Avaliação radiográfica, densitométrica e histológica do uso de perfurações ósseas para o estímulo de consolidação de fraturas do terço distal do rádio de cães

To stimulate the bone callus development process from distal third of radius, 24 adult mongrel dogs used were from both sexes. These dogs were separated in two experimental groups of 12 animals each, named control and treated, divided in 4 moments (M1=15 days; M2=30 days; M3=45 days; M4=60 days), who underwent were performed surgical fractures. In treated group, it was performed bone perforations on proximal and distal edges, craniolateral and mediolateral to the fracture site. At the end of each moment, control and treated animals were evaluated by radiography, histology, and bone mineral densitometry (BMD) was determined on fracture site. According to the radiographic data of treated dogs, it was verified on days 15 and 30 more intense bone regeneration than control group. During M3 and M4, it wasn't detected any difference in bone reparation process betweencontrol and treated groups. In densitometric study, BMD values were greater in treated animals than in control dogs. Histological studies revealed at 15 and 30 days chondrocyte hyperplasia and initial endochondral ossification on drilled limbs; control group showed sustainment connective tissue and initial chondrocyte hiperplasia. At M3 and M4 of the treated group, were verified development and remodeling of periosteal callus in more advanced phases when comparing with limbs from control group. It can be concluded that using perforations enhances blood flow supply and activation of osteogenic cells on fracture site, stimulating the beginning of fracture consolidation process.

Comparison between polyurethanes containing castor oil (Soft Segment) and cancellous bone autograft in the treatment of segmental bone defect induced in rabbits

The aim of this study is to compare polyurethanes containing castor oil (soft segment) in granular form compared to cancellous bone autograft applied to a segmental bone defect. Norfolk adult female rabbits - approximately 13 months of age with a mean body weight of 4.5 kg - are used. In both radial diaphyses, 1 cm osteoperiosteal segmental defects are created. The defect in the left radius is filled with the castor-oil-based polyurethane, and the right one, filled with cancellous bone autograft, collected from the left proximal humerus. The rabbits are euthanazed at 15, 30, 60, and 120 days postsurgery (5 animals/ period), for histological analyses. By radiographic analyses, at these time points, the bone regeneration is more evident and accelerated in the bone defects treated with the cancellous bone autograft. At 120 days postsurgery, the segmental bone defects treated with the cancellous bone autograft are totally reconstituted and remodeled, while the bone defects treated with polyurethane polymer have bone formation of 79%. Histological study shows that the polyurethane acts as a space filler, minimizing the local production of fibrous tissue. No granule degradation, resorption or any inflammatory reaction is detected. Thus, it is possible to conclude that the castor-oil-plant-based polyurethane - in the granule presentation - is biocompatible and osteointegrated, but does not show the same bone regeneration capacity as the cancellous bone autograft. © 2007 SAGE Publications.

Bone mineralization in Brazilian adolescents: The years of maximum bone mass incorporation

Puberty is the fundamental period for bone mass (BM) acquisition. In this period mineralization is found to increase with levels of high bone formation. The critical years of intense bone anabolism deserve special attention, as adequate gain could minimize fracture risk in later years. The objective of this work was to study bone mineral content (BMC) and bone mineral density (BMD) in male adolescents with age bracket and maturation level. Sixty-one healthy male 10 to 19 year-olds were evaluated for calcium intake, weight, stature, BMI, puberty stage and BMC and BMD in the lumbar spine and femur. BM was measured by bone densitometry (DXA). Calcium intake was calculated by recording 3 days diet. Puberty stage was defined as per Tanner. Descriptive statistics was used with means and standard deviations, linear correlation, and analysis of variance for comparison between age groups, and the Tukey test (p<0.05). Linear correlation was positive and indicated body weight as the main correlation variable with BMD in both studied locations (p<0.01). BMC and BMD increased with age, differences were significant from 14 to 15 years, and when adolescents reached Tanner stage G4. These results showed a pronounced increase in bone mineralization, with the years after 14 to 15 being critical for BM acquisition in Brazilian adolescents.

