Plauto Christopher Aranha Watanabe

Craniocervical posture and hyoid bone position in children with mild and moderate asthma and mouth breathing.

INTRODUCTION The objective of the present study was to assess the craniocervical posture and the positioning of the hyoid bone in children with asthma who are mouth breathers compared to non-asthma controls. METHODS The study was conducted on 56 children, 28 of them with mild (n=15) and moderate (n=13) asthma (14 girls aged 10.79+/-1.31 years and 14 boys aged 9.79+/-1.12 years), matched for sex, height, weight and age with 28 non-asthma children who are not mouth breathers. The sample size was calculated considering a confidence interval of 95% and a prevalence of 4% of asthma in Latin America. Eighteen variables were analyzed in two radiographs (latero-lateral teleradiography and lateral cervical spine radiography), both obtained with the head in a natural position. The independent t-test was used to compare means values and the chi-square test to compare percentage values (p<0.05). Intraclass correlation coefficient (ICC) was used to verify reliability. RESULTS The Craniovertebral Angle (CVA) was found to be significantly smaller in asthma than in control children (106.38+/-7.66 vs. 111.21+/-7.40, p=0.02) and the frequency of asthma children with an absent or inverted hyoid triangle was found to be significantly higher compared to non-asthma children (36% vs. 7%, p=0.0001). The values of the inclination angles of the superior cervical spine in relation to the horizontal plane were significantly higher in moderate than in mild asthma children (CVT/Hor: 85.10+/-7.25 vs. 90.92+/-6.69, p=0.04 and C1/Hor: 80.93+/-5.56 vs. 85.00+/-4.20, p=0.04). CONCLUSIONS These findings revealed that asthma children presented higher head extension and a higher frequency of changes in hyoid bone position compared to non-asthma children and that greater the asthma severity greater the extension of the upper cervical spine.

Relationship between bone mineral density and trabecular bone pattern in postmenopausal osteoporotic Brazilian women

ObjectivesThe aim of this study is to evaluate the relative efficacy of the mandibular trabecular bone in detecting osteoporotic-associated bone changes in Brazilian women.Materials and methodsSeventy-three digital panoramic radiographs of healthy and osteoporotic postmenopausal women were used. Regions of interest were selected in the mandibular angle and body of the panoramic images, which were analyzed for fractal dimension (FD) and pixel intensity (PI). Statistical analysis evaluated the distribution pattern, compared normal with osteoporotic patients and the right with the left mandible, and assessed the relationship between FD and PI. The significance level was set at 0.05.ResultsFD and PI values were significantly different (p < 0.05) between normal and osteoporotic patients for the right and left mandibular angle and for the left mandibular body. There was no significant difference (p > 0.05) between the right and left mandibular angle for FD and PI, but a significant difference (p < 0.05) was observed on the mandibular body for PI values. FD and PI values presented positive correlation.ConclusionsThe mandibular trabecular bone was effective in detecting osteoporotic changes, with the exception of the right mandibular body.Clinical relevanceMandibular trabecular bone shows a promising attempt of accurate detection of osteoporotic changes in some regions of the jaws. Fractal analysis and pixel intensity had strong positive correlation.

Morphodigital Study of the Mandibular Trabecular Bone in Panoramic Radiographs

El objetivo de este estudio fue correlacionar las caracteristicas morfodigitales del trabeculado oseo mandibular para de esta manera, verificar indicios de senales de osteoporosis, utilizando para esto, radiografias panoramicas de pacientes de ambos sexos. Los resultados del estudio mostraron diferencias entre los grupos masculino y femenino, en la cuantificacion de hueso trabecular mandibular (p 0,05). El grupo masculino presento un padron oseo trabecular mas compleo y fuerte que el grupo femenino. Este hallazgo puede ser un importante indicador en cuanto a los riesgos de osteoporosis, por ejemplo, siendo posible afirmar que los huesos de los individuos del grupo masculino estan menos sujetos a riesgo de fractura por osteoporosis

Styloid process elongation and calcification in subjects with tmd: clinical and radiographic aspects

Knowledge of the Eagles syndrome shows that its symptoms can be very easily confused with other types of craniomandibular disorders, especially temporomandibular disorders (TMD). The aim of this study was to find a possible correlation between the presence of TMD and elongation of the styloid process as well relate to presence of calcification of the stilohyoid chain. Fifty patients with TMD, confirmed from the RDC/TMD, were examined clinically and radiographically. Radiographic documentation consisted of digital panoramic radiograph and digital lateral cephalometric radiograph. Radiocef software (Radiomemory) was used for the analysis of radiographs by means of specific cephalometric tracing and linear measurements of the styloid process. Each radiograph was traced and measured three times with intervals of 1 month to spread the error. Statistical analysis was performed by Pearsons test (p=0.001) using Biostat 4.0 statistical software. Result showed an incidence of 76% elongation of the styloid process in the sample. There was a correlation between the bilateral measures taken in panoramic radiographs (?<0.001) and also for measures of styloid process length carried out in different panoramic radiographs and lateral cephalometric radiographs (?<0.001). It was concluded that there is prevalence of elongated styloid process in patients with TMD. However, no relationship was found between measurements on the stylohyoid chain and symptoms of headache, orofacial pain, tinnitus and vertigo.

