgery Institute of Science and Technology State University of São Paulo (UNESP)

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.

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 to investigate the volume and linear measurements of the frontal sinuses by means of a three-dimensional software using helical computed tomography images. Materials and methods The samples consisted of 36 tomographic images from 22 women and 14 men aged between 18 and 86 years old. The ITK/SNAP software was used for image segmentation, analysis of volume data, and linear measurements (i.e. height, width and depth). Results The mean volumes of the left and right frontal sinuses were 3.945 mm 3 (SD = 2.803) and 3.423 mm 3 (SD = 2.835). The mean linear measurements were the following: right-side axial depth of 16.1 mm (SD = 7.6), left-side axial depth of 17.0 mm (SD = 5.8), right-side sagittal height of 19.0 mm (SD = 11.1), and left-side sagittal height of 20.5 mm (SD = 9.8), with no statistically significant differences. The right-side axial width of 19.0 mm (SD = 6.8) and left-side axial width of 22.4 mm (SD = 9.1) in women and right-side axial width of 21.6 mm (SD = 12.9) and left-side axial width of 26.5 mm (SD = 9.8) in men, with statistically significant difference ( P = 0.0264) for the left side. Conclusion There was a significant difference only for axial width, with the left side having higher values compared to the right side.

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.

This study was undertaken to assess in vivo the corrosion in two commercial nickel-titanium (NiTi) orthodontic archwires removed from the oral cavity of patients using fluoride mouthwashes. Five volunteers took part in this study on the corrosion behavior of two brands of NiTi archwires (3M and AO (brand of archwire)) during use of two mouthwashes with neutral sodium fluoride 1.1%, one with acidulated fluoride 1.1%, and one with placebo and a control group. Each patient used one mouthwash in three different periods of time for 1 min a day for 30 days. The archwires were assessed with scanning electron microscopy and atomic force microscopy for qualitative and quantitative analysis. The values obtained with atomic force microscopy (AFM) were submitted to normality test, two-way analysis of variance, and Tukey's test at a significance level of 5%. The AFM images showed a gradual qualitative increase in the roughness of both types of wire between the treatments: control

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

The sphenoid sinus is the most inaccessible part of the face, being inside the sphenoid bone and closely related to numerous vital neural and vascular structures. The objective of this study was to analyze and evaluate the variation of anatomy and the volume of the sphenoid sinus using helical computed tomography and medical imaging software. A total of 47 helical CT scans of sinuses of male and female individuals aged 18–86 years were selected. The images were formatted using ITK-SNAP software, consisting of three steps: (1) segmentation; (2) volumetric analysis and (3) 3D reconstruction. The sphenoid sinuses were also classified according to Hammer, i.e., in conchal, pre-sellar, sellar and post-sellar types. A single investigator, who is specialist in dental radiology and was trained and calibrated, performed the volume and image analysis. After 15 days, the segmentations were repeated. The Dunn’s multiple comparison test revealed significant differences in the volume rankings between the right and left sides (P = 0.0002), with the post-sellar type presenting the greatest volume on the right side compared to pre-sellar and sellar types. In the left sphenoid sinuses, the post-sellar type showed the greatest volume. The Lin’s correlation coefficient showed excellent reproducibility values. According to the applied methodology, it was found that the volume of the sphenoid sinus was influenced by neither age nor gender (P > 0.005). There was difference in the volumes of sphenoid sinus on the right and left sides and in the anatomical classification.

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.

To evaluate changes in the oral health status of children under the age of 14 years with acute lymphoblastic leukaemia (ALL) attending a cancer centre before and after chemotherapy treatment. A total of 32 children with ALL without distinction of gender were selected for study. The oral cavity of the patients was evaluated before the induction stage and 17 days later. Clinical evaluation of the submandibular, submental, and cervical lymph nodes was performed. Saliva samples were collected during the early morning hours. Bacterial plaque was assessed by using the Silness and Loe plaque index (SLPI) and gingiva status was evaluated with the gingival Loe and Silness index (GLSI). The WHO toxicity oral scale was used to record the degree of oral mucositis. The resulting data were analysed with McNemar’s test, t test (for related samples), and Wilcoxon test. There were statistically significant differences for palpable lymph nodes, paleness of oral mucosa, and ecchymoseis, respectively, P ≤ 0.000, P = 0.03, and P = 0.01, with these manifestations decreasing significantly after treatment. Incipient gingivitis had frequencies of 71.9% and 75% before and after treatment, respectively. The mean SLPI score declined significantly from 1.16 ± 0.52 (before treatment) to 0.56 ± 0.36 (after treatment) (P

