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The articular surfaces of the temporomandibular joint (TMJ) in the cat consist of the articular head of the condylar process of the ramus of the mandible and the mandibular fossa of the petrous part of the temporal bone. Anatomic conformation of the TMJ articular surfaces can vary; however, this has not been studied in the cat. Thus, the aim of this study was to characterize the conformation of the medial region of the TMJ in mesocephalic adult cats as well as to determine the articular relationship by measurement of the degree of coverage of the mandibular fossa over the articular head. This was accomplished by assessing 60 TMJs from 30 mesocephalic adult cats by means of cone-beam computed tomography (CBCT). The width and depth of the mandibular fossa, and the degree of coverage of the mandibular fossa were evaluated using parasagittal reconstructions of the medial aspect of the TMJ by two observers. No statistically significant difference was observed during the intra and interobserver evaluation of the mandibular fossa width and depth and the degree of coverage of the mandibular fossa over the articular head. P-values for the studied variables were greater than 0.05. The resulting measurements demonstrated a concave mandibular fossa with a prominent retroarticular process and a poorly developed articular eminence; a well-defined rounded articular surface, and a high degree of coverage (171°) of the mandibular fossa over the articular head. In conclusion, the articular surfaces at the medial aspect of the TMJ displayed elevated geometric similarity, with an articular head of the condylar process deeply seated in the mandibular fossa.

The interdisciplinary performance between the specialties of Sports Dentistry with Radiology aided by technology makes possible to perfect and optimize the manufacture of facial protectors. This case report aims to show a case of making a face shield for an athlete after fracturing the nasal pyramid with the aid of digital flow. It was concluded that the facial protector was an effective device to protect the athlete’s face who has recently suffered an orofacial injury. The protector prevents the bone from undergoing refracture or displacement and allows the athlete not to be temporarily stay away of sports practing.

Objectives: This systematic review aimed to answer the following focused question: Do the currently available imaging techniques provide accuracy in the assessment of peri-implant buccal bone thickness? Methods: A search strategy was conducted in eight electronic databases, followed by an additional manual search in grey literature and references of selected articles. Studies evaluating the accuracy of imaging techniques to measure peri-implant buccal bone thickness were included. Individual risk of bias was assessed by the Quality Assessment Tool for Diagnostic Accuracy Studies-2 (QUADAS-2). Meta-analysis was performed to evaluate CBCT accuracy. The overall effect size was determined by means of the Z-test. Q test was used to evaluate the homogeneity of effect sizes among studies and I2 was applied to determine the variance within studies. Results: After an initial screening, 83 studies were further selected for full reading and 13 of them were considered eligible for this review. In sum, the accuracy of Cone-beam Computed Tomography (CBCT), of ultrasound, and of computed tomography were assessed. There was no statistically significant difference between CBCT and the gold standard (p=0.81). The mean difference between measurements of bone thickness obtained by CBCT and the goldstandard was -0.0.3mm [95%CI -0.29;0.253mm]. Conclusion: CBCT showed acceptable accuracy for assessing peri-implant bone. No meaningful conclusion could be drawn about other techniques.

The articular surfaces of the temporomandibular joint (TMJ) in the cat consist of the articular head of the condylar process of the ramus of the mandible and the mandibular fossa of the petrous part of the temporal bone. Anatomic conformation of the TMJ articular surfaces can vary; however, this has not been studied in the cat. Thus, the aim of this study was to characterize the conformation of the medial region of the TMJ in mesocephalic adult cats as well as to determine the articular relationship by measurement of the degree of coverage of the mandibular fossa over the articular head. This was accomplished by assessing 60 TMJs from 30 mesocephalic adult cats by means of cone-beam computed tomography (CBCT). The width and depth of the mandibular fossa, and the degree of coverage of the mandibular fossa were evaluated using parasagittal reconstructions of the medial aspect of the TMJ by two observers. No statistically significant difference was observed during the intra and interobserver evaluation of the mandibular fossa width and depth and the degree of coverage of the mandibular fossa over the articular head. P-values for the studied variables were greater than 0.05. The resulting measurements demonstrated a concave mandibular fossa with a prominent retroarticular process and a poorly developed articular eminence; a well-defined rounded articular surface, and a high degree of coverage (171°) of the mandibular fossa over the articular head. In conclusion, the articular surfaces at the medial aspect of the TMJ displayed elevated geometric similarity, with an articular head of the condylar process deeply seated in the mandibular fossa.

Facial pain is one of the symptoms of temporomandibular disorders (TMDs) but can be associated with other pathological conditions. The present study retrospectively evaluated the occurrence of nonarticular incidental findings in panoramic radiographs in a group of patients with painful TMDs. Outpatients with a diagnosis of TMD were included and distributed into three groups: arthralgia, myalgia or arthralgia and myalgia, according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Nonarticular incidental findings of their panoramic radiographs were classified in relation to pathological, dental and endodontic status. The dependency relationships among the variables were analyzed using the likelihood test. Sixty patients (38 women and 22 men; mean age: 36.9 years) were evaluated. There was a predominance of arthralgia plus disc displacement (43.4 %), followed by myopain plus arthralgia and disc displacement (38.3 %) and myopain (18.3 %). Pathologic radiographic changes such as bone loss, caries, maxillary sinus opacification and periapical lesions were frequent. Dental alterations such as the absence and altered position of teeth and impacted teeth were frequent. Endodontic changes such as periapical lesions with or without endodontic treatment were frequent. There was no significant difference between groups except for gyroversion. The incidental findings were compatible with caries, sinusitis, impacted tooth and periapical lesion, which may be associated with orofacial pain and could potentially be superimposed on the initial diagnosis, although this hypothesis was discarded. Findings such as the absence and altered position of teeth were also frequent, which may represent occlusal factors associated with TMDs.

