Pixel intensity and fractal analyses: detecting osteoporosis in perimenopausal and postmenopausal women by using digital panoramic images

Objective. Pixel intensity values (PI) and fractal dimensions (FD) were compared in selected mandibular regions on digital panoramic images of normal, osteopenic, and osteoporotic perimenopausal and postmenopausal women to evaluate their relative efficacies in detecting osteoporotic-associated bone density changes.Study design. Standardized mandibular angle, body, and canine/premolar (C/PM) regions on 54 charge-coupied device (CCD) digital panoramic images of normal and potentially osteoporotic postmenopausal women were analyzed for PI and FD. Lumbar spine and femoral neck dual-energy x-ray absorptiometry QXA) on each patient served as the reference standard examination. Pearson correlation coefficients and analysis of variance (ANOVA) were performed.Results. There was significant correlation among PI measurements (P < 0.01), and no significant correlation between FD. C/PM had significantly lower PI than control C/PM (P = 0.049).Conclusions. Osteoporotic changes in mandibular C/PM cancellous bone were detected in our study population on CCD digital panoramic images by using a robust image analysis paradigm. Future automated application of such image analysis could enable widespread, cost effective screening for osteoporosis in dental settings.

Comparison of denture microwave disinfection and conventional antifungal therapy in the treatment of denture stomatitis: a randomized clinical study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Multidisciplinary approach for the aesthetic treatment of maxillary lateral incisors agenesis: thinking about implants?

Missing maxillary lateral incisors create an esthetic problem with specific orthodontic and prosthetic considerations. Implants are commonly used to replace congenitally missing lateral incisors in adolescent orthodontic patients. However, an interdisciplinary approach should be observed during the diagnosis, prognosis, and treatment plan to provide a result with good predictability and meet the esthetic and functional expectations of the patient. The present study describes a case of a young patient with tooth agenesis of maxillary lateral incisors, which was conducted with an integrated planning. After 5-year follow-up of 2 fixed implant-supported prostheses, clinical and radiographic examination showed the treatment to be successful. (Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:e22-e28)

An in vitro evaluation of apicoectomies and retropreparations using different methods

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influence of estrogen deficiency and its treatment with alendronate and estrogen on bone density around osseointegrated implants: radiographic study in female rats

Objective. This study evaluated the influence of estrogen deficiency and its treatment on bone density around integrated implants.Study design. Implants were placed in female rat tibiae. The animals were assigned to 5 groups: control, sham, ovariectomy, estrogen, and alendronate. The control group was humanely killed to confirm integration of the implant. The others were submitted to ovariectomy or sham surgery. Bone density was measured by digital radiographs at 6 points on sides of the implant.Results. The analysis of radiographic bone density revealed estrogen privation had a negative impact only in the cancellous bone. The estrogen group differed significantly ( P <.05) from the ovariectomy and alendronate groups. The alendronate group presented the highest density for all evaluated regions.Conclusion. Ovariectomy caused a decrease in the radiographic bone density in the cancellous region. Estrogen replacement therapy and alendronate were effective treatments in preventing bone mass loss around integrated implants.

Evaluation of collagen-based membranes for guided bone regeneration, by three-dimensional computerized microtomography

Objective. The aim of this study was to evaluate the use of a collagen-based membrane compared with no treatment on guided bone regeneration by 3-dimensional computerized microtomography (mu CT).Study Design. Defects were created between the mesial and distal premolar roots of the second and third premolars (beagle dogs; n = 8). A collagen-based membrane (Vitala; Osteogenics Biomedical Inc., TX, USA) was placed in one of the defects (membrane group; n = 16), and the other was left untreated (no-membrane group; n = 16). Left and right sides provided healing samples for 2 and 16 weeks. Three-dimensional bone architecture was acquired by mu CT and categorized as fully regenerated (F, bone height and width) or nonregenerated (N).Results. Chi-square tests (95% level of significance) showed that tooth did not have an effect on outcome (P = .5). Significantly higher F outcomes were observed at 16 weeks than 2 weeks (P = .008) and in membrane group than in no-membrane group (P = .008).Conclusions. The collagen-based membrane influenced bone regeneration at the furcation. (Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:437-443)

Recursive hierarchic segmentation analysis of bone mineral density changes on digital panoramic images

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Detection of periapical lesion development by conventional radiography or computed tomography

Objective. The aim of this study was to detect the development of experimentally induced periapical lesions using conventional radiography and computed tomography.Study design. The root canals of dogs' teeth were exposed to the oral environment for 7 days for contamination and then sealed for 7 days (GI), 15 days (GII), 30 days (GIII), and 60 days (GIV). Immediately after each experimental period, radiographs and tomograms were taken in order to detect the occurrence of periapical bone resorption. The periapical radiographs were digitized and areas of bone resorption were measured using the VIXWIN 2000 software. Scores were assigned to the tomograms based on the progression of periapical bone resorption. The specimens were evaluated by calibrated examiners who were blinded to the groups. The radiographic results were analyzed by ANOVA and Tukey's test (P <.05) and the tomographic results were analyzed by Kruskal-Wallis and Dunn's tests (P <.05).Results. The radiographic evaluation did not reveal periapical lesions at the 7-day control. Lesions were radiographically visible at 15 and 30 days (47.4% and 77.8% of the cases, respectively) and presented similar dimensions (P <.05). At 60 days, lesions were detected in all specimens, presenting larger dimensions than those of the earlier evaluation periods (P <.05). The tomographic evaluation detected lesions at 7 and 15 days (32.5% and 83.3% of the cases, respectively). Lesions were detected in all specimens at the 30- and 60-day periods, when the greatest values of bone resorption were observed (P <.05).Conclusions. Tomography was able to detect periapical lesion development in its initial stages, even when the lesions were undetectable radiographically.