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

The calcifying epithelial odontogenic tumour (CEOT) is an extremely rare benign neoplasia, accounting for approximately 1% of all odontogenic tumours. CEOT can have two clinical manifestations: central or intraosseous (94% of the cases) and peripheral or extraosseous (6% of the cases). Although the latter is less common, the peripheral variant has been described as an insidious lesion, since it is usually asymptomatic and may be erroneously mistaken with gingival hyperplasia, hamartomas, or even metastasis of malignant neoplasia. We report a case of a young male patient presenting with a peripheral CEOT in the mandibular posterior region, mimicking a located gingival inflammation.

Aim The aim of the present study was to correlate the angle formed by inclination of the condylar long axis and median sagittal plane to the presence of internal disc derangement, as well as changes in eccentric mandibular positions. Methods The sample consisted of magnetic resonance images of 35 temporomandibular joint (TMJ) acquired with a 1.5T magnetic resonance imaging system with surface coils of 8.5 cm in diameter. Parasagittal images were used according to the following parameters: TMJ disc position with mouth closed, TMJ disc position with mouth open, TMJ disc function, and degrees of rotation and translation of the condyle. Next, we determined the angles between the condyle long axis and median sagittal plane by using axial images. Results The results showed correlations between TMJ disc position and disc function (P = 0.009), as well as between disc position and degree of condylar rotation (P = 0.008). The main purpose of the present study was to assess the angle of the condylar long axis, with no statistical correlation being found between this variable and disc position (P = 0.787), disc function (P = 0.091), condylar translation (P = 0.808), and condylar rotation (P = 0.115). Conclusion There was no relationship between inclination of the condyle long axis and parameters of internal derangements.

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.

Purpose. The objective of this study was to evaluate the computational reconstruction of the articular eminence of the temporomandibular joint (TMJ) based on magnetic resonance imaging (MRI) and semiautomatic volumetric segmentation techniques for morphological classification of the TMJ structure. Materials and Methods. A total of 36 MRI scans of TMJ individuals were selected and formatted by using the ITK-SNAP software, consisting of MRI segmentation and generation of 3D models. The TMJ articular eminences were also classified according to the morphology analysis of the articular eminence in 3D reconstructions. Two independent trained and calibrated investigators performed the image analysis, which was repeated after thirty days. Results. There was no association between sex and eminence shape (p=0.456). Fisher’s test revealed no statistically significant association between disc classification and eminence shape on both sides (p=0.629). Chi-square test showed a significant statistically association between disc classification and disc displacement (p=0.000). Intra- and interrater correlation coefficients showed excellent reproducibility values. Conclusions. Anatomical variability of the sample investigated was found, with predominantly round shape and presence of correlation between this shape and normal disc position. The correlation of flattened and convex shapes with disc position reduction indicated that type of disc derangement is more prevalent.

To assess the role of ultrasonography as a possible tool for diagnosis of intra-osseous lesions.Our sample comprised five macerated pig jaws. The regions of bony crypts of third molars were examined on both sides, totaling 10 examinations. The degrees of difficulty for both ultrasound image visualization and bone translucency were rated by two groups of evaluators (i.e. dental radiologists and physician ultrasonographers).Our results showed that it is possible to detect images of the intra-osseous cavity at a low-degree difficulty by using both radiographic and ultrasonic techniques (46.6% and 43.3%, respectively). However, the crypts were not fully detected by both groups (16.6% and 13.3%, respectively).We concluded that ultrasonography is a useful method for evaluation of intra-osseous lesions in jaws, provided that the cortical bone is thin enough to allow ultrasound waves to pass through.

