SED-brachydactyly and distinctive speech: Report of a new familial case

Background: Spondyloepiphyseal dysplasia-brachydactyly and distinctive speech (SED-BDS) is a syndrome characterized by short stature, disproportionately short limbs, peculiar face, thick and abundant hair, high-pitched and coarse voice, small epiphyses, brachymetacarpalia, brachymetatarsalia and brachy-phalangia of fingers and toes, small pelvis and delayed carpal bone age, among other features. Case Report: We report a Brazilian patient with father, brother and sister presenting with the same typical features of the syndrome. Clinically, he showed disproportionately short stature, rhizo-meso-acromelic shortness of the extremities, short hands and feet, a peculiar distinctive high-pitched voice, peculiar facies, and other features already reported as characteristic of this syndrome. Radiographic fndings included shape anomalies of the vertebral bodies such as cuboid-shaped vertebral bodies, mild scoliosis, short and broad tubular bones, brachymetacarpalia, brachymetatarsalia, and brachy-dactyly, lumbar hyperlordosis, generalized osteopenia, and hypoplastic iliac wings. Conclusions: Few cases have been described, as this is a rare skeletal dysplasia. This paper describes a new familial case of SED-BDS. © The American Journal of Case Reports.

Physiologic values of broiler femurs at different growth phases using Bone densitometry and Bone Breaking Strength

The objective of this experiment was to determine the normal values of Bone Radiographic Density (BRD) by using the optical densitometry in radiographic images and the Bone Breaking Strength (BBS) of broiler femurs at different ages (8, 22 and 42 d of age). A total of 60 Cobb male broilers were distributed in three age groups of 20 birds. The BRD and the BBS (maxim force and rigidity) values increased (p<0.01) over the course of ages, presenting greater values at 42 d of age when comparing to 8 and 22 d of age, evidencing a biomechanical adaptation of femur to growth. This experiment offers results that can be used in other experiments of broilers fed with different nutritional levels and they can also be related to pathological values, allowing the diagnosis of diseases that affect the integrity of the poultry leg. © Asian Network for Scientific Information, 2011.

Contaminação microbiana das soluções de processamento radiográfico: Risco de infecção cruzada

Objective: To evaluate the microbial contamination in samples of radiographic developing and fixing solutions, radiographic processing water, dental unit waterlines and dental office's external water supply. Methods: Samples of 50 private dental offices and 20 dental offices of the School of Dentistry de Araçatuba-UNESP were collected. The samples were subjected to neutralization of the residual inhibitory agents followed by pre-enrichment in peptone water and EVA broth and were inoculated in selective and non-selective culture media. The DNA of the samples was extracted and the presence of superinfectant microorganisms was evaluated by PCR. The differences in the prevalence of the microorganisms in the samples of the solutions were analyzed by repeated-measures analysis of variance for category data, while the Chi-Square and Mann-Whitney tests were used to evaluate the existence of associations between the total number of heterotrophic microorganisms and infection control protocols. The significance level was set at 5%. Results: Samples of radiographic fixing solution presented a remarkably less frequent contamination than radiographic developing solution and radiographic processing water. The latter exhibited microorganisms typically originated from the oral microbiota and human skin as well as microorganisms frequently found in dental unit waterlines. There was less contamination of radiographic processing water in the dental offices where the x-ray film packets were disinfected before processing or were covered by a plastic film. Additionally, all samples of dental office's external water supply were drinkable. Conclusion: Covering the x-ray film packets with a plastic film protection barrier was proven the best manner to reduce the contamination of the evaluated solutions.

Osteossarcoma mandibular em gato: Relato de Caso

The primary malignant bone tumors are uncommon in cats. Osteosarcoma is the most frequently observed in old animals. This tumors affects the appendicular skeleton, however the axial skeleton is also affected, but the bones of the head and pelvis frequent sites of injury. This paper reports a case of a cat with a history of progressive swelling in the left mandible, with follow-up period of four months. The presumptive diagnosis of osteopathy, signed by clinical and radiographic observations were confirmed by histopathology and there it is moderately productive osteoblastic osteosarcoma.

Hemangiossarcoma cardíaco em cão: Relato de caso

Cardiac tumors are relatively rare in dogs, being hemangiosarcoma (HAS) the most common neoplasia. It consists in a primary, endothelial-originated neoplasia, which frequently compromises the right atrium. The pericardial effusion, frequently identified in dogs with heart HSA is responsible for the clinical signs, such as lethargy, exercise intolerance, dyspnea, and syncope. The diagnosis is difficult and suggested mainly by the clinic, hematologic, radiographic and echocardiographic findings, and was confirmed by histopathological examination. The present study aimed to report the presence of a heart HSA in a seven year old, spayed dog presented with signs of a congestive heart failure, due to the presence of a pericardial effusion secondary to tumor, and also lung, liver and spleen metastases. Despite this uncommon association a cardiac tumor should be suspected when signs of a heart failure, with rapid decline in the clinical status abruptly occurs.