Forensic facial reconstruction (approximation) (FFR) is an aid to human identification when no presumed identity is available. It is based on average soft tissue thickness (STT) applied onto a skull. These averages vary at each landmark according to sex, ancestry, and Facial Growth Patterns (FGP). To obtain the reference, there are different protocols and conditions, such as needles in cadavers, ultrasound, magnetic resonance, and computer tomography. Using cone-beam computed tomography (CBCT), landmark placement and direction of measurement are critical. The purpose of this article is to detailly describe a method for STT measurement in CBCT DICOM files and to test it in the analysis of a multi-ancestral Brazilian sample, subdivided into sex, age and FGP. A sample of 100 (50 male and 50 female) CBCT exams were selected and the volume was primarily been repositioned to cephalometric standards. A detailed description of the location and measurement direction of 32 landmarks was provided and granted good reproducibility of the measurements. The averages were assessed by sex, age, and FGP. There were significant differences between males and females. The CBCT measuring protocol provided standardization of measurements and is a method to be used in future researches. Advantages of CBCT, such as the subject's upright position and adjustable volume positioning, also justify its usage. Limited differences of STT were related to age and FGP. The updated Brazilian soft tissue thickness chart is a reliable source of data for forensic and clinical purposes.

Objective:This research aimed to longitudinally evaluate the optical density of peri-implant alveolar bone. The data acquired from study participants previously treated with 37 osseointegrated implants were analyzed utilizing the radiographic subtraction technique.Methods and materials:The radiographic follow-ups were performed five times: at the implantation of the prostheses and after 15, 90, 180 and 360 days. Intraoral radiographs were obtained by the paralleling technique using individualized Hanshin-type positioners to guarantee the standardization of the images. The obtained digital images were aligned and equalized before they were submitted to the radiographic subtraction procedure.Results:A significant difference was found between the distal region of Group I (patients treated with osseointegrated implants who required extraction of the dental element) and the 360 day follow-up and the distal region of Group II (patients with healed alveolar sockets) in all follow-up analyses (p < 0.05). We did not observe a significant difference between the groups analyzed and other follow-ups concerning the subcrestal and middle third regions for both the mesial and distal variables (p > 0.05). There was a statistically significant difference in the distal sites [χ2 = 5,745,, p = 0.03], showing a significant association between time and the presence of bone resorption. This association was not shown on the mesial surface (p = 0.16).Conclusion:We concluded that there was no statistically significant difference between groups I and II. Using this technique, we were able to quantitatively and qualitatively evaluate the changes in the proximal sites on the digital radiographic images for the analyzed data. Digital subtraction technology to measure peri-implant bone density is an accurate and reproducible technique for quantifying peri-implant bone reactions to different therapeutic modalities.

O padrão estético exige sorrisos bonitos e harmoniosos, o que incentiva a procura por procedimentos odontológicos para correção de imperfeições no sistema estomatognático. Na periodontia as cirurgias plásticas com intuito de corrigir o chamado sorriso gengival vêm sendo cada vez mais rotineiras. Com o advento de novas tecnologias, aumentam as opções de tratamento estético que se tornaram cada vez menos invasivos, menos traumáticos e com maior previsibilidade, possibilitando ênfase neste âmbito. Nesse sentido, toma-se o perioguide como objeto de pesquisa, uma vez que o que o mesmo se propõe a auxiliar o cirurgião-dentista na previsibilidade na cirurgia de correção do sorriso gengival. Este trabalho trata-se de um estudo de caso único, pois possui a intenção de relatar um trabalho que trata cirurgia de gengivoplastia/gengivectomia com utilização do perioguide. Concluiu-se que a atuação interdisciplinar entre as especialidades da Periodontia com a Radiologia auxiliada com a tecnologia possibilita aperfeiçoar e otimizar a cirurgia de gengivoplastia/gengivectomia. O uso do perioguide foi um diferencial para sucesso do tratamento.

Aim: To describe cone-beam computed tomography (CBCT) features in patients with temporomandibular disorders (TMDs), in terms of degenerative changes, condylar excursions and positioning as well as their possible correlations with signs and symptoms. Methods: Clinical records of patients diagnosed with TMD who were seen between January 2018 and December 2019 were retrospectively evaluated. These patients were divided into the following groups based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): arthralgia, myalgia, and arthralgia and myalgia groups. The CBCT examination findings of the patients were evaluated in relation to degenerative changes, estimates of condylar excursion, and condylar positioning. The likelihood ratio test was used to verify the possible differences among the three groups, whereas the chi-square test was used to verify the possible differences among the signs and symptoms for the tomographic findings (p ≤ 0.050). Results: In this study, 65 patients with TMD were included. These patients were predominantly female (84.6%) with a mean age of 40.6 years. Tomographic findings of flattening, hyperexcursion and posterior condylar positioning were frequent. A significant correlation was noted between osteophyte and lateral capsule pain (p = 0.027), erosion and posterior capsule pain (p = 0.026), and flattening, pseudocysts (p < 0.050) and condylar excursion (p < 0.001) with mouth opening. Conclusion: Few correlations were noted between degenerative changes and signs of joint pain as well as degenerative changes and condylar hypoexcursion with mouth opening. These correlations were likely associated with division by diagnosis, whereas condylar positioning did not correlate with signs and symptoms.

