[This corrects the article on p. 43 in vol. 52, PMID: 35387095.].
[This corrects the article on p. 43 in vol. 52, PMID: 35387095.].
The aim of this report is to present a case of chondroblastic osteosarcoma located in the right maxillary premolar region of a 17-year-old female patient. The initial clinical presentation and 2-dimensional (2D) radiographic methods proved inadequate for a definitive diagnosis. However, a cone-beam computed tomography scan revealed a hyperdense, heterogeneous lesion in the right maxillary premolar region, exhibiting a characteristic "sun-ray" appearance. To assess soft tissue involvement, a medical computed tomography scan was subsequently conducted. A positron emission tomography scan detected no metastasis or indications of secondary tumors. T1- and T2-weighted magnetic resonance imaging showed signal heterogeneity within the lesion, including areas of low signal intensity at the periphery. A histological examination conducted after an incisional biopsy confirmed the diagnosis of high-grade chondroblastic osteosarcoma. The patient was then referred to an oncology department for chemotherapy before surgery. In conclusion, these findings suggest that early diagnosis using 3-dimensional imaging can detect chondroblastic osteosarcoma in its early stages, such as before metastasis occurs, thereby improving the patient's prognosis.
Purpose: This study was performed to develop a linear regression model using the pulp-to-tooth volume ratio (PTVR) ratio of the maxillary canine, assessed through cone-beam computed tomography (CBCT) images, to predict chronological age (CA) in Indonesian adults.
Materials and methods: A sample of 99 maxillary canines was collected from patients between 20 and 49.99 years old. These samples were obtained from CBCT scans taken at the Universitas Padjadjaran Dental Hospital in Indonesia between 2018 and 2022. Pulp volume (PV) and tooth volume (TV) were measured using ITK-SNAP, while PTVR was calculated from the PV/TV ratio. Using RStudio, a linear regression was performed to predict CA using PTVR. Additionally, correlation and observer agreement were assessed.
Results: The PTVR method demonstrated excellent reproducibility, and a significant correlation was found between the PTVR of the maxillary canine and CA (r=-0.74, P<0.01). The linear regression analysis showed an R2 of 0.58, a root mean square error of 5.85, and a mean absolute error of 4.31.
Conclusion: Linear regression using the PTVR can be effectively applied to predict CA in Indonesian adults between 20 and 49.99 years of age. As models of this type can be population-specific, recalibration for each population is encouraged. Additionally, future research should explore the use of other teeth, such as molars.
Purpose: This study was conducted to compare dental plaque scores obtained through clinical examinations and various imaging techniques, as well as to assess the effectiveness of herbal and conventional toothpastes for plaque removal.
Material and methods: Thirty volunteers were divided into 3 groups. Each group was given a different toothpaste (from 2 herbal toothpastes and a conventional toothpaste) with which to brush their teeth for 21 days. Both initially and after brushing, dental plaque samples were collected, and plaque on the buccal surfaces of anterior teeth was scored using several imaging systems after staining with a disclosing agent. Specifically, digital dental photography, intraoral digital scanning, and FluoreCam imaging were employed to capture intraoral images. The Turesky Modified Quigley-Hein Plaque Index was used for clinical examination and image analysis. Quantitative polymerase chain reaction analyses and correlational assessments between clinical examination and imaging scores were conducted before and after toothpaste use. The Shapiro-Wilk test and Pearson correlations were utilized.
Results: The lowest mean value was observed in the clinical examination without staining, while the highest was obtained using the FluoreCam method. No significant change was found in the level of any microorganism assessed following toothpaste use (P<0.05), with the exception of a decrease in S. mutans levels after using conventional toothpaste (P<0.05).
Conclusion: Herbal toothpaste demonstrated plaque-removal effectiveness comparable to that of conventional toothpaste. The use of imaging methods for measuring plaque index has been suggested as a means to educate patients about plaque control and promote ongoing oral care.
Purpose: Prior to cone-beam computed tomography (CBCT), orthodontic competence included radiological interpretation. Nevertheless, maxillary impacted canines (MICs), because of their position and adjacent complex anatomy, have been challenging to interpret, particularly with regard to root resorption. Although CBCT cross-sectional reconstructions of MICs yielded clearer insights into its diagnosis and treatment planning, the value of simultaneously using 2 different cross-sectional or multiplanar reconstructions of the CBCT datasets - orthogonal and curved/panoramic multiplanar reconstructions - has hitherto not been considered.
Materials and methods: Both orthogonal and curved/panoramic multiplanar reconstruction series of 5 screenshots were each reconstructed from the 5 cm × 5 cm CBCT datasets of 15 separate MICs. Fifteen credentialled and experienced orthodontist volunteers reviewed 2 separate PowerPoints of 15 randomized series each, 1 week apart. Their review considered 6 factors that could affect treatment: the position and level of the MIC, the presence or absence of root resorption, ankylosis, cysts, and dilaceration.