Made available in DSpace on 2018-12-11T16:44:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-01-01 Odontogenic cysts have a high prevalence in the dental clinic population, with dentigerous cyst being one of the most frequent ones and whose aetiology involves accumulation of fluid between the reduced enamel epithelium and the crown of an unerupted tooth. In the diagnostic process of these lesions, one should consider complementary imaging exams such as conventional radiography and computed tomography, which are commonly used for providing anatomical information on the tissues compromised by the lesion, but not on the nature of it. Magnetic resonance imaging (MRI) scans are noninvasive modalities which, due to their unique acquisition characteristics, can provide distinct information on the nature of the lesion. This study reports on a case of dentigerous cyst in the mandible of a 9-year-old patient, documented by means of different imaging modalities. MRI played an important role in both diagnosis of the lesion and differential diagnosis between neoplastic lesions presenting similar imagenological behaviour under other techniques of radiography. Department of Morphology Faculty of Medicine Federal University of Ceara Department of Orthodontics and Radiology University of S�o Paulo City (UNICID) Piracicaba Dental School State University of Campinas (UNICAMP) Department of Diagnosis and Surgery S�o Jos� Dos Campos Dental School S�o Paulo State University (UNESP) Department of Diagnosis and Surgery S�o Jos� Dos Campos Dental School S�o Paulo State University (UNESP)

The aim of this study was to evaluate the performance of CBCT three-dimensional (3D) reconstructions and sagittal sections for estimates of cervical vertebrae maturation index (CVMI).The sample consisted of 72 CBCT examinations from patients aged 8-16 years (45 females and 27 males) selected from the archives of two private clinics. Two calibrated observers (kappa scores: ≥0.901) interpreted the CBCT settings twice. Intra- and interobserver agreement for both imaging exhibition modes was analyzed by kappa statistics, which was also used to analyze the agreement between 3D reconstructions and sagittal sections. Correlations between cervical vertebrae maturation estimates and chronological age, as well as between the assessments by 3D reconstructions and sagittal sections, were analyzed using gamma Goodman-Kruskal coefficients (α = 0.05).The kappa scores evidenced almost perfect agreement between the first and second assessments of the cervical vertebrae by 3D reconstructions (0.933-0.983) and sagittal sections (0.983-1.000). Similarly, the agreement between 3D reconstructions and sagittal sections was almost perfect (kappa index: 0.983). In most divergent cases, the difference between 3D reconstructions and sagittal sections was one stage of CVMI. Strongly positive correlations (0.8, p 0.001) were found not only between chronological age and CVMI but also between the estimates by 3D reconstructions and sagittal sections (p 0.001).Although CBCT imaging must not be used exclusively for this purpose, it may be suitable for skeletal maturity assessments.

Background To analyze the face vascularization pattern using B-mode and Doppler ultrasonography, and also propose an arterial vessel mapping. Material and Methods The investigation was performed on 20 ultrasonography exams of facial vessels through linear and endocavitary transducers. We analyzed and determined the average values for diameters, peak systolic velocity and resistive index of the following arteries: external carotid, lingual, deep lingual, sublingual, facial, submental, inferior labial, superior labial, angular, maxillary inferior alveolar, mental, buccal, greater palatine, infraorbital, superficial temporal, transverse facial and frontal. Results Data was obtained allowing the analysis of the tissue hemodynamics. We were able to map the vascularization of the face and it was possible to access three arteries of small diameter (0,60mm angular artery; 0,55mm greater palatine artery; 0,45mm infraorbital artery). Conclusions The results presented in this article are valid tool supporting the non-invasive mapping of facial vascularization. Key words:Anatomy, vascularization, ultrasonography, doppler.

Paradental cyst is an inflammatory odontogenic cyst linked with mandibular molars. The occurrence rate of the lesion ranges from 0.9 to 4.7% suggesting its infrequency. The histopathologic findings in hematoxylin and eosin routine staining are not pathognomonic, and the correlation with clinical and imaging characteristics is essential to establish the final diagnosis. The periapical radiographs show a unilocular radiolucency on the distal or disto/buccal aspect of the involved tooth, however, the lesion can superimpose over the roots and mimic periapical pathology. We report the imaging features of a rare bilateral paradental cyst with an emphasis on magnetic resonance imaging and cone beam computed tomography to help a correct identification and characterization of the cyst and to reliably establish the diagnosis.