Few studies have assessed the use of the frontal sinus cavities for sex differentiation. In this study, a new methodology was used to assess the reliability of CBCT images of the frontal sinus cavity for determining sex based on the sexual dimorphism found in this anatomical structure. The survey sample consisted of 130 scans that were reconstructed three-dimensionally. 3D images of the cavity volume in the frontal, lateral, and basal views were exported in TIFF. The following variables were measured in a second program: area, perimeter, bounding rectangle, ellipse fit, circularity, aspect ratio, roundness, solidity, and Feret's diameter. The methodology demonstrated the existence of sexual dimorphism with an accuracy of 80.0% in the logistic regression model. The basal view had the greatest explanatory power in the final model. This methodology may be used as an alternative way of determining a reliable biological profile during the analysis of skeletal remains.

Objetivos: Fornecer informações básicas sobre as modalidades de ressonância magnética (RM), enfatizando o método da imagem ponderada em difusão, bem como apontar sua aplicabilidade para diagnosticar doenças das glândulas salivares maiores. Métodos: O método Prisma foi usado durante a extração e avaliação dos dados. As buscas foram feitas no banco de dados MEDLINE (PubMed) considerando o período de 2010 a novembro de 2017 e estudos que contivessem informações básicas sobre as modalidades de RM, bem como seu uso para diagnosticar doenças das glândulas salivares. A extração de dados incluiu informações sobre a aplicação das modalidades de RM, especialmente dos métodos de coeficiente de difusão aparente e da imagem ponderada em difusão, para diagnosticar doenças das glândulas salivares maiores. Resultados: A busca encontrou 58 publicações no MEDLINE (PubMed). A triagem inicial das publicações foi realizada usando os resumos e palavras-chave. Após a aplicação dos critérios de exclusão, um total de 9 estudos foi identificado como elegível para ser avaliado. Os estudos apontaram dois tipos principais de modalidades de RM: o coeficiente de difusão aparente e a imagem ponderada em difusão. A maioria dos estudos sugere que a RM pode ser uma útil ferramenta de diagnóstico para as glândulas salivares maiores. Conclusão: Modalidades de RM são vantajosas ferramentas para avaliações dos tecidos das glândulas salivares. São necessários mais estudos envolvendo um maior número de pacientes estudados para demonstrar a eficácia dos métodos e modalidades de abordagem distinta. Objectives: To provide basic information on the magnetic resonance imaging modalities, emphasizing the diffusion-weighted imaging technique, as well as to clarify its applicability to diagnose major salivary gland disorders. Methods: The PRISMA statement was used during data assessment and extraction. The MEDLINE (PubMed) database was searched for the period from 2010 to November 2017, for studies providing basic information on the MRI modalities as well its applicability to diagnose salivary gland disorders. Data extraction included information regarding: application of MRI modalities especially ADC and DWI to diagnose major salivary gland disorders. Results: The search yielded 58 publications in MEDLINE (PubMed). The initial screening of the publications was performed using abstracts and keywords. After application of exclusion criteria, we identified a total of 9 studies as eligible to be discussed. Studies revealed two main types of MRI modalities: ADC and DWI. Most of the studies suggest that MRI can be useful as a diagnostic tool for major salivary glands. Conclusion: MRI modalities are advantageous tools for salivary gland tissue evaluations. To demonstrate the accuracy of the distinct approach methods and modalities, more studies involving a larger number of patients studied are necessary.

As a unique anatomical feature of the human body, the frontal sinus morphology has been used for identification of unknown bodies with many techniques, mostly using 2D postero-anterior X-rays. With the increase of the use of Cone-Beam Computer Tomography (CBCT), the availability of this exam as ante-mortem records should be considered. The purpose of this study is to establish a new technique for frontal sinus identification through direct superimposition of 3D volumetric models obtained from CBCT exam, by testing two distinct situations. First, a reproducibility test, where two observers independently rendered models of frontal sinus from a sample 20 CBCT exams and identified them on each other's list. In the second situation, one observer tested the protocol and established on different exams of three individual. Using the open source DICOM viewer InVesallius(®) for rendering, Mesh Lab(®,) for positioning the models and CloudCompare for volumetric comparison, both observers matched cases with 100% accuracy and the level of coincidence in a identification situation. The uniqueness of the frontal sinus topography is remarkable and through the described technique, can be used in forensic as an identification method whenever both the sinus structure and antemortem computer tomography is available.