Comparison between inverted and unprocessed digitized radiographic imaging in periodontal bone loss measurements

The advances in digital imaging technology in dentistry have provided an alternative to film-based radiography and have given new options to detect periodontal bone loss. The purpose of this study was to compare inverted and unprocessed digitized radiographic imaging in periodontal bone loss measurements. Thirty-five film-based periapical radiographs of patients suffering from moderate to advanced untreated periodontal bone loss associated to lower premolar and molars was selected from the department files, with 40 bone loss areas. The film-based radiographs were digitized with a flatbed scanner with a transparency and radiograph adapter used for transilluminating the radiograph imaging. Digitization was performed at 600 dpi and in gray scale. The images were digitized using Image Tool software by applying image inversion, that is, transformation of radiopaque structures into radiolucent structures and vice-versa. The digital data were saved as JPEG files. The images were displayed on a 15-inch and 24-bit video monitor under reduced room lighting. One calibrated examiner performed all radiographic measurements, three times, from the cementoenamel junction to the most apical extension of the bone loss, in both types of image (inverted and unprocessed). Brightness and contrast were adjusted according to the examiner's individual demand. Intraclass correlation coefficient was used to compare the measurements from both types of images. The means of radiographic measurements, in mm, for inverted and unprocessed digitized imaging were 6.4485 and 6.3790, respectively. The intraclass correlation coefficient was significant (0.99) The inverted and unprocessed digitized radiographic images were reliable and there was no difference in the diagnostic accuracy between these images regarding periodontal bone loss measurements.

A survey of radiographic measurement estimation in assessment of dental implant length.

The aim of this study is to survey radiographic measurement estimation in the assessment of dental implant length according to dentists' confidence. A 19-point questionnaire with closed-ended questions was used by two graduate students to interview 69 dentists during a dental implant meeting. Included were 12 questions related to over- and underestimation in three radiographic modalities: panoramic (P), conventional tomography (T), and computerized tomography (CT). The database was analyzed by Epi-Info 6.04 software and the values from two radiographic modalities, P and T, were compared using a chi2 test. The results showed that 38.24% of the dentists' confidence was in the overestimation of measurements in P, 30.56% in T, and 0% in CT. On the other hand, considering the underestimated measurements, the percentages were 47.06% in P, 33.33% in T, and 1.92% in CT. The frequency of under- and overestimation were statistically significant (chi2 = 6.32; P = .0425) between P and T. CT was the radiographic modality with higher measurement precision according to dentists' confidence. In conclusion, the interviewed dentists felt that CT was the best radiographic modality when considering the measurement estimation precision in preoperative dental implant assessment.

Conservative treatment of patients with periapical lesions associated with extraoral sinus tracts

This paper describes the clinical courses of three cases with extra-oral sinus tract formation, from diagnosis and treatment to short-term follow-up and evaluation. All teeth involved had periradicular radiolucent areas noted on radiographic examination and extra-oral sinus tracts appearing on the chin with exudation and unpleasant aesthetic appearance. The adopted treatment protocol included treating the sinus tract surface simultaneously with the root canal therapy. After root canal shaping using 5.25% sodium hypochlorite solution, calcium hydroxide-based pastes associated with different vehicles were inserted into the root canal for 4 months, and were changed monthly. All the sinus tracts healed in 7 to 10 days. The apical lesions were completely repaired in a maximum period of 24 months. The treatment adopted provided a complete healing of the periapical lesions in a short follow-up period. Surgical repair of the cutaneous sinus tract was therefore unnecessary. © 2007 The Authors. Journal compilation © 2007 Australian Society of Endodontology.

Dental age in patients with Down syndrome

The aim of this research was to evaluate dental age in 102 patients with Down Syndrome, using panoramic radiographs. A software program developed by the Discipline of Radiology, School of Dentistry of São José dos Campos, São Paulo State University (UNESP), was used. A table of mineralization chronology of permanent teeth among Brazilians conceived by Nicodemo, Moraes and Medici Filho was used within the software. Statistical analysis of the results showed that 70.91% of the males land 61.21% of the females presented advanced dental age. Only 32.09% of the males and 39.79% of the females presented delayed dental age. Regarding the differences between the dental and chronological ages, two thirds of the males and females presented dental age with differences of up to 12 months, which means that they can be considered to be within normal standards, whereas only 18.87% of the males and 10.21% of the females presented dental age outside normal standards, with differences of over 24 months. In conclusion, the majority of the patients with Down Syndrome were considered to be within the normal standards of mineralization chronology.

