Maria de Paula Caldas

New formula to objectively evaluate skeletal maturation using lateral cephalometric radiographs.

The aim of this study was to establish two new formulas for objectively evaluating skeletal maturation of cervical vertebrae in female and male Brazilian subjects using lateral cephalometric radiographs. The sample included 128 girls and 110 boys, aged 7.0 to 15.9 years, from the files of the Oral Radiology Clinic, Piracicaba Dental School, University of Campinas (Unicamp), SP, Brazil. The cervical vertebral bodies of C3 and C4 were traced and measured and regression formulas were developed in order to determine cervical vertebral bone age. Another sample of lateral teleradiographs and hand-wrist radiographs of 55 girls and 54 boys (aged 7.0 to 15.9 years) was used to verify the reliability of the developed regression formulas, as compared with bone age assessed using the Tanner et al.15 (2001) Method (TW3) in hand-wrist radiographs. The analysis of both the boys and girls data (ANOVA) showed no statistical difference between cervical vertebral bone age, bone age, and chronological age, indicating that these formulas can be used in this population (p=0.5721 and p=0.6007 for girls and boys, respectively). Female cervical vertebral bodies of C3 and C4 increased in an accelerated manner from 10 to 13 years. Analysis of the male sample showed that C3 measurements increased in an accelerated manner from 12 to 15 years. The C4 measurements, however, did not increase at all. Using cervical vertebral bone age it is possible to evaluate skeletal maturation objectively in cephalometric radiographs.

Comparative evaluation among different materials to replace soft tissue in oral radiology studies

Objective The aim of this study was to establish which materials afford better simulation of soft tissues in Oral Radiology studies. Material and Methods The sample was composed of four materials in eleven different thicknesses to simulate the soft tissues of the face. The mean values of the relative amounts of radiographic contrast of the materials were determined and compared to a gold standard value, which was obtained from 20 patients who were referred to have periapical radiographs taken of the left mandibular molars. Data were subjected to statistical analysis with Dunnetts test (p<0.05). Results The mean value of the relative amounts of contrast encountered in the patients was 0.47, with a range between 0.36 and 0.64 for all 44 material/thickness combinations. The majority of the tested materials showed values close to those of the patients’ tissues, without statistically significant differences among them. The values of only three materials/ thickness combinations differed statistically from those of the patients’ tissues. Conclusions Based on the results of the present study, it may be concluded that except for utility wax (4 mm and 8 mm) and water (4 mm), all materials tested at different thickness could be used as soft tissue substitute materials in Oral Radiology studies.

Tonsillolith--report of an unusual case.

Tonsilloliths are rare concretions found in the tonsillar crypt. They are usually single and unilateral, but occasionally may be multiple or bilateral. This report describes a case of a 47-year-old woman whose radiography revealed one radiopaque image located in the right ramus of the mandible. The patient revealed a history of slight dysphagia, halitosis and swallowing pain with a foreign body sensation. Her medical history revealed a tonsillectomy when she was eight years old and the removal of the uvula because of sleep apnoea six years ago. Computer tomography showed a delimited and calcified oval image measuring 0.6 × 0.6 cm. The tonsillar concretion might have been formed because of a calcification of the lymphoid tissue. On the patients request, surgical excision was not performed and she will be monitored due to the tendency of such lesions to grow.

Computer-assisted analysis of cervical vertebral bone age using cephalometric radiographs in Brazilian subjects

The aims of this study were to develop a computerized program for objectively evaluating skeletal maturation on cephalometric radiographs, and to apply the new method to Brazilian subjects. The samples were taken from the patient files of Oral Radiological Clinics from the North, Northeast, Midwest and South regions of the country. A total of 717 subjects aged 7.0 to 15.9 years who had lateral cephalometric radiographs and hand-wrist radiographs were selected. A cervical vertebral computerized analysis was created in the Radiocef Studio 2 computer software for digital cephalometric analysis, and cervical vertebral bone age was calculated using the formulas developed by Caldas et al.17 (2007). Hand-wrist bone age was evaluated by the TW3 method. Analysis of variance (ANOVA) and the Tukey test were used to compare cervical vertebral bone age, hand-wrist bone age and chronological age (P < 0.05). No significant difference was found between cervical vertebral bone age and chronological age in all regions studied. When analyzing bone age, it was possible to observe a statistically significant difference between cervical vertebral bone age and hand-wrist bone age for female and male subjects in the North and Northeast regions, as well as for male subjects in the Midwest region. No significant difference was observed between bone age and chronological age in all regions except for male subjects in the North and female subjects in the Northeast. Using cervical vertebral bone age, it might be possible to evaluate skeletal maturation in an objective manner using cephalometric radiographs.