Made available in DSpace on 2018-12-11T17:09:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-08-01 Statement of problem The longevity of silicone facial prostheses is short, and published data concerning this type of rehabilitation are limited. Purpose The purpose of this retrospective study was to identify predictive variables for prosthetic failure and to highlight the results that can be expected after treatment with silicone facial prostheses. Material and methods After institutional approval, patient records from a single Brazilian institution for the time period 2004 to 2015 were assessed. A standardized form was used to collect patient data. Frailty survival modeling (simple random effects survival model) was used to test whether age, sex, type of prosthesis, source of defect, number of implants, and type of retention have a direct impact on the prosthetic failure rate (α=.05). Results Auricular prostheses were the most frequently fabricated prostheses. Eighty-four prostheses were fabricated during the follow-up period. The overall survival rate for facial prostheses was 34.5%. Color alteration was the most common reason for new prostheses (27.38%). The implant success rate was 98.18%. The number of implants approached statistical significance (P=.06) with a reduced risk of failure when the patient had 2 implants compared with patients with zero implants and patients with more than 2 implants. Conclusions Patients should be recalled frequently so that retouches can be performed, avoiding the repeated fabrication of new prostheses. Well-designed studies are necessary to identify more relevant complications and factors that lead to prosthetic failure. Coordinator Dental Oncology Service Institute of Cancer of São Paulo (ICESP) São Paulo Brazil; and Coordinator Anaplastology Service of Brånemark Institute Assistant Dental Oncology Service Institute of Cancer of São Paulo São Paulo (ICESP) Doctoral student Department of Dental Materials and Prosthodontics Aracatuba Dental School Sao Paulo State University (UNESP) Assistant Dental Oncology Service Institute of Cancer of São Paulo (ICESP) Professor Department of Traumatology and Bucomaxillofacial Surgery University of Sagrado Coração (USC) Surgery Service of Brånermark Institute Department of Stomatology School of Dentistry University of Sao Paulo (USP) Director Center of Oral Health Research School of Dentistry Academic Partners Center for Promoting Health and Health Equality Creighton University Assistant Professor Oral Diagnosis Department Piracicaba Dental School University of Campinas (UNICAMP) Assistant Professor Department of Prosthodontics and Periodontology University of Campinas (UNICAMP) Piracicaba Dental School Section head Maxillofacial Prosthodontics Veteran's Affairs Nebraska-Western Iowa Health Care System Doctoral student Department of Dental Materials and Prosthodontics Aracatuba Dental School Sao Paulo State University (UNESP)

Purpose The aim of this prospective clinical study was to evaluate the clinical and histomorphometric data of newly formed bone tissue from fresh frozen human allograft in sinus lift surgery. Patients and Methods Thirty-three sinus lift procedures were performed in 20 patients, divided into two groups. The control group (n = 8) received autogenous bone from the mandibular ramus, and the experimental group (n = 12) received fresh frozen bone (FFB) allograft in chips. After 6 months, 52 implants were placed and 50 biopsies were collected for histomorphometric analysis. Cone beam computed tomography scans were performed at preoperative, immediate postoperative, and delayed postoperative time intervals to assess the degree of graft volume loss. Results There was no statistically significant difference between groups as regards degree of graft volume loss (p = .983), total bone area (p = .191), remaining particles (p = .348), and proportion of active osteoblasts (p = .867). There was a statistically significant difference in the vitality rate between the groups (p = .043). In both groups, all implants were clinically osseointegrated after 4 months. Conclusion FFB allograft was shown to be a feasible substitute for autogenous bone graft in sinus lift surgery.

The aim of this study was to determine whether image artifacts caused by orthodontic metal accessories interfere with the accuracy of 3D CBCT model superimposition. A human dry skull was subjected three times to a CBCT scan: at first without orthodontic brackets (T1), then with stainless steel brackets bonded without (T2) and with orthodontic arch wires (T3) inserted into the brackets' slots. The registration of image surfaces and the superimposition of 3D models were performed. Within-subject surface distances between T1-T2, T1-T3 and T2-T3 were computed and calculated for comparison among the three data sets. The minimum and maximum Hausdorff Distance units (HDu) computed between the corresponding data points of the T1 and T2 CBCT 3D surface images were 0.000000 and 0.049280 HDu, respectively, and the mean distance was 0.002497 HDu. The minimum and maximum Hausdorff Distances between T1 and T3 were 0.000000 and 0.047440 HDu, respectively, with a mean distance of 0.002585 HDu. In the comparison between T2 and T3, the minimum, maximum and mean Hausdorff Distances were 0.000000, 0.025616 and 0.000347 HDu, respectively. In the current study, the image artifacts caused by metal orthodontic accessories did not compromise the accuracy of the 3D model superimposition. Color-coded maps of overlaid structures complemented the computed Hausdorff Distances and demonstrated a precise fusion between the data sets.

Purpose: The aim of this study was to evaluate the accuracy of cone-beam computed tomography (CBCT) for measuring the buccal bone volume around dental implants. Materials and methods: Three to six implants were inserted into the anterior maxilla of eight skulls, depending on the availability of bone, and after this, the CBCT was performed. By means of CBCT image, measurements of the bone wall at three points of the implant were obtained, analyzed and compared with those obtained in the plaster skull casting. Results: The results showed that for the three points of the implants, no statistically significant difference in the measurements was obtained from the plaster model and CBCT images. Conclusions: CBCT can be a useful tool for assessing buccal bone volume along the implant. To cite this article: Shiratori LN, Marotti J, Yamanouchi J, Chilvarquer I, Contin I, Tortamano-Neto P. Measurement of buccal bone volume of dental implants by means of cone-beam computed tomography. Clin. Oral Impl. Res. 23, 2012; 797–804. doi: 10.1111/j.1600-0501.2011.02207.x

The relationship of mandibular condyle dimensions and its association with unilateral posterior crossbite (UPXB) has been suggested in the literature. The purpose of this prospective study was to evaluate mandibular condyles on the left and right sides and between crossed and non-crossed sides in the sagittal and coronal planes, using cone-beam computed tomography (CBCT). Twenty CBCT images of 40 temporo mandibular joints (TMJs) in individuals in mixed dentition phase, which included 9 males (mean 7.9 years) and 11 females (mean 8.2 years), with unilateral posterior crossbite without premature contacts and functional mandibular shifts and with transverse maxillary deficiency. The criteria for sample exclusion included the presence of painful symptoms, facial trauma history, systemic diseases such as juvenile rheumatoid arthritis, mouth opening limitation (< 40 mm), congenital or genetic anomalies, and skeletal asymmetries that may result in TMJ disorders. Dimensional measurements of the condyles between the right and left sides and crossed and non-crossed sides in sagittal and coronal view were made. There was no significant difference between the measurements of the crossed and non-crossed sides in both sagittal and coronal view. These findings suggest that the presence of unilateral posterior crossbite in children with UPXB did not result in changes between the mandibular condyles in the right and left sides or between the crossed and non-crossed sides in the coronal or sagittal plane.