The challenges of treating a fused tooth

This paper describes and discusses the multidisciplinary treatment involving a permanent maxillary lateral incisor fused to a supernumerary tooth, both presenting pulp necrosis and periapical lesion. A 15-year-old male patient sought treatment complaining of pain, swelling and mobility on the maxillary right lateral incisor. After clinical and radiographic examination, root canal preparation was performed according to the crown-down technique and a calcium hydroxide dressing was placed for 15 days. The patient returned and the definitive endodontic filling was done with thermomechanical compaction of gutta-percha and sealer. After 18 months, clinical and radiographic examinations were carried out and no pain or swelling was reported. Two years after endodontic treatment, the patient returned for periodontal and cosmetic treatments. Nine months later, a cone-beam computed tomography (CBCT) revealed that the previously detected periodontal defect and periapical lesion were persistent. Apical endodontic surgery was indicated. The supernumerary tooth was removed, the communicating distal surface was filled and the surgical site received bioactive glass and demineralized bovine organic bone. The pathological tissue was submitted to histopathological examination and the diagnosis was periapical cyst. One year after the apical endodontic surgery, CBCT showed bone formation at maxillary lateral incisor apical area. Two years after the surgery, the restoration was replaced due to aesthetic reasons and periapical radiograph showed success after 5 years of treatment. A correct diagnosis and establishment of an adequate treatment plan resulted in a successful management of the case.

Intussuscepção ileocólica associada a torção mesentérica em um cão: Relato de caso

Mesenteric torsion is a rare disease in dogs whereas it is more common to affect large animals. The main clinical signs observed are acute, such as prostration and abdominal distension which evolve to a state of shock and death. This paper reports the mesenteric torsion in a dog that was presented to veterinary care with generalized acute abdominal pain of sudden onset. At the physical examination, signs of acute abdomen, rectal temperature of 35 oC, moderate dehydration, congested mucous membrane, and prostration were detected. Emergency therapy was instituted and radiographic and ultrasound examinations were requested. The radiography showed increase in the bowel diameter and an image suggestive of intussusception. The patient was referred to emergency exploratory laparotomy and obtained a definite diagnosis of ileocolic intussusception associated to mesenteric torsion. Due to the extent of intestinal dysfunction, the patient was euthanized on the operating table.

Measurements of simulated periodontal bone defects in inverted digital image and film-based radiograph: An in vitro study

Purpose: This study was performed to compare the inverted digital images and film-based images of dry pig mandibles to measure the periodontal bone defect depth. Materials and Methods: Forty 2-wall bone defects were made in the proximal region of the premolar in the dry pig mandibles. The digital and conventional radiographs were taken using a Schick sensor and Kodak F-speed intraoral film. Image manipulation (inversion) was performed using Adobe Photoshop 7.0 software. Four trained examiners made all of the radiographic measurements in millimeters a total of three times from the cementoenamel junction to the most apical extension of the bone loss with both types of images: inverted digital and film. The measurements were also made in dry mandibles using a periodontal probe and digital caliper. The Student's t-test was used to compare the depth measurements obtained from the two types of images and direct visual measurement in the dry mandibles. A significance level of 0.05 for a 95% confidence interval was used for each comparison. Results: There was a significant difference between depth measurements in the inverted digital images and direct visual measurements (p>|t|=0.0039), with means of 6.29 mm (IC95%:6.04-6.54) and 6.79 mm (IC95%:6.45-7.11), respectively. There was a non-significant difference between the film-based radiographs and direct visual measurements (p>|t|=0.4950), with means of 6.64mm (IC95%:6.40-6.89) and 6.79mm(IC95%:6.45-7.11), respectively. Conclusion: The periodontal bone defect measurements in the inverted digital images were inferior to film-based radiographs, underestimating the amount of bone loss. copy; 2012 by Korean Academy of Oral and Maxillofacial Radiology.