Results: All 15 orthodontists were statistically similar regarding overall years of experience and of CBCT use. Although either reconstruction alone allowed the orthodontists to determine whether ankylosis and, to a lesser extent, most of the other features were present or absent in the MIC, reviewing both reconstructions together was necessary to determine whether root resorption was present or absent in the adjacent tooth.
Conclusion: Reviewing both orthogonal and curved/panoramic multiplanar reconstructions was necessary to evaluate the presence or absence of root resorption in the teeth adjacent to MICs and that of many other features.
Purpose: The aim of this study was to evaluate changes in the trabecular bone through texture analysis and compare the texture analysis characteristics of different areas in patients with medication-related osteonecrosis of the jaw (MRONJ).
Materials and methods: Cone-beam computed tomographic images of 16 patients diagnosed with MRONJ were used. In sagittal images, 3 regions were chosen: active osteonecrosis (AO); intermediate tissue (IT), which presented a zone of apparently healthy tissue adjacent to the AO area; and healthy bone tissue (HT) (control area). Texture analysis was performed evaluating 7 parameters: secondary angular momentum, contrast, correlation, sum of squares, inverse moment of difference, sum of entropies, and entropy. Data were analyzed using the Kruskal-Wallis test with a significance level of 5%.
Results: Comparing the areas of AO, IT, and HT, significant differences (P<0.05) were observed. The IT and AO area images showed higher values for parameters such as contrast, entropy, and secondary angular momentum than the HT area, indicating greater disorder in these tissues.
Conclusion: Through texture analysis, changes in the bone pattern could be observed in areas of osteonecrosis. The texture analysis demonstrated that areas visually identified and classified as IT still had necrotic tissue, thereby increasing the accuracy of delimiting the real extension of MRONJ.
Gardner syndrome has head and neck manifestations that may be recognized during dental visits. Features such as multiple gnathic osteomas, impacted supernumerary teeth, and multiple foci of idiopathic osteosclerosis can be easily identified on dental radiographs, prompting the clinician to refer the patient for further investigation. A dental examination and routine radiographs play a vital role in revealing the extracolonic presentation of Gardner syndrome, which facilitates timely screening and detection of colorectal cancer and other malignancies associated with this condition. This report discusses the case of a 50-year-old Caucasian man who presented with a hard swelling of the left angle of the mandible and was diagnosed with Gardner syndrome based on abnormal findings from an oral examination, dental imaging, and medical and family history.
Purpose: Odontomas represent a common clinical entity among odontogenic tumors, but are not well-addressed in the Vietnamese population. The present study aimed to determine the clinical and preclinical characteristics of odontomas and associated factors in the Vietnamese population.
Materials and methods: This retrospective study retrieved data from histopathological diagnoses from 2 central hospitals of Odonto-Stomatology in Ho Chi Minh City, Vietnam during 2004-2017. The odontomas were classified as complex (CxOD) or compound (CpOD) subtypes. The epidemiological, clinical, and radiological characteristics of the odontomas, stratified by subtype and sex, were obtained and analyzed.
Results: Ninety cases, consisting of 46 CxODs and 44 CpODs, were included. The average age of patients was 32.4 (±20.2) years. The patients with CxOD were older than those with CpOD (P<0.05). Clinically, 67% of patients showed an intraoral bone expansion. Approximately 60% of patients with CxOD exhibited a painful symptom, about 3-fold more than those with CpOD (P<0.05), whereas almost all patients with CpOD exhibited perturbations of dentition, unlike those with CxOD (P<0.05). Radiologically, CxOD was characterized by a larger dimension than CpOD in both sexes (P<0.05), and CpOD induced complications in adjacent teeth more often than CxOD (P<0.05). The development of odontoma with advancing age differed significantly in odontoma subtypes related to their pathological origins, and between the sexes, resulting from different physiological states.
Conclusion: The findings of this study highlight the value of clinical and radiological features of odontomas and their associated factors for the early diagnosis and adequate treatment of younger patients.
Purpose: The objective of this study was to assess the fractal dimension, lacunarity, trabecular microarchitecture parameters, and cortical linear measurements in the mandibles of male and female individuals to identify differences between them.
Materials and methods: In total, 116 cone-beam computed tomography scans of healthy individuals of different ages (57 men and 59 women, aged between 20 and 60 years) were selected. The following bone parameters were measured: 1) buccal, lingual, and basal cortical bone thickness in 5 standard parasagittal sections (the midline, the left and right sides of the lower lateral incisors, and the left and right sides of the lower canines); 2) the bone volume fraction of 10 sequential axial sections from each patient by creating a volume of interest in the area between the lower canines; and 3) fractal dimension and lacunarity using grayscale images of the same region of the volume of interest in the anterior mandible. Spearman correlation coefficients and the Mann-Whitney test were used.
Results: A significant and positive correlation was found between age and cortical thickness, especially in the region of the central incisors. Significant differences between sexes in terms of fractal dimension, lacunarity, and bone volume were found. Women revealed lower fractal dimension values and higher lacunarity and bone volume ratio values than men.
Conclusion: Fractal dimension, lacunarity, trabecular bone volume, and cortical thickness were different between men and women of different ages.