OBJETIVO: o objetivo neste trabalho é avaliar e localizar o Forame de Huschke. FORMA DE ESTUDO: anatômico. MATERIAL E MÉTODO: utilizando materiais de contraste como a Guta percha e o sulfato de bário, através de técnicas radiográficas extrabucais, como a panorâmica, submentovértex e a tomografia linear lateral corrigida para a Articulação Têmporo-mandibular, em quatro crânios, onde foi verificada clinicamente a presença do Forame de Huschke. RESULTADO: Os resultados obtidos mostraram que o Forame de Huschke pôde ser observado em crânios secos após a sua evidenciação por meio de material de contraste nestas técnicas radiográficas.

OBJETIVO: o objetivo neste trabalho é avaliar e localizar o Forame de Huschke. FORMA DE ESTUDO: anatômico. MATERIAL E MÉTODO: utilizando materiais de contraste como a Guta percha e o sulfato de bário, através de técnicas radiográficas extrabucais, como a panorâmica, submentovértex e a tomografia linear lateral corrigida para a Articulação Têmporo-mandibular, em quatro crânios, onde foi verificada clinicamente a presença do Forame de Huschke. RESULTADO: Os resultados obtidos mostraram que o Forame de Huschke pôde ser observado em crânios secos após a sua evidenciação por meio de material de contraste nestas técnicas radiográficas.AIM: the aim of this study is to assess and locate the Foramen of Huschke. STUDY DESIGN: anatomical. MATERIAL AND METHOD: using contrast material like gutta-percha and barium sulfate, through extraoral radiographs, such as panoramic, submental vertex and corrected saggital linear Temporal Mandibular Joint tomograms in four skulls where we clinically checked the existence of foramen of Huschke. RESULTS: The results proved that the foramen of Huschke can be observed in skulls submitted to contrast using radiographic techniques.

Summary The incidence of mineralization of the stylohyoid ligament complex, according to radiographic findings, was analysed in a group of patients with temporomandibular disorders (TMD), and compared with that of a control group of asymptomatic individuals (AI). Both groups were similar considering the prevalence of the female gender as well as the distribution of cases according to age. ‘Elongated’ was the most frequent radiographic appearance in both groups; ‘partially mineralized’ was the most frequent radiographic pattern in the TMD group; and the lower ramus was the most frequent location of mineralization in both groups. When comparing between groups and according to each class, there was only one significant difference in radiographic appearance, ‘pseudoarticulated’ being more frequent in the TMD group. We can conclude that the occurrence and characteristics of mineralization of stylohyoid ligament complex were similar in TMD patients and AIs.

Traumas to deciduous teeth may have severe consequences. This article addresses a dentigerous cyst case report associated with an upper permanent incisor, unusual site of occurrence, which was impacted and dislodged from its natural site of eruption after trauma at the deciduous predecessor.The main aspects of etiopathology and its clinical characteristics are also discussed, with especial focus on the radiographic features of the diagnosis in order to allow for an accurate surgical planning.

The aim of this prospective clinical study was to evaluate the clinical and histomorphometric data of newly formed bone tissue from fresh frozen human allograft in sinus lift surgery.Thirty-three sinus lift procedures were performed in 20 patients, divided into two groups. The control group (n = 8) received autogenous bone from the mandibular ramus, and the experimental group (n = 12) received fresh frozen bone (FFB) allograft in chips. After 6 months, 52 implants were placed and 50 biopsies were collected for histomorphometric analysis. Cone beam computed tomography scans were performed at preoperative, immediate postoperative, and delayed postoperative time intervals to assess the degree of graft volume loss.There was no statistically significant difference between groups as regards degree of graft volume loss (p = .983), total bone area (p = .191), remaining particles (p = .348), and proportion of active osteoblasts (p = .867). There was a statistically significant difference in the vitality rate between the groups (p = .043). In both groups, all implants were clinically osseointegrated after 4 months.FFB allograft was shown to be a feasible substitute for autogenous bone graft in sinus lift surgery.

Objective: This article presents an interesting case of osteochondroma of the the sigmoid notch.Case Report: A 15-year-old female with severe facial asymmetry, malocclusion, open bite and extreme limitation of mouth opening. Panoramic radiography showed an exophytic radiopaque mass arising from the sigmoid notch on the right side. CT images revealed bony proliferation with benign signs causing damage to the articular eminence, condilar morphology and periarticular soft tissue calcifications. Magnetic Resonance confirmed the findings of the CT and revealed modifications on disc morphology. A surgical resection was performed.Conclusion: The OC located at the sigmoid notch presented is probably the rarest site seen in the existing literature. Objetivo: O presente artigo apresenta um caso interessante de osteocondroma (OC) no sulco sigmoide.Relato do caso: Paciente do sexo feminino, com 15 anos de idade, apresentada assimetria facial severa, mal oclusão, mordida aberta e restrição severa da abertura bucal. A radiografia panorâmica evidenciou a presença de uma massa radiopaca exofítica, partindo do sulco sigmoide do lado direito. Imagens de tomografia computadorizada (TC) evidenciaram a presença de proliferação óssea, com características benígnas, causando alterações na eminência articular, morfologia condilar e calcificação dos tecidos moles peri-articulares. A ressonância magnética confirmou os achados da TC com relação à alteração da morfologia do disco articular. Como tratamento, foi realizada a ressecção cirúrgica.Conclusão: O OC localizado no sulco sigmoide, apresentado no presente relato de caso, é provavelmente a localização mais rara citada na literatura.