Use of cervical vertebral dimensions for assessment of children growth

Objective: The purpose of this study was to investigate whether skeletal maturation using cephalometric radiographs could be used in a Brazilian population. Material and Methods: The study population was selected from the files of the Oral Radiological Clinic of the Dental School of Piracicaba, Brazil and consisted of 128 girls and 110 boys (7.0 to 15.9 years old) who had cephalometric and hand-wrist radiographs taken on the same day. Cervical vertebral bone age was evaluated using the method described by Mito and colleagues in 2002. Bone age was assessed by the Tanner-Whitehouse (TW3) method and was used as a gold standard to determine the reliability of cervical vertebral bone age. An analysis of variance and Tukeys post-hoc test were used to compare cervical vertebral bone age, bone age and chronological age at 5% significance level. Results: The analysis of the Brazilian female children data showed that there was a statistically significant difference (p<0.05) between cervical vertebral bone age and chronological age and between bone age and chronological age. However no statistically significant difference (p>0.05) was found between cervical vertebral bone age and bone age. Differently, the analysis of the male children data revealed a statistically significant difference (p<0.05) between cervical vertebral bone age and bone age and between cervical vertebral bone age and chronological age (p<0.05). Conclusions: The findings of the present study suggest that the method for objectively evaluating skeletal maturation on cephalometric radiographs by determination of vertebral bone age can be applied to Brazilian females only. The development of a new method to objectively evaluate cervical vertebral bone age in males is needed.

A methodology to measure cervical vertebral bone maturation in a sample from low-income children

This study evaluated the applicability of the regression method for determining vertebral age developed by Caldas et al. (2007) by testing this method in children from low-income families of the rural zone. The sample comprised cephalometric and hand-wrist radiographs of 76 boys and 64 girls aged 7.0 to 14.9 years living in a medium-sized city in the desert region of the northeastern region of Brazil, with an HDI of 0.678. C3 and C4 vertebrae were traced and measured on cephalometric radiographs to estimate the bone age. The average age, average hand-wrist age and average error estimated for girls and boys were, respectively, 10.62 and 10.44 years, 11.28 and 10.57 years, and 1.42 and 1.18 years. Based on these results, the formula proposed by Caldas et al. (2007) was not applicable to the studied population, and new multiple regression models were developed to obtain the childrens vertebral bone age accurately.

Telerradiografias obtidas em posição natural da cabeça alteram as grandezas cefalométricas

AIM: the aim of this study was to quantify the real variation of cephalometric measurements obtained from lateral cephalometric radiographs using a natural head posture (NHP) and a conventional technique, positioning Frankfurt Horizontal Plane parallel to the horizontal. A facial analysis was performed in order to compare postural measurements, facial profile and antero-posterior measurements. METHODS: fifty lateral cephalometric radiographs from 25 females and 25 males composed the sample, mean aged 21 years. The cephalometric measurements were divided into three groups: 4 postural measurements, 3 profile measurements, and 9 antero-posterior measurements. RESULTS AND CONCLUSION: no statistically significant differences were found for females, while males showed statistically significant differences for sella-nasion (SN), Frankfurt, and mandibular planes in relation to true vertical line (T). For antero-posterior and facial profile measurements, no statistically significant differences were found in both groups. A correlation of the SN/V (sella-nasion/true vertical line) plane with the palatal and Frankfurt planes was found for both techniques, except when conventional lateral cephalometric radiographs were taken from males. No correlation was found between the SN/V base of the skull plane and the mandibular plane in both positions.