Alterações da densidade mineral óssea em vértebras de ratos wistar submetidos à ausência de carga nos membros pélvicos

The suspension of rats by the tail model is used to investigate the behavior of bone in animals unable to move around. Bone is an adaptative tissue that develops in structure and function, among other factors, in response to mechanical forces applied to it and metabolic demands that it will suffer. The absence of mechanical forces and deformation of bone that occurs causes a decrease in calcium deposition in the absence of stimuli on osteoblasts and osteocytes, favoring the action of osteoclasts, making bones weak and brittle. Therefore, the mechanical action is necessary to stimulate local bone response and thus provide growth and remodeling. The aim of this study was to evaluable by radiographic densitometry, the tail suspension for 15 and 36 days alter the bone mineral density of cervical vertebrae (C3), thoracic (T6) and lumbar (L1 and L3) of Wistar rats. Thirty Rattus norvegicus albinus, adult, male, Wistar strain, average body mass ± 350g, were divided into 3 groups: control (n = 10) - not suspended; S15 (n = 10) - suspended for 15 days and S36 (n = 10) - suspended for 36 days. For densitometric analysis vertebrae were radiographed, scanned, digitized and analyzed by the computer program ImageJ®. There was a statistically significant increase in bone mineral density in group S15, probably by the restlessness of the animals to the suspension, with a decrease in group S36, and this hypothetically is linked to the accommodation of the rats, concluding that the tail suspension altered bone mineral density in first time with a decrease over time.

Traditional and novel methods for occlusal caries detection: Performance on primary teeth

This study aimed to assess the performance of International Caries Detection and Assessment System (ICDAS), radiographic examination, and fluorescence-based methods for detecting occlusal caries in primary teeth. One occlusal site on each of 79 primary molars was assessed twice by two examiners using ICDAS, bitewing radiography (BW), DIAGNOdent 2095 (LF), DIAGNOdent 2190 (LFpen), and VistaProof fluorescence camera (FC). The teeth were histologically prepared and assessed for caries extent. Optimal cutoff limits were calculated for LF, LFpen, and FC. At the D 1 threshold (enamel and dentin lesions), ICDAS and FC presented higher sensitivity values (0.75 and 0.73, respectively), while BW showed higher specificity (1.00). At the D 2 threshold (inner enamel and dentin lesions), ICDAS presented higher sensitivity (0.83) and statistically significantly lower specificity (0.70). At the D 3 threshold (dentin lesions), LFpen and FC showed higher sensitivity (1.00 and 0.91, respectively), while higher specificity was presented by FC (0.95), ICDAS (0.94), BW (0.94), and LF (0.92). The area under the receiver operating characteristic (ROC) curve (Az) varied from 0.780 (BW) to 0.941 (LF). Spearman correlation coefficients with histology were 0.72 (ICDAS), 0.64 (BW), 0.71 (LF), 0.65 (LFpen), and 0.74 (FC). Inter- and intraexaminer intraclass correlation values varied from 0.772 to 0.963 and unweighted kappa values ranged from 0.462 to 0.750. In conclusion, ICDAS and FC exhibited better accuracy in detecting enamel and dentin caries lesions, whereas ICDAS, LF, LFpen, and FC were more appropriate for detecting dentin lesions on occlusal surfaces in primary teeth, with no statistically significant difference among them. All methods presented good to excellent reproducibility. © 2012 Springer-Verlag London Ltd.

Combined therapy with mineral trioxide aggregate, and guided tissue regeneration for a large radicular cyst: A 13-year follow-up

Biomaterials such as membrane barriers and/or bone grafts are often used to enhance periapical new bone formation. A combination of apical surgery and these biomaterials is one of the latest treatment options for avoiding tooth extraction. In case of periapical lesions, guided tissue regeneration (GTR) is attempted to improve the self-regenerative healing process by excluding undesired proliferation of the gingival connective tissue or migration of the oral epithelial cells into osseous defects. In many cases, GTR is necessary for achieving periodontal tissue healing. This report describes the healing process after surgery in a challenging case with a long-term followup. In this case report, endodontic surgery was followed by retrograde sealing with mineral trioxide aggregate (MTA) in the maxillary right central incisor and left lateral incisor. Apicectomy was performed in the maxillary left central incisor and a 1-mm filling was removed. The bone defect was filled with an anorganic bone graft and covered with a decalcified cortical osseous membrane. No intraoperative or postoperative complications were observed. After 13 years of follow-up, the patient showed no clinical signs or symptoms associated with the lesion and radiographic examination showed progressive resolution of radiolucency. In conclusion, the combination of apical surgery and regenerative techniques can successfully help the treatment of periapical lesions of endodontic origin and is suitable for the management of challenging cases.