Electromyographic Activity of Masticatory Muscles in Women with Osteoporosis

The purpose of this study was to analyze the electromyographic (EMG) activity and the maximal molar bite force in women diagnosed with osteoporosis in the maxillary and mandibular regions, considering the habits and conditions that lead to development of generalized skeletal bone loss, including on face bones, can disturb the functional harmony of the stomatognathic system. Twenty-seven women with mandibular and maxillary osteoporosis and 27 healthy controls volunteered to participate in the study. A 5-channel electromyographer was used. Muscle activity was evaluated by means of EMG recordings of the masticatory musculature (masseter and temporalis muscles, bilaterally) during the following clinical conditions: rest (5 s); right and left lateral excursions (5 s); protrusion (5 s); maximal dental clenching on Parafilm (4 s) and maximal voluntary contraction (4 s). This latter clinical condition was used as the normalization factor of the sample data. It was observed that individuals with osteoporosis presented greater EMG activity when maintaining mandible posture conditions and less activity during dental clenching and when obtaining maximal molar bite force. It may be concluded that facial osteoporosis can interfere on the patterns of masticatory muscle activation and maximal bite force of the stomatognathic system.

Assessment of osteoporotic alterations in achondroplastic patients: a case series

Achondroplasia (ACH) is the most common form of human dwarfism and has been associated with biochemical alterations of the bone tissue, also observed in cases of osteoporosis. The present case series aimed at assessing low bone density, diagnosed with spinal bone mineral density (BMD) analysis and with panoramic radiograph measurements, in ACH patients. Spinal BMD was measured by means of dual-energy X-ray absorptiometry at the lumbar region (L1–L4). On dental panoramic radiographs of the patients, the mandibular cortical width was measured separately on the right and left sides. The Klemetti Index was also assigned as appropriate for evaluating the cortical area below the mandibular foramen. Additional parameters such as patient age, gender, body mass index, and number of teeth were also recorded. BMD results showed that 5/11 cases presented with skeletal osteopenia/osteoporosis diagnoses. Additionally, mandibular cortical erosion was detected in panoramic radiographs in 8/11 cases. The BMD and panoramic radiographic alterations found in this study suggest that the diagnosis of low bone density may have a special clinical relevance in cases of bone tissue disorders, such as achondroplasia.

Assessment of Panoramic Radiomorphometric Indices of the Mandible in a Brazilian Population

The aim of this study was to evaluate radiomorphometric indices in dental panoramic radiographs in order to identify possible interrelationships between these indices and the sex and age of the patients analyzed. The study included 1287 digital panoramic radiographic images of patients that were grouped into five age groups (1 = age 17–20; 2 = age 21–35; 3 = age 36–55; 4 = age 56–69; 5 = over age 70). Two indices—cortical width at the gonion (GI) and below the mental foramen (MI)—were measured bilaterally in all panoramic radiographs. Statistical analysis was performed with Kruskal-Wallis and Mann-Whitney tests (alpha = 0.05). Results for the indices measurements showed significant differences among patient age groups of both sexes, considering that groups 4 and 5 presented lower values for the cortical width of both indices. The present paper supports the role of sex- and age-related changes in mandibular radiomorphometric indices in identifying skeletal osteopenia.

A Singular Method to Compare Dental Radiographic Films Used to Study Maxillofacial Structures

El objetivo de este articulo es presentar un metodo singular y practico para comparar roentgenogramas, referentes a la densidad optica y al contraste. Este metodo se indica especificamente para la investigacion con el penetrometro stepwedge y el fotodensitometro

Comparación de Dos Métodos Radiológicos para Evaluación de Densidad Ósea en Mujeres Posmenopáusica

Debido a la importancia del diagnostico precoz de osteoporosis, fue objeto de este estudio realizar la comparacion de dos metodos radiologicos convencionales para la evaluacion de la densidad osea en mujeres posmenopausicas. Fueron seleccionadas imagenes de radiografia panoramica y de radiografia carpal, correspondiente a 68 pacientes de sexo femenino, con edades comprendidas entre los 49 y 80 anos de edad, realizadas en la Clinica de Radiologia Odontologica, para evaluacion previa a la colocacion de implantes. Para la interpretacion de la densidad osea en la mandibula a traves de las radiografias panoramicas fue utilizado el metodo del espesor cortical mandibular (PMI). Para la evaluacion de las imagenes radiologicas obtenidas por la radiografia carpal, fue aplicado el metodo de la radiogrametria. Se concluye que existe correlacion entre la presencia de una baja densidad osea a nivel mandibular observada en la radiografia panoramica en las pacientes de la muestra, con la baja densidad osea presentada en la radiografia carpal.

Radiodensitometric and DXA analyses for the measurement of bone mineral density after systemic alendronate therapy

Precise techniques for the measurement of maxillary bone mineral density (BMD) are useful for the early diagnosis of systemic diseases. The aim of this study was to compare in vivo the efficacy of dual-energy x-ray absorptiometry (DXA) and radiographic densitometry for the measurement of BMD after systemic administration of sodium alendronate. Wistar rats were randomly allocated to a control group (n = 5), which received distilled water, and a sodium alendronate group (n = 8), which received two doses of chemically pure sodium alendronate (1 mg/kg) per week. After 8 weeks, the animals were euthanized, the tibias were removed, and the BMD of the proximal tibial metaphysis was analyzed radiographically and by DXA. The data were subjected to statistical analysis by the Kruskal-Wallis test at a significance level of 5%. Both of the techniques revealed that the alendronate-treated group had a significantly higher BMD (p < 0.05) than the control group after 8 weeks of treatment. Comparing the groups with and without alendronate therapy revealed increases of 14.9% and 29.6% in BMD, as detected radiographically and by DXA, respectively. In conclusion, both of the methods were able to detect an increase in BMD of the proximal tibial metaphysis after alendronate therapy.