Lombalgia em eqüinos

Back pain, whether they have a primary or secondary origin, is a important cause to the drop of the equine performance, but the size and the complex biomechanics make it difficult to diagnosis and treat the injury. As it is, the knowledge of this anatomic site is of great importance to the thoracolumbar examination. The diagnosis of back pain is done through physical examination and complementary exams, represented by the image methods of diagnosis, such as radiography, ultrasonography and thermography. The most important lesions that cause the back pain in an equine are impingement of the dorsal spinous processes, desmopathy of the supraespinous ligament, osteoarthritis of the articular processes and lesions of the vertebral discs and body. The most common treatments to back pain are the non-steroidal anti-inflammatory drugs, local injections, acupuncture, physiotherapy, training management and surgery.

Mensuração do tamanho cardíaco em radiografias de gatos com hipertireoidismo experimental

Feline hyperthyroidism (thyrotoxicosis) is now recognised as the most common endocrine disease of the domestic cat. Feline hyperthyroidism cause multisystemic disorder associated with incresead circulating concentrations of the thyroid hormones, tri-iodothyronine (T3) and thyroxine (T4). Cardiovascular abnormalities in cats with spontaneous hyperthyroid have been described. Objective to determine heart size of progressing experimental thyrotoxicosis of 19 cats, using a vertebral scale system (VHS). The lateral, dorsoventral e ventrodorsal radiographs thoracic were measured using a vertebral scale system. Lateral radiographs thoracic to efficient develop that DV and VD. The VHS method is easy to use, allows objective assesment of heart size in cats hyperthyroid, and may be helpful to identify cardiomegaly and heart size progressing.

Edema agudo pulmonar associado à obstrução das vias aéreas. Relato de caso

BAKGROUND AND OBJECTIVES: Negative pressure pulmonary edema has been defined as non-cardiogenic edema, with transudation of fluid to the interstitial space of the lungs due to an increase in negative intrathoracic pressure secondary to obstruction of the upper airways. This is the case of a healthy patient who underwent general anesthesia and developed acute pulmonary edema after extubation. CASE REPORT: A 23-year old female patient, physical status ASA II, underwent gynecologic videolaparoscopy under general anesthesia. The procedure lasted 3 hours without intercurrence. After extubation the patient developed laryngeal spasm and reduction in oxygen saturation. The patient improved after placement of an oral cannula and administration of oxygen under positive pressure with a face mask. Once the patient was stable she was transferred to the recovery room where, shortly after her arrival, she developed acute pulmonary edema with elimination of bloody serous secretion. Treatment consisted of elevation of the head, administration of oxygen via a face mask, furosemide and fluid restriction. Chest X-ray was compatible with acute pulmonary edema and normal cardiac area. Electrocardiogram (ECG), echocardiogram and cardiac enzymes were normal. The condition of the patient improved and she was discharged from the hospital the following day, asymptomatic. CONCLUSIONS: Acute pulmonary edema associated with obstruction of the upper airways can aggravate surgical procedures with low morbidity, affecting mainly young patients. Early treatment should be instituted because it has a fast evolution and, in most cases, resolves without lasting damages. © Sociedade Brasileira de Anestesiologia, 2008.

Florid cemento-osseous dysplasia: A report of three cases

Florid cemento-osseous dysplasia (FCOD) is a non-neoplastic condition of the jaws that Is not associated with inflammation of the pulp or periodontal tissue. This article reports on three cases that were diagnosed as FCOD, demonstrating the importance of both clinical and radiographic diagnosis and the clinical management of these lesions.

Skeletal age of individuals with Down syndrome

The aim of this study was to assess the skeletal age of Brazilian individuals with Down syndrome (DS) using the method of Greulich and Pyle. Forty subjects with DS between the ages of 6 and 16 years were studied and compared to a control sample of children without DS. The statistical analysis showed that at the age of 7 years the skeletal age (SA) of the individuals with DS was delayed in relation to their chronological age (CA) (SA < CA). On the other hand, at the age of 15 years, their SA was advanced in relation to their CA (SA > CA). An evaluation of the results suggests that the period of adolescent development for individuals with DS was shorter. These individuals reach the completion of bone maturation earlier compared to individuals without DS. © 2008 Special Care Dentistry Association and Wiley Periodicals, Inc.