Orthodontic miniscrews are commonly used to achieve absolute anchorage during tooth movement. One of the most frequent complications is screw loss as a result of root contact. Increased precision during the process of miniscrew insertion would help prevent screw loss and potential root damage, improving treatment outcomes. Stereolithographic surgical guides have been commonly used for prosthetic implants to increase the precision of insertion. The objective of this paper was to describe the use of a stereolithographic surgical guide suitable for one-component orthodontic miniscrews based on cone beam computed tomography (CBCT) data and to evaluate implant placement accuracy.Acrylic splints were adapted to the dental arches of four patients, and six radiopaque reference points were filled with gutta-percha. The patients were submitted to CBCT while they wore the occlusal splint. Another series of images was captured with the splint alone. After superimposition and segmentation, miniscrew insertion was simulated using planning software that allowed the user to check the implant position in all planes and in three dimensions. In a rapid-prototyping machine, a stereolithographic guide was fabricated with metallic sleeves located at the insertion points to allow for three-dimensional control of the pilot bur. The surgical guide was worn during surgery. After implant insertion, each patient was submitted to CBCT a second time to verify the implant position and the accuracy of the placement of the miniscrews.The average differences between the planned and inserted positions for the ten miniscrews were 0.86 mm at the coronal end, 0.71 mm at the center, and 0.87 mm at the apical tip. The average angular discrepancy was 1.76 degrees.The use of stereolithographic surgical guides based on CBCT data allows for accurate orthodontic mini screw insertion without damaging neighboring anatomic structures.

The aim of this study was to evaluate the accuracy of cone-beam computed tomography (CBCT) for measuring the buccal bone volume around dental implants.Three to six implants were inserted into the anterior maxilla of eight skulls, depending on the availability of bone, and after this, the CBCT was performed. By means of CBCT image, measurements of the bone wall at three points of the implant were obtained, analyzed and compared with those obtained in the plaster skull casting.The results showed that for the three points of the implants, no statistically significant difference in the measurements was obtained from the plaster model and CBCT images.CBCT can be a useful tool for assessing buccal bone volume along the implant.

To compare 2 methods used to determine the disk position based on sagittal magnetic resonance images.A cross-sectional study of patients with the signs and symptoms of temporomandibular disorders was conducted. The patients' ages and gender distributions were collected. The disk position diagnosis from the clinical examination was considered the primary outcome. Three observers evaluated the presence of anterior displacement on magnetic resonance images according to 2 criteria: method 1 (12-o'clock position) and method 2 (location of the intermediate zone). To assess the intraobserver variability of the 2 methods, the examiners evaluated the same magnetic resonance images at the beginning of the study (time 1) and 40 days later (time 2). The intraobserver agreement was assessed using the observed agreement and the kappa statistic. McNemar's test was used to assess the differences between each method and the clinical examination findings (P.05). The accuracy, sensitivity, specificity, and positive and negative predictive values were calculated by comparing the diagnosis from each method with that from the clinical examination (considered the reference standard).The final sample was composed of 20 subjects with a mean age of 33.0 ± 33.7 years; 3 were men (15%) and 17 were women (85%). A statistically significant difference between the 2 methods was found. Method 1 yielded a greater percentage of anterior displaced disks (52.5%). The agreement between the clinical diagnosis and method 1 was lower (70.0%) than that between the clinical diagnosis and method 2 (87.5%). No statistically significant difference was found between the clinical diagnosis and method 2.The disk position should be judged according to the intermediate zone criterion.

minimal density variations of mineralized tissues can be reliably detected with quantitative image subtraction analysis. The aim of this study was to evaluate quantitative variations of in vitro mineral density by varying the exposure time of direct digital radiographs using a computer assisted densitometric image analysis (CADIA) program.in a human mandibular segment a three-wall periodontal defect was created mesial to a molar. Bone chips were created from the marrowbone of the same mandible with masses of 1 to 5 mg. A triplicate radiograph of the defect was taken as a baseline for seven different exposure times. The bone chips were inserted into the defect and another triplicate series of radiographs for the seven exposure times were taken as follow-up images. The images were analysed using CADIA software to detect variations in bone density.the results of CADIA revealed increased density when the size of the inserted bone chip increased. The 2 mg chip was underestimated owing to mass reduction during insertion. The regression line of the CADIA values was consistent with the weight of the bone chips of 1, 3, 4 and 5 mg. The exposure time f6 (0.178 s) showed the best correlation with the bone chip weight. Loss of information in the images occurred when the exposure time exceeded the sensor's latitude.CADIA analysis is a reliable and sensitive tool for detecting subtle bone density variations. More reliable results are obtained with increased exposure time; however, excessive exposure should be avoided.