Ameloblastoma mandibular rostral em um cão

Odontogenics tumors are uncommon in the dog. Ameloblastoma is considered a benign, aggressive and non-inductive odontogenic neoplasia commonly located in the incisor teeth. Its conclusive diagnosis is obtained by histopathological examination. Due to the expansive nature of this neoplasia, its resection needs to have an adequate surgical margin so it will have excellent prognostics. A canine, male, Pekingese, 8 years old had an increased volume in the rostral region of the mandible, adhered, consistency moderately firm. Radiography revealed extensive mandibular bone lysis caused by the neoplasia. Biopsy identified the tumor as ameloblastoma. Combining data from the clinical, radiographic and histopatological study and after explain to the owner regarding the postoperative esthetic it was held a bilateral rostral mandibulectomy. The fragment removed was assessed radiographically and histopathologically for evidence of tumor at its edges. The patient is active and healthy without evidence of metastasis or recurrence. The radiographic and histopathologic evaluation of edges of the fragment showed no tumor evidence. The patient is active and healthy without evidence of metastasis or recurrence since January 2010 when mandibulectomy was performed.

Case report: Disseminated Mycobacterium tuberculosis infection in a dog

An uncommon disseminated Mycobacterium tuberculosis infection is described in a 12-year-old female dog presenting with fever, dyspnea, cough, weight loss, lymphadenopathy, melena, epistaxis, and emesis. The dog had a history of close contact with its owner, who died of pulmonary tuberculosis. Radiographic examination revealed diffuse radio-opaque images in both lung lobes, diffuse visible masses in abdominal organs, and hilar and mesenteric lymphadenopathy. Bronchial washing samples and feces were negative for acid-fast organisms. Polymerase chain reaction (PCR)-based species identification of bronchial washing samples, feces, and urine revealed M. tuberculosis using PCR-restriction enzyme pattern analysis-PRA. Because of public health concerns, which were worsened by the physical condition of the dog, euthanasia of the animal was recommended. Rough and tough colonies suggestive of M. tuberculosis were observed after microbiological culture of lung, liver, spleen, heart, and lymph node fragments in Löwenstein-Jensen and Stonebrink media. The PRA analysis enabled diagnosis of M. tuberculosis strains isolated from organs. Copyright © 2013 by The American Society of Tropical Medicine and Hygiene.

Meniscal mineralisation in little spotted cats

Background: The aim of this study was to evaluate the stifle joints of little spotted cats in captivity using radiographic and CT studies. The hypothesis was that these animals would have meniscal mineralisation that could be detectable by imaging studies. Twelve intact little spotted cats (Leopardus tigrinus), 2 females and 10 males, aged from 1.5 to 11.11 years old and weighing 1.9-3.05 kg were studied. These animals, which were living in the Quinzinho de Barros Municipal Zoo, had no symptoms or known disease processes at the time of the study. The plain radiographs and computed tomography (CT) scans of both stifle joints were performed under general anaesthesia. Sequential transverse images were acquired on a spiral scanner.Results: No signs of articular disease were observed in any of the animals. Radiographically, the meniscal mineralisation was detected as an oval radiopacity in the cranial compartment on the mediolateral projection, located within the area of the medial meniscus. On craniocaudal projection, the mineralisation was more difficult to visualise. In one of the animals, it was not possible to identify the meniscal mineralisation in either of the stifle joints. Using CT, meniscal mineralisation was best identified in the transverse plane images.Conclusions: Meniscal mineralisation appears to be a normal anatomic feature in little spotted cats. © 2013 Rahal et al.; licensee BioMed Central Ltd.

A prospective study on implants installed with flapless-guided surgery using the all-on-four concept in the mandible

Aim: Clinical data are scarce on flapless-guided surgery in the mandible using the all-on-four concept. In addition, limited documentation exists on the latter under immediate loading conditions with a pre-fabricated implant bridge. The aim was to provide detailed documentation focusing on clinical and radiographic outcome and complications. Material and methods: Sixteen systemically healthy non-smoking patients (10 women, 6 men, average age 59 years) with sufficient bone volume in the mandible were operated via flapless-guided surgery using the all-on-four concept. Clinical and radiographic data and complications were registered at 3, 6 and 12 months. Results: The overall implant survival rate was 90% with a trend for higher failure of short implants (P = 0.098). The mean bone level after 12 months of function was 0.83 mm with a maximum of 1.07 mm. Technical complications were common (15/16 patients). These mainly related to a misfit between the pre-fabricated prosthesis and abutment(s) (13/16 patients). Conclusion: If immediate loading of implants is pursued fabrication of the implant bridge should be based on actual impression of the implants at the time of surgery and not on their virtual position. © 2011 John Wiley & Sons A/S.