Comparative radiographic and histological analyses of periapical lesion development

Objective. The present study evaluated the dynamics of the development of periapical lesions.Study design. Root canals from dogs' teeth were exposed to the oral environment, and then sealed for 7 days (Group A), 15 days (Group B), 30 days (Group C), and 60 days (Group D). After each experimental period, radiographs were taken to detect periapical bone resorption. In addition, histological sections from the periapical region were prepared. The radiographic and histological results were analyzed by ANOVA and Tukey's, Wilcoxon, and Pearson's tests. Significance level was set at 5%.Results. Lesions were radiographically visible at 15 and 30 days, and had similar size at these periods (P > .05). At 60 days, lesions were larger than in the other periods (P < .05). Bone resorption was detected histologically at 7 days. The greatest values of bone resorption were observed at the 30- and 60-day periods (P < .05). The results of the methods of evaluation were similar only at the 30-day period. There was no correlation between the radiographic and histological results.Conclusions. Periapical radiography did not provide detection of periapical lesion in its initial stages. The periapical lesions became more evident radiographically when the bone resorption area increased. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:442-447)

Candida spp. prevalence in well controlled type 2 diabetic patients with denture stomatitis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Denture stomatitis treated with photodynamic therapy: five cases

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Bacterial leakage evaluation of root canals filled with different endodontic sealers

Objective. The objective of this study was to evaluate the sealing ability of AH Plus, Epiphany, Acroseal, Endofill, and Polifil after active lateral condensation technique, by using a bacterial test, during 64 days.Study design. One hundred bovine incisors were cleaned and shaped; then they were filled with the endodontic sealers and adapted into a microcentrifuge tube. The setup root/microcentrifuge tube was added to glass flasks containing Brain Heart Infusion broth. A culture of Enterococcus faecalis was inserted into the upper chamber of each assembly. Daily leakage was evaluated through the broth turbidity.Results. The results were submitted to statistical analysis (Kaplan-Meier method, Kruskal-Wallis and Dunn tests).Conclusions. AH Plus and Endofill had the worst sealing ability when compared with Polifil, which showed the least leakage. Acroseal and Epiphany showed a tendency toward having an intermediate behavior; however, there was no significant difference among Acroseal, Epiphany, and the other sealers. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: e56-e60)

Evaluation of pH, available chlorine content, and antibacterial activity of endodontic irrigants and their combinations against Enterococcus faecalis

Objectives. The objectives of this study were to evaluate pH, available chlorine content, and antibacterial activity of endodontic irrigants and their combinations.Study design. The pH and chlorine content of sodium hypochlorite (NaOCl) were analyzed pure and in combination with 10% citric acid (CA) and apple vinegar (AV). The antibacterial effect of the following solutions was measured by direct contact test against Enterococcus faecalis: 2.5% NaOCl, 2.5% NaOCl + 10% CA (7:3), 2.5% NaOCl + AV (5:5), 10% CA, and AV. Sterile saline was used as control. The colony-forming units were determined by serial decimal dilutions.Results. The combination of 2.5% NaOCl with CA or AV lowered the pH and the chlorine content. NaOCl, alone or in combination was able to eliminate E. faecalis in 30 seconds, and CA, after 10 minutes. AV promoted reduction (32.2%) after 10 minutes.Conclusions. NaOCl with acidic solutions lowered the pH and the chlorine content, but did not alter its antibacterial effect. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112:132-135)

Direct pulp capping with a self-etching adhesive system: Histopathologic evaluation in dogs' teeth

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Radiographic effect of different radiopacifiers on a potential retrograde filling material

Objective. The objective of this study was to evaluate the radiopacity of white Portland cement (PC) associated with bismuth oxide (Bi(2)O(3)), barium sulfate (BaSO(4)), iodoform (CHI(3)), and zirconium oxide (ZrO(2)). White mineral trioxide aggregate (WMTA) and PC without radiopacifier were used as positive and negative controls, respectively.Study design. Following International Organization for Standardization (ISO) 6876/2001, 5 circular specimens (10 x 1 mm) were made from each material. After the materials set, radiographs were taken using occlusal film and a graduated aluminum step-wedge varying in thickness from 2 to 16 mm. The dental X-ray unit (GE1000) was set at 50 Kvp, 10 mA, 18 pulses/s, and distance of 33.5 cm. The radiographs were digitized, and radiopacity was compared with the aluminum step-wedge, using Wixwin-2000 software (Gendex). Data (mm Al) were analyzed using analysis of variance and Tukey tests.Results. The PC + Bi(2)O(3) and WMTA samples presented greater radiopacity (5.88 and 5.72 mm Al, respectively), followed by PC + ZrO(2) (3.87 mm Al) and PC + CHI(3) (3.50 mm Al). The PC + BaSO(4) and PC samples presented the lowest radiopacity values (2.35 and 1.69 mm Al, respectively), which were below the minimum value recommended by the ISO.Conclusion. Analysis of the present results led to the conclusion that all of the materials tested presented acceptable radiopacity, except PC + BaSO(4) and pure PC. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: 628-632)