PURPOSE: To evaluate the rehabilitation of edentulous mandibles with osseous integrated implants in immediate loading, using models in reverse planning. METHODS: A prospective study was performed on 14 patients with a total of 56 implants placed. It was proposed a technique for the rehabilitation of edentulous mandible with osseous integrated implants of immediate loading, using anatomical replicas derived from computerized tomography scan linked to the rapid prototyping technique of stereolithography in reverse planning, elaborating the definitive fixed prosthesis, with rigid union of the implants on the same day. The patients' mandible models were divided in two groups. In the first one, there were patients with edentulous mandible models and with models elaborated after exodontics procedures (Group 1). In the second (Group 2), patients with dentulous mandible models, which allow an evaluation of difficulty in the surgery. RESULTS: The proposed technique using anatomical models for the personalization of mandibles in immediate loading had 100% of less difficulty in the adaptation of the surgery guide while the dentulous models had 83,3% of more difficulty. CONCLUSION: The proposed technique using the mandible models in the rehabilitation of mandibles is feasible. OBJETIVO: Avaliar a reabilitação de mandíbulas edêntulas com implantes osseointegrados, em função imediata, utilizando biomodelos no planejamento inverso. MÉTODOS: Foi realizado um estudo prospectivo em 14 pacientes com um total de 56 implantes colocados, em que foi proposta uma técnica de reabilitação de mandíbulas edêntulas com implantes osseointegrados, em função imediata, utilizando biomodelos, confeccionados a partir dos dados da tomografia computadorizada, no planejamento inverso, confeccionando a prótese fixa final, com união rígida dos implantes, no mesmo dia. Os biomodelos dos pacientes foram divididos em dois grupos. Um deles composto pelos pacientes com biomodelos edêntulos e aqueles confeccionados após exodontia (grupo 1). O outro (grupo 2) composto pelos pacientes com biomodelos dentados, sendo avaliada a dificuldade do procedimento, quanto a cirurgia. RESULTADOS: A técnica proposta do uso da prototipagem biomédica na função imediata nas mandíbulas com biomodelos edêntulos teve 100,0 % de menor dificuldade na adaptação da guia cirúrgica, enquanto os biomodelos dentados apresentaram 83,3 % de maior dificuldade. CONCLUSÃO: O biomodelo no planejamento inverso de reabilitações orais teve 100,0 % de menor dificuldade em comparação com os protótipos dentados 83,3 % de maior dificuldade.

The purpose of this study was to assess, by panoramic radiographs, the prevalence of morphological dental changes in children with cancer who were submitted for chemotherapy alone or concomitant radiotherapy of the head and neck.All patients admitted between March, 1996 and February, 2004 were analyzed and 137 were included in this retrospective, nonrandomized, institutional study. The rates of microdontia, taurodontia, anodontia, macrodontia, blunt root, and tapered root were assessed.The patients were distributed into 2 groups: (1) those with lymphoproliferative neoplasias (61%); and (2) those with solid tumors (39%). Their mean age when treatment began was 5 years and 6 months. Dental abnormalities were found in 39 (29%) patients, while 98 (72%) patients did not present any abnormality. The abnormalities found were: (1) microdontia (7%; N= 10); (2) anodontia (6%; N=8); (3) taurodontia (14%; N=19); (4) macrodontia (5%; N=7); (5) blunted root (2%; N=2); and (6) tapered root (4%; N=5). Of these patients: 22% (N=30) presented 1 abnormality; 4% (N=6) presented 2 abnormalities; and 2% (N=3) presented 3 abnormalities.Taurodontia was the most frequent abnormality found in children and adolescents who underwent antineoplastic treatment, and its rate was significantly higher than those found for the healthy Brazilian population. This study's results show that it is necessary for the odontologist to systematically research the dental changes that occur among this special group of patients.

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:21:36Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:44:17Z : No. of bitstreams: 1 2-s2.0-33645536671.pdf: 179671 bytes, checksum: 99e2d8210462e0bf22755de08e53f1f9 (MD5) Made available in DSpace on 2014-05-27T11:21:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2005-09-01 Aim: the aim of this study is to assess and locate the Foramen of Huschke. Study design: anatomical. Material and Method: using contrast material like gutta-percha and barium sulfate, through extraoral radiographs, such as panoramic, submental vertex and corrected saggital linear Temporal Mandibular Joint tomograms in four skulls where we clinically checked the existence of foramen of Huschke. Results: The results proved that the foramen of Huschke can be observed in skulls submitted to contrast using radiographic techniques. Dental School Universidade Ibirapuera Department of Stomathology University of Sao Paulo FOUSP University of Texas, San Antonio, TX Universidade Ibirapuera Department of Imaging Universidade Ibirapuera Master Program in Dental Prosthesis PUC-MG Universidade Ibirapuera-Unib Department of Dental Prosthesis Dental School São José Dos Campos/UNESP , R. Joao de Souza Dias 43 apt 21, São Paulo SP 04618-000 Department of Dental Prosthesis Dental School São José Dos Campos/UNESP

Os achados radiográficos e os sinais e sintomas de pacientes com disfunções da articulação temporomandibular (ATM) foram estudados. Através da incidência transcranial para ATM, foram verificadas a presença de alterações degenerativas e a estimativa de excursão condilar. Pelo exame clínico, foram avaliados dados como queixa principal, padrão de ocorrência de dor, sinais de dor muscular e sinais articulares de disfunção. As alterações radiográficas mais freqüentes foram as degenerativas. As alterações degenerativas mais freqüentes foram, em ordem decrescente, facetamento, eburnação e osteofito. As alterações degenerativas foram mais freqüentes no côndilo do que na eminência articular. A estimativa de excursão condilar foi, em ordem decrescente, normo, hiper e hipoexcursão. Não foi observada relação entre achados radiográficos e sinais ou sintomas específicosA study of radiographic findings and of signs and symptoms in temporomandibular joint (TMJ) dysfunction was made. Through TMJ transcranial radiographs, the presence of degenerative alterations as well as the estimate of condylar excursion were examined. Data such as chief complaint, pattern of occurrence of pain, signs of muscular pain, and articular signs of dysfunction were evaluated through clinical examination. The most frequent radiographic findings were the degenerative alterations. The most frequent ones were, in decreasing order, flattening, eburnation and osteophyte. Degenerative alterations were more frequent in the condyle than in the articular eminence. The estimates of condylar excursion were, in decreasing order, normo, hyper and hypoexcursion. No relationship between radiographic findings and specific signs or symptoms was observed

Two cases of active unilateral condylar hyperplasia which were treated with condylectomy alone are presented. The first case was an adult form and the other a juvenile form. Both were classified as active by using 99Tc bone scintigraphy. Clinical and radiographic features of both cases conformed to the hemimandibular hypertrophy type. Satisfactory facial symmetry and dental occlusion were achieved. Histopathological data confirmed the activity of the articular cartilage layers.