The large vestibular aqueduct syndrome: A cause of neurosensory dysacusia

Background: The large vestibular aqueduct syndrome (LVAS) is characterized by the enlargement of the vestibular aqueduct associated with sensorioneural hearing loss. The level of hearing loss varies and may be fluctuant, progressive or sudden. Vestibular symptoms may be present. The diagnosis is reached by imaging methods. Aim: To report an LVAS case. Method: A female infant was submitted to a computerized tomography of the ears and to audiologic tests. Results: Enlargement of the vestibular aqueduct of more than 1.5mm and sensorioneural hearing loss in the right ear were observed. Conclusion: With an early hearing evaluation it is possible to diagnose hearing loss, even in children were this loss is unilateral. Although the literature indicates that the diagnosis of LVAS occurs at a later age, in this case time etiologic diagnosis was enabled by computerized tomography.

Orthognathic Surgery in the Young Cleft Patient: Preliminary Study on Subsequent Facial Growth

Purpose: This study evaluated the long-term effects of orthognathic surgery on subsequent growth of the maxillomandibular complex in the young cleft patient. Patients and Methods: We evaluated 12 young cleft patients (9 male and 3 female patients), with a mean age of 12 years 6 months (range, 9 years 8 months to 15 years 4 months), who underwent Le Fort I osteotomies, with maxillary advancement, expansion, and/or downgrafting, by use of autogenous bone or hydroxyapatite grafts, when indicated, for maxillary stabilization. Five patients had concomitant osteotomies of the mandibular ramus. All patients had presurgical and postsurgical orthodontic treatment to control the occlusion. Radiographs taken at initial evaluation (T1) and presurgery (T2) were compared to establish the facial growth vector before surgery, whereas radiographs taken immediately postsurgery (T3) and at longest follow-up (T4) were used to determine postsurgical growth. Each patient's lateral cephalograms were traced, and 16 landmarks were identified and used to compute 11 measurements describing presurgical and postsurgical growth. Results: Before surgery, all patients had relatively normal growth. After surgery, cephalograms showed statistically significant growth changes from T3 to T4, with the maxillary depth decreasing by -3.3° ± 1.8°, Sella-nasion-point A by -3.3° ± 1.8°, and point A-nasion-point B by -3.6° ± 2.8°. The angulation of the maxillary incisors increased by 9.2° ± 11.7°. Of 12 patients, 11 showed disproportionate postsurgical jaw growth. Maxillary growth occurred predominantly in a vertical vector with no anteroposterior growth, even though most patients had shown anteroposterior growth before surgery. The distance increased in the linear measurement from nasion to gnathion by 10.3 ± 7.9 mm. Four of 5 patients operated on during the mixed dentition phase had teeth that erupted through the cleft area. A variable impairment of postoperative growth was seen with the 2 types of grafting material used. No significant difference was noted in the effect on growth in patients with unilateral clefts versus those with bilateral clefts. The presence of a pharyngeal flap was noted to adversely affect growth, whereas simultaneous mandibular surgery did not. After surgery, 11 of 12 patients tended toward a Class III end-on occlusal relation. Conclusions: Orthognathic surgery may be performed on growing cleft patients when mandated by psychological and/or functional concerns. The surgeon must be cognizant of the adverse postsurgical growth outcomes when performing orthognathic surgery on growing cleft patients with the possibility for further surgery requirements. Performing maxillary osteotomies on cleft patients would be more predictable after completion of facial growth. © 2008 American Association of Oral and Maxillofacial Surgeons.

BMP implant associated with platelet-rich plasma in orbit fracture repair

Purpose: To evaluate a bone morphogenetic protein (BMP) implant with and without platelet-rich plasma (PRP), which is supposed to accelerate fracture consolidation in the orbit fracture treatment. Methods: Thirty-six white rabbits were subjected to orbital fracture and treated in three groups: BMP implant fracture repair (G1), BMP plus PRP implant fracture repair (G2), and fracture and spontaneous repair (G3). The animals were sacrificed at 7, 30, 90, and 180 days after surgery. A radiology evaluation was carried out on the 7th day after the fracture and at the sacrifice moments. After the animals' death, the orbital content material was removed and prepared for morphological and morphometric analysis. Results: Radiology suggested intramembranous and progressive cavitation and ossification without a reduction in implant size and with signs of calcium deposition; these events were confirmed by histological analysis, which showed a lymphomononuclear inflammatory reaction in G1 and G2, more intense 7 days after surgery and reducing after 30 days. Associating PRP with BMP did not accelerate bone induction. Conclusion: BMP implant promotes bone induction, integration at fracture site, scarce inflammatory reaction, and may be a good alternative in orbit fracture reconstruction. The addition of PRP to the BMP plate did not accelerate the resolution, and its use is not necessary. Copyright © Informa Healthcare USA, Inc.