A new technique for imaging the temporomandibular joint with rotational panoramic radiography is explained and demonstrated with a tissue-equivalent phantom. In this technique the patient is displaced forward and laterally away from the side under examination. Radiographs made with the proposed technique show the temporomandibular joint with more sharpness and less distortion than do radiographs made with conventional panoramic techniques.

In the first article of this series, a new panoramic technique for visualization of the temporomandibular joint was described. In this article, it is shown that the patient positoning required for the implementation of this technique can be inferred from the gender, ethnicity, and bizygomatic width of the patient. Tables for estimating positioning in the Panoral panoramic machine have been derived from the analysis of data from 196 patients. Use of this approach eliminates the requirement for an additional submentovertex radiograph and the associated radiation dose to the patient.

The aim of the present study was to generate one consistent set of data for evaluating and comparing radiobiologic risks from different dental radiographic techniques. To accomplish this goal, absorbed doses were measured in fourteen anatomic sites from (1) five different panoramic machines with the use of rare-earth screens, (2) a twenty-film complete-mouth survey with E-speed film, long round cone, (3) a twenty-film complete-mouth survey with E-speed film, long rectangular cone, (4) a four-film interproximal survey with E-speed film, long round cone, and (5) a four-film interproximal survey with E-speed film, long rectangular cone. The dose to the thyroid gland, the active bone marrow, the brain, and the salivary glands was evaluated by means of exposure of a tissue-equivalent phantom, fitted with lithium fluoride thermoluminescent dosimeters (TLDs) at the relevant locations.

With the use of the measured absorbed doses from part I of this article, the specific radiobiologic risk to the patient from (1) five different panoramic machines with rare-earth screens, (2) a 20-film complete-mouth survey with E-speed film, long round cone, (3) a 20-film complete-mouth survey with E-speed film, long rectangular cone, (4) a 4-film interproximal survey with E-speed film, long round cone, and (5) a 4-film interproximal survey with E-speed film, long rectangular cone, was calculated. The estimated risks are expressed in two ways: the probability of radiation-induced cancer in specific organs per million examinations and the probability of expression of a fatal cancer per million examinations. The highest risks calculated were from the complete-mouth survey with the use of round collimation. The lowest risks calculated were from panoramic radiography and four interproximal radiographs with rectangular collimation.

Osteomas are benign osteogenic lesions characterized by compact and/or cancellous bone proliferation. The aetiology of these lesions remains unknown. It is usually asymptomatic and it is often detected incidentally on routine radiographic examination or until it causes facial asymmetry or dysfunction. It is characterized by very slow and continuous growth. The peripheral osteoma of the jaw is uncommon. Radiographically, peripheral osteomas are seen as oval radiopaque well-circumscribed masses attached to the cortex by a broad base or a pedicle. Three theories have been proposed: developmental, neoplasic and reactive. The possibility that peripheral osteomas may be a reaction to trauma could explain the occurrence on the lower border and buccal aspect of the mandible. The objective of this article is to present the radiographic features of two cases of osteomas, one in the lingual site of the mandibular angle and another one on the zygomatic arch.

Os achados radiográficos e os sinais e sintomas de pacientes com disfunções da articulação temporomandibular (ATM) foram estudados. Através da incidência transcranial para ATM, foram verificadas a presença de alterações degenerativas e a estimativa de excursão condilar. Pelo exame clínico, foram avaliados dados como queixa principal, padrão de ocorrência de dor, sinais de dor muscular e sinais articulares de disfunção. As alterações radiográficas mais freqüentes foram as degenerativas. As alterações degenerativas mais freqüentes foram, em ordem decrescente, facetamento, eburnação e osteofito. As alterações degenerativas foram mais freqüentes no côndilo do que na eminência articular. A estimativa de excursão condilar foi, em ordem decrescente, normo, hiper e hipoexcursão. Não foi observada relação entre achados radiográficos e sinais ou sintomas específicos A study of radiographic findings and of signs and symptoms in temporomandibular joint (TMJ) dysfunction was made. Through TMJ transcranial radiographs, the presence of degenerative alterations as well as the estimate of condylar excursion were examined. Data such as chief complaint, pattern of occurrence of pain, signs of muscular pain, and articular signs of dysfunction were evaluated through clinical examination. The most frequent radiographic findings were the degenerative alterations. The most frequent ones were, in decreasing order, flattening, eburnation and osteophyte. Degenerative alterations were more frequent in the condyle than in the articular eminence. The estimates of condylar excursion were, in decreasing order, normo, hyper and hypoexcursion. No relationship between radiographic findings and specific signs or symptoms was observed

The effect of rotating the patient's head for optimum imaging of the temporomandibular region with the use of a panoramic radiographic machine with a continuous center of rotation (Panex-E) was studied. The result showed that the intercondylar distance influenced the amount of rotation necessary for the optimum image.